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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest treatment for idiopathic interstitial pulmonary disease and peripheral neuropathy

Recent blood tests done on me - CBC w/Differential/Platelet - show my red blood cell count is 5.35. Hemoglobin is 16.1. Hematrocrit is 48.3. I take B-12 injections ev. other week because my entire ilium was removed and 1/2 colon due to Crohn s Disease in remission since 1979. Reason was that I needed iron injected since I could not absorb it. Have been taking these injections since 1985 with no problems. These CBC numbers have been heightened a little since that time anyway & my GE doc said it is to be expected. Now my new, younger GP says he s concerned about the numbers because it may show I need oxygen through supplemental therapy. I presently have Idiopathic Interstitial Pulmonary Disease, DX in 2012. My GP wants the CBC redrawn now. He thinks the numbers are too high. I don t. I also was DX with Peripheral Neuropathy in 2003 - I take Lyrica for that. Your thoughts for the doctor s concern?
Tue, 12 Feb 2019
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Diabetologist 's  Response
Hi,

The fact remains that you are taking an injection of iron and vitamin B12. These are the 2 main components that are needed for blood formation. So, personally, I think your older GP is correct.

However, to be fair, loss of oxygen intake capacity due to lung disease also causes the haemoglobin to rise.

Peripheral neuropathy does not play a role in it. The ideal way I would suggest is to test iron and vitamin B 12 levels. If these levels are high then the injection of iron and vitamin B 12 can be stopped.

Monitor haemoglobin monthly thereafter. If it remains high then the lungs are the trigger. Else the injection may have been the cause.

This is, of course, assuming you have no acute problem needing urgent treatment.

Hope I have answered your query. Let me know if I can assist you further.
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