I went for my physical last week and had all kinds of blood work done in preparation for it.
Everything looked fine except for the hemoglobin and hematocrit levels - slightly below the norm. Doctor recommended iron supplementation and to come back in three months to have the levels re-checked. Does this sound reasonable to you?
I logged into the electronic system and was able to see that my hemoglobin levels have dropped 1.5 points within the last two years so there is a clear downward trend here. What really bothers and concerns me is that during the visit with him I asked specifically if these low numbers could indicate a serious health issue and he said no. Now, I will readily acknowledge that I’ve been suffering from a constant intractable anxiety and have come to him with all kinds of issues in the past that turned out to be either nothing at all or very insignificant. He knows me pretty well, I’ve been coming to see him for many years so I think in order to avoid the predictably emotional panicky reaction from me, he just said no, it’s nothing serious, just take the supplement and we’ll recheck.
Of course, I went home and started researching it online and see that it could in fact be a sign of something really serious and now I am frankly really freaking out. I will be calling him to discuss it all but wanted to run it by others to see if you have any suggestions or have had a similar issue before.
Or, and another thing is that it says everywhere online that you should see some change in stool color after starting the iron supplement and I am not seeing that so it’s probably not being absorbed.
Any feedback is greatly appreciated.
Emily.
Relax. Your doctor knows your entire history and medical conditions, and he’s telling you it’s nothing serious. Many women become anemic during their menstruating years due to loss of blood. If you’re not having symptoms such as extreme fatigue or bleeding from odd places, I would just sit back, take the supplement, and report to your doctor in three months. Really.
Females go through a large portion of their lives with fluctuating hemoglobin because of menses. Also, hemoglobin is affected by diet; vegetarians can have lower hemoglobin. On the flip side, dehydration will push hemoglobin levels up. Hemoglobin can be affected by so many factors that a slight drop is no reason for concern. Start to worry if you see a continuing drop. Symptoms of seriously low hemoglobin are fatigue and dizziness. I had a GI bleed three years ago (hgb dropped to 6!!!) that was triggered by taking low dosage of baby aspirin. Easy fix – stopped taking the baby aspirin.
It fluctuates. You may have been eating a little less red meat, been more hydrated, heavier menses. Cook in cast iron when possible, as the little bit of iron added to the food is more assimilable than some forms. No reason to worry!
My advice to you is to see a hematologist as that is the medical specialty field for the issue. As Evermom points out hemoglobin is affected by all sorts of things and sometimes getting to the bottom of low value is not worth the tests and problems caused by them, (test like a bone marrow biopsy, aspiration). Without stronger indications of some problem afoot, you may have to pay for such tests and then YOU personally get to decide whether it’s worth that expense and trouble.
I should clarify that I had an unknown stomach ulcer and the baby aspirins triggered a bleed.
Well, I definitely have fatigue but I’ve had it for as long as I can remember. Between horrible anxiety, insomnia and dealing with my dad’s terminal illness, I always feel tired so I don’t know how to interpret that.
I was thinking of going to a hematologist too.
I just don’t like this downward trend and that he didn’t even point it out to me last year when it was still technically within the norm but just barely so. Now I am seeing the same thing with the RBC - still within the norm but went down from last year.
Red cells carry the hemoglobin so one would expect a decreased RBC with decreased Hgb. I am so sorry to hear about your dad. We watched my mom die of a terminal illness a while back. It’s very stressful.
@Emily0722, are you seeing a good therapist? If not, I would schedule that before a hematologist. Your self-reported anxiety, insomnia, dealing with grief, and hypochondria should all be addressed before worrying about a mildly low reading on a blood test.
Please take this in the spirit in which it’s offered. A good Cognitive Behavioral Therapist (CBT) wild be a good starting point.
Good luck. Remember, when you hear hoof beats, think of horses not zebras.
Good advice Bob, also ditto with cooking in cast iron.
Bob, I had to smile when I read your quote about zebras. I heard it so many times.
