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What Causes Macrocytic Anemia?

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Posted on Tue, 5 May 2015
Question: yes, as a follow up to my question I would like to send you some test results and ask you how serious this situation is. The doctor said if alcohol is not stopped (currently cut it in half - consuming 200ML/day of 80proof vodka down from 400ML/day) I am killing myself. What does this mean - what is the prognosis at my age after drinking for the last 25-30 years and what does that look like when it comes?
doctor
Answered by Dr. Prakash H Muddegowda (50 minutes later)
Brief Answer:
Liver is still good - continue to reduce vodka intake, if possible.

Detailed Answer:
Hi,
Thanks for asking again.

I have gone through the reports. After going through it, my opinion is as follows:

1. Based on your latest values, and in comparison with previous values, there is nothing significant or life threatening values here.
2. Mild anemia - Macrocytic anemia, due to Vit B12 deficiency.
3. Increased ammonia, without any other symptoms has not relevance at present. Liver is currently in good condition and so is the kidney.
4. Good to know, you have cut down consumption of alcohol by half.
5. Creatine kinase is low, possibly due to low muscle mass.
6. Only significant complication would be alcohol interacting with your medications, which could cause error in judgement like fall and injuries. Rarely if uncontrolled, alcohol toxicity. Otherwise, nothing life threatening.

Prognosis at present is good. Improve nutrition, with a protein rich diet. Also mild to moderate exercises, including walking.

Keep well hydrated. Nothing to worry for now. Prognosis is good, based on reports available.

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Prakash H Muddegowda (9 minutes later)
Thank you so much for your speedy reply. Do you have any idea or concerns of my diarrhea (lasting for a week or so) followed by no BM for another 5-7 days then solid stools. Any suggestions here?

My doctor has me on a generic anti diarrheal - which I take quite sparingly so as not to cause the reverse. No matter that I take it sparingly - only once a day after a large loose stool and only one - not two as suggested - I still end up constipated. For instance, I have not had a BM of any sort for about 6 days now.

Also, I am told by everyone that I do not eat much - normally only a brunch and late dinner - but my stomach is getting HUGE HUGE HUGE! Could this be fluids or something?
doctor
Answered by Dr. Prakash H Muddegowda (25 minutes later)
Brief Answer:
Mild exercises, good hydration, fiber diet and probiotics essential

Detailed Answer:
Hi,
Thanks for asking again.

Diarrhea could be due to increased gastro intestinal motility, changed bacterial flora or infections. However, as it has stopped, it could be due to altered gastro intestinal motility.

Taking anti diarrhea agent sparingly, so as not to cause the reverse is good.
During these periods, and also at this age, regular nutritional intake with fiber rich diet is necessary. GIT requires training, or else motility will be affected. At-least 6-8 liters water intake is also necessary to maintain solid, but not hard stools. Fiber needs to be added into diet along with regular moderate quantity, minimum of 4 times per day.

Checking your weight, will give you an idea, if it is fluids. If its increasing, it is fluids or fat. Ultrasound of abdomen, can give a better evaluation. However, gas accumulation due to irregular bowel habits can also cause it. Probiotics and yogurt in diet to improve bacterial flora will help. Increase soluble fiber in diet from fruits and vegetables. Mild to moderate exercises is essential, as it helps in improvement of gastro intestinal motility.

If its fluid accumulation (ascites), it requires evaluation of a complete liver function tests. If fat or gas, not much to worried for now.

Need to follow a regular regimen. As with age, more rest ensues with irregular food habits, which can impact bowel movements.

Hope it helps.
Any further queries, happy to help again.

Dr. Prakash HM
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Prakash H Muddegowda

Geriatrics Specialist

Practicing since :2004

Answered : 2138 Questions

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What Causes Macrocytic Anemia?

Brief Answer: Liver is still good - continue to reduce vodka intake, if possible. Detailed Answer: Hi, Thanks for asking again. I have gone through the reports. After going through it, my opinion is as follows: 1. Based on your latest values, and in comparison with previous values, there is nothing significant or life threatening values here. 2. Mild anemia - Macrocytic anemia, due to Vit B12 deficiency. 3. Increased ammonia, without any other symptoms has not relevance at present. Liver is currently in good condition and so is the kidney. 4. Good to know, you have cut down consumption of alcohol by half. 5. Creatine kinase is low, possibly due to low muscle mass. 6. Only significant complication would be alcohol interacting with your medications, which could cause error in judgement like fall and injuries. Rarely if uncontrolled, alcohol toxicity. Otherwise, nothing life threatening. Prognosis at present is good. Improve nutrition, with a protein rich diet. Also mild to moderate exercises, including walking. Keep well hydrated. Nothing to worry for now. Prognosis is good, based on reports available. Hope it helps. Any further queries, happy to help again. Dr. Prakash HM