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24-year-old female with recurrent anemia
My Hb has generally remained around 8–10 g/dL. I currently have severe tiredness/fatigue, dizziness, weakness and frequent body pains. I also have significant menstrual cramps. My periods usually last around 6 days, although the amount of bleeding varies. I had a sonography done because of the menstrual cramps, but it was normal.
Recent CBC: Hb 10.4 g/dL, HCT 33.5%, RBC 4.32 ×10⁶/µL, MCV 77.5 fL, MCH 24.2 pg, MCHC 31.1 g/dL, RDW-CV 15.2%, RDW-SD 41.7 fL, WBC 9.3 ×10³/µL, platelets 305 ×10³/µL.
Iron profile: Serum iron 28.3 µg/dL (ref 50–170), TIBC 410.5 µg/dL, transferrin saturation 6.89% (ref 15–45%), UIBC 382.2 µg/dL, and ferritin 4 µg/L.
Vitamin B12: 311; Vitamin D3: 33.29.
Given my recurrent low Hb and very low ferritin, I would like to know how significant my iron deficiency is, whether it could explain my symptoms, why my anemia keeps recurring, and what investigations I should undergo to identify the cause. Would oral iron or IV iron be appropriate in my case?
Answers (25)
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Results are suggestive towards Iron Deficiency Anemia.
First of all any kind of excessive bleeding or decrease absorption may lead to Anemia so the core cause for iron deficiency will be dependent upon more detailed history and some tests, in other words one can't move towards diagnosis before knowing about your diet.
Next Steps
don't miss iron supplements they are important
vitamin C will also help
Health Tips
avoid iron supplements with tea/coffee (it reduces the absorption)
Have a glass of Lemonade with the IFA tabs will increase availabilit.
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Common causes of recurrent iron-deficiency anemia include heavy menstrual bleeding, inadequate dietary iron intake, poor absorption such as celiac disease, chronic gastrointestinal blood loss, and increased iron requirements. Persistent or recurrent anemia should be evaluated with CBC, ferritin, iron studies, and appropriate investigations to identify the underlying cause.
Also do consider some genetic diseases
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The test result values you have mentioned, point to iron deficiency anemia.There are number of causes.Initialy you can take oral iron tablets,if not tolerated consider parenteral iron
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Your symptoms are due to chronic anemia. Include iron and vit c rich substances in your diet, use jaggery in place of white sugar . Start supplements immediately, till Haemoglobin becomes 12.
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Consult
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You should consult with a General Physician in your area for a physical y, a few other investigations and further management. Not a case for Tele-consultation (In any case you are not an emergency , you have enough time for your treatment).
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Your results suggest iron deficiency, and the please book a consultation with me so we can review your menstrual history, diet absorption and reports and plan the appropriate treatment and investigations
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It's recurring due to low diet intake and poor absorption. Go with oral iron . If not tolerable or not improving then shift to iv dose
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kindly do connect and consult with me for better treatment plan and advice on your case via PRACTO app
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Do consult
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Your problem needs proper treatment and management so you may consult with me through this channel and solve your problem.
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I am Suffering from "Lower Back Pain" and I have medical history of Acute Pancreatitis, Diabetes and Anxiety.
I am feeling Numbness on my Back,
Reduced ability to feel temperature or touch on my back,
Tingling ("pins and needles") around the lower back,
Heightened sensitivity,
light touch is painful on my back,
Difficulty sitting,
Difficulty in climbing stairs or standing,
Muscle wasting of my back,
Sharp shooting or electric-like sensations in the lower back,
Pain that worsens at night or with sudden movements.
Pain in Penis,
Improper nails growing of Legs,
Irritable bowel syndrome,
Stomach pain in early morning wake up,
Pimples types on both the Elbows,
Changes in bowel or bladder control,
Sexual dysfunction,
More Burning or aching inner muscles,
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DEWARMING EVERY 3 MONTHS. BANDY PLUS ONE BEFORE BREAKFAST WITH ONE GLASS OF WATER
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Hello,
Take Balanced diet which is mentioned below,
1/3 of food plate should contain bread ( or 4 roti ), pasta, potato and rice.
1/3 of food plate should contain fruits and vegetables.
1/9 of food plate should contain fish, meat, egg, beans and other non dairy sources of protein.
1/9 of food plate should contain milk and dairy foods.
1/9 of food plate should contain food and drink high in fat and/ or sugar.
plus a glass of milk daily.
For prescription contact me at WhatsApp at +91959508739nine or consult by practo app.
In future if consultations are required than contact me at WhatsApp at +91959508739nine or consult by practo app.
Thanks.
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Your results are strongly consistent with iron-deficiency anemia (low ferritin, low transferrin saturation and microcytosis), most likely related to ongoing menstrual blood loss. This can explain the fatigue, dizziness and body aches.
