I just have a few questions about some fo my bloodwork and symptoms. I am a 24 y/o male. I currently am seeing a hem-onc regarding iron deficiency. My serum iron is 7 microg/dL, TIBC 460, transferrin sat 3%, and MCV 71.4. EGD and colonoscopy showed nothing, and Hemoccult negative for occult blood x2 separate occasions. I have been on p.o. iron for 5 months (serum feritin was 3 in nov 2010 and mar 2011 was 7). Also, celiac sprue panel negative. Hgb 13.8. All other blood tests and serum chemistry are normal. U/A was negative for blood. Retic count 2.5%. I have also had a couple of night sweats, spleen was 12 cm in 11/2010 and 14.5 cm in 2/2011, also I have 2 cervical lymph nodes (about 1cm each) enlarged just above clavicle. They are painless, but non-fixed and have been enlarged for about 8 weeks but have not increased in size. I have had no recent illnesses, except for strep throat in 12/2010 and glomerulonephritis shortly after that. I also have very bad exertional dyspnea since about october, to the point where I'm SOB after 2-3 minutes of minimal exercise (and i've been taking tae kwon do for 2 yrs without any trouble unitl recently). I also am extremely tired recently (I used to operate on about 5 hrs sleep/night and am now sleeping 12-15 hrs/day). I have never had any anemia or iron deficiency before. I have no family hx of blood cancers; however, my maternal grandmother had stage 4 breast cancer at 31 y/o and stage 2 breast cancer (which was unrelated to the first cancer) at 40 y/o. No family hx of iron absorption dz. My hematologist recommended IV iron dextran 1x per month x 4 months. Just wanted to know if I need a second opinion or is this just probably an iron absorption problem. Only past med hx is mild GERD. Currently taking nexium (for past 5 years ) and Bifera rx iron supplement (since nov. 2010).