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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?
Answers (20)
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Consult a gynecologist for evaluation of reason for HMB.
Consult me on practo for Iron deficiency anemia treatment.
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Kindly consult gyenocologist physically
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If you would like to discuss your concern in more detail, please feel free to contact me on WhatsApp at nine one one nine two five five six nine nine. Alternatively, you can connect with me through the Practo app for a detailed consultation
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See a gynecologist physically, excess blood loss during periods, does cause anemia, hair loss, and weakness.
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Treat the cause of heavy mensuration. N u need consultation for this kind of anemia
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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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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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Uprise d60k inj once a month for 3 months.
Neurokind od after dinner for two months.
Rb tone syr10 ml after dinner for two months.
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Better u consult gynaecologist...
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Iron tablet ,Methylcobalamin 1500mcg, uprise 60 k once weekly upto 3 months.increase leafy vegetables in your diet .avoid tea coffee after takin iron tablets ,because its contains phytates and they reduce absorption or iron.
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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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Requires a proper assessment to understand the underlying cause and guide you.
Please book a consultation for a detailed evaluation, personalized treatment plan and further advice.
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Dr. Anuj Mothsra
General Practitioner
7 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Dr. Sachin Bhiwaji Sanap
General Practitioner
7 yrs exp
Hingoli
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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Dr. Harsh Patel
General Medicine
4 yrs exp
Ahmedabad
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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Dr. Chaithra H
General Physician
5 yrs exp
Bangalore
Needs evaluation
Do consult
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Reesha Varshney
General Physician
1 yrs exp
Bareilly
I can help you out kindly connect with me for consultation
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Dr. Shubham Kumar
General Physician
New Delhi
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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Dr. Amit Singh
General Physician
9 yrs exp
Rewa
first you go to the hematologist for further investigation like the thyroid and peripheral smear of blood
take vita d supplement and vitamin b 12 supplement
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