I would usually start oral iron under medical supervision, with a repeat CBC and ferritin in 4â6 weeks; IV iron is considered if tablets are not tolerated, ineffective or absorption is poor.
Please discuss evaluation of heavy or painful periods with a gynecologist, and seek urgent care for fainting, chest pain or breathlessness.
Im Dr Shamoonâbook a Practo consultation or visit me at Synergy Multispeciality Hospital, Miraj, so we can tailor treatment and investigate the cause.
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Dr. Abhinav Singh
General Physician
1 yrs exp
Kanpur
Requires further work up ..do take online consultation my no is 864 zero zero 2 zero 56 zero
It can be easily treated as serum iron levels have depleted and just required single tablet per day for 3 months .....
Y will experience better results in 24 hours ..do take consultation
Before starting a drug ...
Do y have any thyroid related disorder
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Dr. Garima
General Physician
Rohtak
Your reports confirm iron-deficiency anemia with significantly depleted iron stores. Hb 10.4 g/dL is mildly low, but ferritin 4 µg/L and transferrin saturation 6.9% indicates severe case of iron deficiency anemia.
This can definitely explain your fatigue, dizziness, weakness and reduced stamina.
Since your Hb has repeatedly been 8–10 g/dL, the underlying cause should be evaluated. Menstrual blood loss is a common possibility, even with a normal ultrasound, but other causes such as GI blood loss or malabsorption should be considered depending on your history.
B12 311 and vitamin D 33.3 are unlikely to explain the current picture.
Next Steps
Oral iron is usually first-line if tolerated. IV iron may be considered if oral iron is poorly tolerated, ineffective, poorly absorbed, or there is ongoing significant blood loss/need for rapid repletion. Repeat Hb and ferritin after treatment to assess response and restoration of iron stores.
Please don't self-start high-dose iron indefinitely without medical advice, particularly because recurrent anemia needs evaluation for the underlying cause. Seek urgent care if you develop fainting, chest pain, breathlessness at rest, severe palpitations, or very heavy menstrual bleeding.
Health Tips
Include iron-rich foods regularly—green leafy vegetables, lentils/dal, beans, chickpeas/rajma, soy, sesame seeds, nuts and iron-fortified foods. Combine these with vitamin-C-rich foods such as lemon, amla, guava or oranges to improve iron absorption. Avoid tea/coffee and calcium-rich foods/supplements around the time of taking iron, as they can reduce absorption.
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Kindly book an online consultation with me
Anemia can be due to variable reasons diet , some foods that you take which would prevent ur oral iron uptake absorption,
Hormonal causes like thyroid problems and inborn errors and disorders can also cause them .
So it is important you consult with a registered practitioner for a detailed analysis of your health profile before blindly proceeding with iron supplements and other measures
Next Steps
kindly consult with a registered doctor
You can add iron rich food to your diet ,if you are someone taking less of nutritious rich meal
Health Tips
Do not self diagnose based on mere facts and lab reports and also do not self medicate yourself with iron supplements
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Ms. Hiba U C
General Practitioner
1 yrs exp
Kozhikode
Your reports points towards Iron deficiency Anaemia .
Cause of it varied , such as improper diet , high menstrual loss of blood , worm infestations etc.
Next Steps
Do consult a physician. If the issue is with the menstrual loss of blood and irregularities, they can direct to you to an obstretrician .
Treatment plan will be accordingly.
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Dr. Anshul Agrahari
General Physician
9 yrs exp
Ayodhya
Most probably iron deficiency anemia. Iron rich diet with vitamin C supplements. Iron tablets may help. But should be taken under the guidance of doctor. As it may cause gastritis.
Health Tips
Iron with Vitamin C supplements will definitely help .
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
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Dr. Abdul Qauum
General Physician
3 yrs exp
Lucknow
According to your descriptions you are having anemia .
Next Steps
There are several underlying causes of anemia. It can be Iron deficiency,hemetemesis, melena etc. You should consult a good physian so that underlying cause could be found and trated properly.
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Dr. Ankita Gahlot
Obstetrician
12 yrs exp
Bangalore
Your ferritin of 4 with a low transferrin saturation points to significant iron depletion, which fits with the fatigue, dizziness and weakness you're feeling. Heavy or prolonged periods are a common reason iron deficiency keeps returning even when your scan is normal.
Next Steps
Ask your gynaecologist to specifically look at your monthly blood loss pattern, since a normal scan doesn't rule out heavy bleeding as the driver here. Recheck your iron levels a few months after starting any treatment to see if it's holding steady.
Health Tips
Whoever is treating you should decide how best to correct this and how quickly, once they've seen your full picture.
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