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Abnormal Lab results treated with iron only
Oct 13, 2002

A little over a year ago, I had some bloodwork done and did not know until recently that some of the results were abnormal. My WBC was 3.8; RBC 3.41; Hemoglobin 6.9; Hematocrit 22.7; MCV 67; MCH 20.1; MCHC 30.2; RDW 19.0; Cholesterol 128 ---- At that time, the doctor just told me to start taking iron and I did. It did more lab more but I have not seen it yet but did say that he was a "little concerned." This seems strange to me. Your opinion would be greatly appreciated.

Response from Dr. Frascino

Hello,

Your hemoglobin was down to 6.9 and you didn't realize it? Wow! Most folks with anemia that severe are quite symptomatic - extreme tiredness, shortness of breath, rapid heartbeat, paleness, headaches, exercise intolerance, decreased sex drive, inability to concentrate, etc. And this happened over a year ago!?! Iron deficiency could have been the problem, but that can easily be determined by a blood test. And a whole year has now gone by, and your doctor is just now getting additional tests, and becoming "a little concerned." I'm more than a little concerned that you are seeing the wrong doctor. You need a more thorough evaluation of the exact cause or causes of your anemia.

Your physician assumes you have iron-deficiency anemia. Other common causes of anemia include:

1. Other nutritional deficiencies (vitamin B12, folic acid) 2. Blood loss or bleeding 3. Medication side effects (AZT, ganciclovir, etc.) 4. Opportunistic infections (MAC, TB, Parvovirus B19, etc.) 5. Anemia of chronic disease 6. Genetic causes

Once the exact cause or causes are determined, the appropriate therapy can be started. You are correct that your evaluation and treatment so far "seem strange." Incompetent is another word that comes to mind. Perhaps you should collect up your lab tests and medical records, and get a second opinion! That's probably the best advice I can offer you!

Good luck.

Dr. Bob


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