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Iron deficient anaemia
I am a 28-year-old female with recurrent iron-deficiency anemia for several years. My recent blood tests (18 Aug 2026) show Hb 9.4 g/dL, MCV 65.84 fL, serum iron 15.8 µg/dL, transferrin saturation 3.94%, Ferritin 7.8, RDW 17.1%, vitamin D 6.01 ng/mL, B12 182 pg/mL, calcium 8.37 mg/dL and ESR 32.
I have heavy menstrual bleeding and have required several iron infusions in the past, but the anemia keeps recurring. I currently have significant fatigue, hair fall, irritability and mood changes and also gut issues.
My questions:
1. What could be causing my recurrent anemia?
2. What tests should I have to investigate heavy menstrual bleeding, iron malabsorption/coeliac disease, or other causes of recurrent iron deficiency?
3. Should I see a gynecologist, hematologist, or gastroenterologist?
4. What treatment would you recommend for my iron deficiency, severe vitamin D deficiency and low B12?
5. How can I prevent the anemia from recurring?
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Hi
1. Cause for recurrent anaemia is mostly your heavy menstrual bleeding and B12 deficiency
2 amd 3. First visit a gynaecologist and get and Ultrasound Abdomen and Pelvis done to.dind out cause of heavy menstrual bleeding.
4. Iron, B12, Vit D deficiency needs to be treated, prescription better to give on consultation.
5. B12 deficiency can recur in pure vegetarians. So need to either take regular injections 3 or 6 monthly or add eggs to diet,
Second, treat the cause of heavy menstrual bleeding.
Tc
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evaluation for an additional cause such as uterine pathology, bleeding disorder, celiac disease or malabsorption.
Next Steps
UPT
Pelvic USG ± TVS to r/o fibroid, Endometrial pathology
TSH, tTG-IgA
Peripheral smear
Reticulocyte count
CRP, Renal function and LFT
Health Tips
OBGY opinion is must
If you want to discuss your symptoms in detail, you can connect with me on Practo or WA business- 77 260 46 121,
I’ll take your complete history and guide you about the appropriate next step.
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Iron deficiency anemia is common in Indian females reasons may be several iron deficient diet, heavy menstrual bleeding
Consult to gynaecologist and get treated for anemia and heavy menstrual bleeding if not relived after that then do consult to hematologist
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1. Heavy menstrual bleeding regulary can cause anemia
2. For menstrual bleeding consult gynecologist, celiac disease needs to b evaluated by antibody testing and duodenal biopsy through ugi scopy
3. Consult gynecologist and physician
4. For iron dediciency u can take tablets or injection ferric carboxymaltose. For d 3 start vit d3 tablets once weekly. For b12 start tab methylcobalmine 1500 mcg once daily.
5. Have to control ur menstrual issues first
Next Steps
consult gynecologist and physician
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Your reports are clearly suggestive of iron-deficiency anemia. Since this has been recurring despite previous iron infusions, the important thing is to find and treat the underlying cause. Heavy menstrual bleeding is likely contributing, but other causes such as fibroids, thyroid problems, bleeding disorders or poor iron absorption should also be considered.
Next Steps
I would suggest seeing a gynecologist first to evaluate the heavy menstrual bleeding, usually with a pelvic examination and ultrasound. Repeat CBC and iron studies can help assess the response to treatment. Since the anemia is recurrent, a hematology consultation is also reasonable. If needed, tests for celiac disease or gastrointestinal blood loss can be considered.
Your vitamin B12 and vitamin D are also significantly low and should be corrected. Depending on your previous response and tolerance, your doctor can decide between oral and IV iron.
Health Tips
Try to include iron-rich foods such as meat, eggs, legumes and green leafy vegetables, along with vitamin-C-rich foods to improve absorption. Avoid taking tea or coffee close to iron tablets. Most importantly, treating the heavy menstrual bleeding is essential to prevent the anemia from coming back.
If you develop severe weakness, fainting, chest pain, significant breathlessness or very heavy bleeding, seek medical attention promptly.
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