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Tiredness, loss of concentration, blood test shows low hemoglobin content and abnormal TSH. Treatment?

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My daughter is 19 years old and is having several symptoms like tiredness, loss of concentration etc. I have recently got a comprehensive blood test done . The reports indicate that her haemoglobin content is low and TSH reading too is out of range.

What line of treatment do you suggest?
Posted Sun, 30 Sep 2012 in Blood Disorders
Answered by Dr. Ratnakar Kini 1 hour later

Thanks for the query.

I went through your reports submitted. Accordingly she seems to have the following condition:
- Low hemoglobin, low transferrin saturation, microcytosis and hypochromia which indicates she is anemic probably related to iron deficiency.
- High TSH levels suggestive of hypothyroidism.
- Low Vitamin D levels
- Marginally elevated Hba1c which suggest a prediabetic state.

All these abnormalities can explain your daughter’s symptoms of easy tiredness and loss of concentration.

The next step of management is to look of the causes of above condition. Therefore she may need further test done under the guidance of your physician. Three main possibilities of iron deficiency need to be explored. They include:
1. Excess blood loss during menstrual periods
2. Poor intake of nutritional food
3. Hookworm infestation
* Hemorrhoids (piles) and fissures which can cause bleeding and result in anemia over a period of time can be other causes.

Meanwhile she can take iron supplements and iron XXXXXXX food to improve her hemoglobin level. Iron XXXXXXX food includes XXXXXXX leafy vegetables like spinach, dates, apples, red meat ( if she is a nonvegetarian), fenugreek and fig.

She may need thyroid hormone supplementation and vitamin D supplementation too. Exposure to evening sunlight would also be beneficial.

Does that answer your question? Let me know if you have other queries.

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