Complains - fatigue , pricking senstaion in lowr limb ,burning sensation in fool ,Low hb levels since past 2 yrs (9.4-10.5) after multiple courses of iron ,vitb12,vitd,
calcium ..hemorrhoids -controlled bleeding since past 1year .recurrent hx of bloating abd pain (gastritis),constipation .
Hx of GERD hemorrohids asthma and back ache
Current inv - hb 9.7, ESR 20
hba1c 5.77, FBS 97 , ..vit
b12 via inhection weekly for a mnth and vit d once a week contiuing for 2 more weekz ..
No other medication except PPI on daily basis .
Kindly suggest what can be the cause for low hb and in which direction to go?