As for the therapist, I’ve been to some and am yet to find someone who really understands what it’s like to live with the severe anxiety. I’ve done lots of research and reading on the subject to a point where one of the therapist told me I know more about it than he does.
Putting that aside though, I am not sure how to ignore all the information available online and also, it seems to me like my physician is playing a guessing game. He doesn’t really know why my hemoglobin has been going down for the last two years and it feels like he is just using some sort of a flow chart of “start with the easiest thing and go from there”.
Emily, you have not been to the right therapist. You might “know” more about anxiety than a therapist, but no matter how sharp the knife, it can’t cut itself.
Since today seems to be my day for metaphors and analogies, let me give you another one. When I’m not on CC, I spend time on a forum for financial matters (Bogleheads). There are some people for whom the best advice is to pick an asset allocation, invest accordingly, and don’t pay attention to market news (we call it financial porn). Those people overreact to market moves, to their detriment. When someone is really afflicted with an inability to ignore the noise, we go so far as to advise letting a Financial Planner manage their money (which we’re usually opposed to, but sometimes it’s the lesser of two evils). Let your doctor handle this; if you don’t trust his judgment, get a new doctor you do trust. What you’re doing now is not working and you need to find something that does.
How about a psychiatrist? Have you tried that?
I think he is using a flow chart that starts with the most likely thing, and go from there. Give this treatment a chance.
Emily are you double jointed?
I am, and it has been interesting to read about connections to anxiety.
http://www.intechopen.com/books/new-insights-into-anxiety-disorders/co-morbid-anxiety-and-physical-disorders-a-possible-common-link-with-joint-hypermobility-syndrome
Regardless, CBT can be very helpful.
VeryHappy, yes, I know that’s what he is doing but aren’t we losing time and opportunity to figure out what is causing the anemia instead of guessing by doing it this way?
I envy (in a good way) people who can just relax and see what happens. I am too anxious and frankly too analytical for this. Shouldn’t he be looking for an actual cause? Wouldn’t you be worried that you are missing something and not catching it on time?
As for psychiatrists, have you tried talking to any of them Bob? They pretty much play a guessing game as well and just adjust the med dosage. Trust me, I had to deal with multiple ones helping a family member and it wasn’t pretty.
My son had this and took slow release tab for a couple of years. I think the actual product was called Slo FE or something like that. FYI - there is apparently a difference in the irons used in various products. Check with your pharmacist to see if elemental iron or ferrous sulfate is better absorbed. There are equivalency charts, but my pharma says the levels of iron may be the same, but the way your body uses it is not.
Iron from meat sources tends to be better absorbed than from vegetable sources, although consuming vitamin C containing foods with vegetable sources of iron increases iron absorption.
And you will get better iron absorbtion from beef that is grass-fed rather than grain/corn fed so you do get extra
nutritional value for the extra money you spend for grass-fed.
Emily, yes I have spoken with psychiatrists. Adjusting meds and titrating doses is not a precise science, and a good doc will be conservative. Your desire for a precise diagnosis and remedy NOW is a symptom of what’s going on. If your doctor doesn’t think the anemia is a major concern, either take him at his word or get another doctor.
In the past, there was a form of hypochondria that afflicted medical students (medical student’s disease, second year syndrome, intern’s syndrome); they convinced themselves that they had every disease they studied. With the Internet and Google, the syndrome has been democratized and now everyone can play.
I say this with respect for your situation, but I don’t think an anonymous web site is where you will find solutions, so I’m going to bow out of this thread.
I feel sorry for OP’s discomfort and think it’s nice that so many have come forward to give their thoughts, but trying to assuage the fears of a hypochondriac is an exercise in futility. How many of us have ever compared past and current blood test readings? (Who even keeps old ones?) I have a hypochondriac in the family. Offering rational advice is a waste of time, trust me. Until OP’s anxiety condition is addressed, this and other symptoms will continue unabated despite all the internet advice in the world.