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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Low WBC count, Low serum Iron, Dizziness, Anemia or leukemia ?

I am a 39 year old female and a vegetarian since I was 7 years old. I have regular check ups and have never before had an issue with my iron; however recently I have been extremely tired and unable to concentrate. My blood work showed a low white blood cell count at 3.0, Hemoglobin low at 9.5, Hematocrit low at 31, MCV low at 71, MCH low at 21.7, MCHC low at 30.6 and my RDW high at 15.3. My red blood cell count was within the normal range. It also came back with my Serum Iron low at 19 (with a normal range of 50 to 212) and Ferritin low at 2 (with a normal range of 10 to 291). I was told to take a daily iron supplement and come back in in 3 months to have my blood re-tested. Two weeks into taking the iron supplements , I still feel absolutely awful, even perhaps worse. In fact, I fell down several stairs on Friday from a dizzy spell. I now have a productive cough, nausea when I exercise and shakiness. I am concerned that perhaps I should see a hematologist to rule out more serious causes for the anemia, such as leukemia or other disease, rather than wait the 3 months to be re-tested. My questions are as follows: Is a low white blood cell count common with anemia? Should I see a hematologist now go review the results or wait the 3 months to be re-tested by my primary care doctor? Would it ever be recommended to have iron shots or IV for someone with my iron levels? At what point does iron deficiency call for a blood transfusion? Thank you for your help in sorting this out. - Melissa
Fri, 11 May 2012
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Oncologist 's  Response
Thanks for quiry. At Hb. Of 9.5 gm you don't need a blood transfusion.get repeat blood count done with peripheral blood smear examination to find that if any abnormal cells are present in it. For ruling out the cause of anemia you need detailed gen. Physical examination, thyroid examination and thyroid assay done. Some times there is problem in the digestive system which prevents your iron absorption in your body. Many more things need to be ruled out which a hematologist will do after examining you thoroughly an d having alook at your investigations. If other things are found in order last but not the least a bone marrow examination might be required. So I advise you to visit the hematologist who will decide what appropriate investigation you need.
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Oncologist Dr. Jawahar Ticku's  Response
Thanks for quiry. At Hb. Of 9.5 gm you don't need a blood transfusion.get repeat blood count done with peripheral blood smear examination to find that if any abnormal cells are present in it. For ruling out the cause of anemia you need detailed gen. Physical examination, thyroid examination and thyroid assay done. Some times there is problem in the digestive system which prevents your iron absorption in your body. Many more things need to be ruled out which a hematologist will do after examining you thoroughly an d having alook at your investigations. If other things are found in order last but not the least a bone marrow examination might be required. So I advise you to visit the hematologist who will decide what appropriate investigation you need.
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Low WBC count, Low serum Iron, Dizziness, Anemia or leukemia ?

Thanks for quiry. At Hb. Of 9.5 gm you don t need a blood transfusion.get repeat blood count done with peripheral blood smear examination to find that if any abnormal cells are present in it. For ruling out the cause of anemia you need detailed gen. Physical examination, thyroid examination and thyroid assay done. Some times there is problem in the digestive system which prevents your iron absorption in your body. Many more things need to be ruled out which a hematologist will do after examining you thoroughly an d having alook at your investigations. If other things are found in order last but not the least a bone marrow examination might be required. So I advise you to visit the hematologist who will decide what appropriate investigation you need.