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What Could Bring Up Hemoglobin Levels If Erythropoiesis Is Functioning Normally?

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Posted on Fri, 2 Feb 2024
Question: I have been complaining to my Primary Physician and Cardiologist for about 10 months now about not being able to walk 20 feet without experiencing shortness of breath. Since I needed a hip replacement last July, but then after to pre admit Nuclear Stress I required another heart stent *drug eluding? I was then required to put off my hip surgery for one year. 4 weeks ago I went to the ER because I was sure something more than the "your difficulty walking is most likely due to the pain you experience from your hip" excuse. My oxygen levels have always been good. After a bloodtest the hospital determined me to be severly anemic with a hemoglobin of 6.7. After 2 bags of blood and a colonoscopy and upper endoscopy which showed nothing, I was discharged 4 days later with a hemoglobin of 9.7. A few days later I swallowed the camera to view my middle GI tract. It showed blood and 3 cauterizations in duodenum and jujuneum were
done. I had bloodwork 4 days later and had an appointment with a hematologist moved up one week due to my hemoglobin being back down to 7.8. That was last Friday, and the hemotologist scheduled me for IV Iron for today. I called twice this week saying I know I needed more blood due to how I felt. They checked my hemoglobin when I went for the iron today and it was again 6.8. I received a bag of iron and a bag of blood today. I am scheduled for iron again next week on Friday. I am truly concerned that when the blood was taken last Thursday and was 7.8 (three days after the cauterizations) that it was only 6.8 today. Do you think the iron will be enough to get my body to make red blood cells and carry oxygen to my organs. Is there something else you believe I should look into, or have checked. I do plan on asking for my hemoglobin to be checked again next week at the Infusion Center. Thank you
doctor
Answered by Dr. Malik (2 hours later)
Brief Answer:
If Erythropoiesis is functioning normally IV iron may bring up Hb levels

Detailed Answer:
Hello and welcome,

Your doctor prescribed you second dose of intravenous iron infusion after a week of the first dose because your hemoglobin (Hb) is quite low. Intravenous iron infusion is used to increase Hb level quickly or when a patient has iron absorption problems or to avoid oral iron therapy side effects. After iron infusion your body starts to make Hb and red blood cells (RBCs).
I will answer your first question. If you red blood cell making process (erythropoiesis) is functioning normally, intravenous iron infusion alone will be enough to increase your RBC and hemoglobin. After increase of Hb in a certain level you will be switched to an oral iron supplementation therapy (if you tolerate it well) to bring Hb to a normal level.
Answer the second question. RBC making process (erythropoiesis) is complexand takes time to markedly increase Hb or RBCs. If you check Hb after a week of iron and RBC infusions and see increase in Hb levels it is most probably the effect of RBC infusions. The effect of intravenous iron infusion may take 3-4 weeks to see marked increase in Hb.
Your hemoglobin is decreased again after a week of cauterizations. This suggests there is either re-bleeding from the cauterizations or the other sources of bleeding exist in your body.

Hope, this information is helpful for you. Please, feel free to ask me if there is anything else you need to know.

Regards
Note: For more detailed guidance, please consult an Internal Medicine Specialist, with your latest reports. Click here..

Above answer was peer-reviewed by : Dr. Yogesh D
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Answered by
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Dr. Malik

Internal Medicine Specialist

Practicing since :2006

Answered : 353 Questions

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What Could Bring Up Hemoglobin Levels If Erythropoiesis Is Functioning Normally?

Brief Answer: If Erythropoiesis is functioning normally IV iron may bring up Hb levels Detailed Answer: Hello and welcome, Your doctor prescribed you second dose of intravenous iron infusion after a week of the first dose because your hemoglobin (Hb) is quite low. Intravenous iron infusion is used to increase Hb level quickly or when a patient has iron absorption problems or to avoid oral iron therapy side effects. After iron infusion your body starts to make Hb and red blood cells (RBCs). I will answer your first question. If you red blood cell making process (erythropoiesis) is functioning normally, intravenous iron infusion alone will be enough to increase your RBC and hemoglobin. After increase of Hb in a certain level you will be switched to an oral iron supplementation therapy (if you tolerate it well) to bring Hb to a normal level. Answer the second question. RBC making process (erythropoiesis) is complexand takes time to markedly increase Hb or RBCs. If you check Hb after a week of iron and RBC infusions and see increase in Hb levels it is most probably the effect of RBC infusions. The effect of intravenous iron infusion may take 3-4 weeks to see marked increase in Hb. Your hemoglobin is decreased again after a week of cauterizations. This suggests there is either re-bleeding from the cauterizations or the other sources of bleeding exist in your body. Hope, this information is helpful for you. Please, feel free to ask me if there is anything else you need to know. Regards