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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 (30)
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The findings are consistent with iron-deficiency anemia, with very low ferritin and iron stores. This can contribute to fatigue, dizziness and weakness, and recurrent deficiency warrants evaluation for the underlying cause, including menstrual blood loss and dietary/absorption factors.
For a detailed assessment and personalized advice regarding further evaluation and treatment options, you may consult me through Practo.
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Anemia could be due to nutritional factors, menstrual loss,thalassemia,gut blood loss,hook worm ,malabsorption,piles,drug intake,hereditary defects in haem metabolism,chronic diseases
Next Steps
Depending on these factors you can do the appropriate tests as recommended by the physician and take oral iron supplements or injections if highly symptomatic
Health Tips
Eat iron rich food,do stool RE
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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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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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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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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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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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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 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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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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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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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,
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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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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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1 # Eat a balanced diet
Plenty of vegetables, fruits,
whole grains, pulses, nuts, and seeds.
Limit ultra-processed foods, excess sugar, and excessive salt.
Choose healthy protein sources and healthy fats.
2 # Stay physically active
Aim for at least 150 minutes of moderate exercise per week.
Include strength training 2–3 times weekly.
3 # Maintain a healthy weight
Excess body weight increases the risk of many chronic diseases.
4 # Get adequate sleep
Most adults need 7–9 hours of quality sleep each night.
5 # Stay hydrated
Drink enough water throughout the day.
6 # Avoid tobacco and limit alcohol
Smoking and tobacco use significantly increase disease risk.
7 #Manage stress
Meditation, yoga, hobbies, social connections, and relaxation techniques can help.
8 # Practice good hygiene
Wash hands regularly and follow food-safety practices
9 # Have regular health checkups
Monitor blood pressure, blood sugar, cholesterol, dental health, and vision as recommended.
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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 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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