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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Reduction Of Hemoglobin Level And CA Level?

I have type 2 diabetes for 10 years. I take metformin, symbastatin, lisynnprol. (Spelling?)

In the past 2 years my Hemoglobin has dropped to 11.7 from 13.2. I am not bleeding anywhere. My CA is 6.6 which is a little low. My lytes are somewhat low also. Any suggestions?
Wed, 17 Dec 2014
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Geriatrics Specialist 's  Response
Hi,
Thanks for asking.
Based on your query, my opinion is as follows.
1. Complete hemogram is necessary to identify the type of anemia. If no bleeding, iron, Vit B12 or folic acid deficiency is common. Needs correlation with MCV and MCH.
2. If low MCV, iron deficiency is common. If high MCV, Vit B12 and folic acid deficiency. If normal, both needs to be taken.
3. Calcium correction needs to be done with calcium supplements.
4. Possible malnutrition due to selective diet due to diabetes is common cause of anemia. If not sure, iron studies, and Vit B12 assay will be helpful. Adequate hydration is essential. Specific lytes, specially potassium requires correction with oral supplements.
Hope it helps.
Any further queries, happy to help again.
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What Causes Reduction Of Hemoglobin Level And CA Level?

Hi, Thanks for asking. Based on your query, my opinion is as follows. 1. Complete hemogram is necessary to identify the type of anemia. If no bleeding, iron, Vit B12 or folic acid deficiency is common. Needs correlation with MCV and MCH. 2. If low MCV, iron deficiency is common. If high MCV, Vit B12 and folic acid deficiency. If normal, both needs to be taken. 3. Calcium correction needs to be done with calcium supplements. 4. Possible malnutrition due to selective diet due to diabetes is common cause of anemia. If not sure, iron studies, and Vit B12 assay will be helpful. Adequate hydration is essential. Specific lytes, specially potassium requires correction with oral supplements. Hope it helps. Any further queries, happy to help again.