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80 year old with anemia. On iron pills. What could be causing this?

80 year old male went to primary in Dec because a Dr. friend said he looked anemic, Hgb=11.0, Hct=32.5 in December, primary started him on 1 iron pill a day, same results in January, increased him to 2 pills a day, today Hgb=10.3, Hct=30.0, primary today increased iron pills from 2 to 3 per day and says she does know why levels are low
Asked On : Tue, 26 Feb 2013
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Critical Care Specialist 's  Response
Hi thanks for your question.
In 80 year old some amount of anaemia is expected but you have to first rule out any pathological cause of aneamia that is bleeding some where from gastro intestinal tract or occult malignancy malignancy some wher in body .If any pathological cause of anaemia is ruled out then some amount of anaemia could be due to poor absorption of iron contained in food from intestine due to decreased blood supply which is normal process with age.Second reason coud be decreased erytropoitin production from kidney (due to decreased blood supply) which stimulates the bone marrow to produce red blood cell (RBC) containing haemoglobin.Third and final physilogical cause could be decreased RBC production by bone marrow.again due to decrease blood supply to bone marrow.If iron is not absorbed from ,increasing its dose will not improve haemoglobin.
I would suggest you to get your friend examined by internal medicine specialist who may be able to evualvate your friend for cause of anaemia and treat him accordingly
Hope this answers your question.
Answered: Tue, 26 Feb 2013
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