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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Diabetic, High BP, Recurring Low Levels Of Hemoglobin. History Of Stroke. What Might Be Causing This?

hello doctor ,my mother in her 70s is suffering from low Hemoglobin .6 days back her hemoglobin level was only for.n she was addmitted to the hospital .then she was given blood around 3 bottels .then it became 9.5 then the doc discharged her .again yesterday we made her blood test now the level is 7 .what might b the reason .she is diebtic n HBP ALSO.SHE HAD A STROKE ON ONE SIDE 10 YEARS AGO.PLZ SUGEST US WHAT TO DO NOW.
Sat, 29 Dec 2012
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General & Family Physician,  's  Response
hello sir,

As you mention about your mother,I think this low hemoglobin problem is unrelated to previous illness.

But anemia i.e low hb is not good for patient of hypertension and stroke as anemia causes more workload

on heart.

There are lots of causes of anemia .But in age group of 70 year old female history of passing blood in

urine ,stool or per vaginal bleeding is important.Also any history of gastric or intestinal operation is
important.

On investigation -peripheral blood smear s/o microcytic or macrocytic picture is also important.As causes
are different for both this condition.

Microcytic picture is most commonly consistent with iron deficieny and Macrocytic due to vit b12 an folic
acid deficiency.

So sir,I suggest you to do peripheral blood smear,urine microscopic examination,stool for occult blood.

According to peripheral picture iron or vit b12 ,folic acid supplementation.

Also important is diabetic control an control of high BP ,as this are independent risk factor for recurrent
stroke.
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General & Family Physician,  Dr. Mamun Kabir's  Response
you mentioned rapidly developing anemia even after blood transfusion.now some thing is need to be know. any history of vomiting out of blood,black tarry stool,fever,bony pain,skin rash,palpable lymph node,weight loss . some inv.should be done urgently like blood film,iron profile & lastly the bone marrow.consult a hematologist.
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Diabetic, High BP, Recurring Low Levels Of Hemoglobin. History Of Stroke. What Might Be Causing This?

hello sir, As you mention about your mother,I think this low hemoglobin problem is unrelated to previous illness. But anemia i.e low hb is not good for patient of hypertension and stroke as anemia causes more workload on heart. There are lots of causes of anemia .But in age group of 70 year old female history of passing blood in urine ,stool or per vaginal bleeding is important.Also any history of gastric or intestinal operation is important. On investigation -peripheral blood smear s/o microcytic or macrocytic picture is also important.As causes are different for both this condition. Microcytic picture is most commonly consistent with iron deficieny and Macrocytic due to vit b12 an folic acid deficiency. So sir,I suggest you to do peripheral blood smear,urine microscopic examination,stool for occult blood. According to peripheral picture iron or vit b12 ,folic acid supplementation. Also important is diabetic control an control of high BP ,as this are independent risk factor for recurrent stroke.