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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Would The Diagnosis Be For Chronic Fatigue And Anemia While On Iron, Folic Acid And B12 Medication For Over 2 Decades?

I am a 55 yr. old lady with present levels of Hb 8.7%, PCV 29.9%, MCV 57.3%, MCH 16.7%, MCHC 29.1%, RDW 16.7% & platelet count of 538. RBC morphology : Hypochromia++, Microcytosis+, Anisopoikilocytosis. Remaining counts in CBC are in normal range. I have always been anaemic & have needed iron & folic acid supplements since teen age. No investigation was done before then although I was always fatigued. I take iron & folic acid supplements regularly with B12 injections (5) every half year. I am having mouth ulcers (insides of cheeks & lips) constantly since the last 6 yrs. The CBC varies very little despite treatment. Please advise.
Tue, 11 Dec 2018
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General & Family Physician,  's  Response
Hello,

Your workup is done in detail for proper treatment of anemia it seems to be microcytic hypochromic anemia according to history. Further workup needed as follow:
- Serum ferritin to reflect iron store
- Serum TIBC to support iron deficiency anemia diagnosis
- Stool occult blood test to check gi ulcerative lesion
- Provide your RBC count value
- Serum vitamin b12

According to reports, further management plan decided.If oral medication can't improve CBC than injectable therapy needed.

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

Regards,
Dr. Parth Goswami
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What Would The Diagnosis Be For Chronic Fatigue And Anemia While On Iron, Folic Acid And B12 Medication For Over 2 Decades?

Hello, Your workup is done in detail for proper treatment of anemia it seems to be microcytic hypochromic anemia according to history. Further workup needed as follow: - Serum ferritin to reflect iron store - Serum TIBC to support iron deficiency anemia diagnosis - Stool occult blood test to check gi ulcerative lesion - Provide your RBC count value - Serum vitamin b12 According to reports, further management plan decided.If oral medication can t improve CBC than injectable therapy needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Parth Goswami