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    Old 02-14-2008, 10:48 AM   #1
    hfm123
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    Question about lab ranges

    I had a Hgb of 11.8 with a range of 12.0-16.0 at the end of December. Towards the end of January I saw my doctor and she told me to take iron and to recheck my blood in two weeks. I, pretty consistently, took one 65mg tablet.

    My doctor just called and left a message that everything (I had a bunch of bloodwork done for a routine physical too) was normal except my Hgb was 11.4 so I was slightly anemic. That was it--no come in and see me or anything.

    I think the range for the lab I used for this last CBC was (11.5-15.0)--I will know for sure when I pick up a copy of the labs. What I'd like to know is if the values are the same from both labs and just what the lab considers normal is different. I have blood work from a couple of different labs and they all show 12.0-16.0 as the range for women except the one I used for this last draw. A result from 2004 from this lab showed the range as 11.5-15.0.

    I guess what I'm wondering is if I need to be concerned at all. If my Hgb has dropped from 11.8 to 11.4 with the addition of iron should I take still more iron or have other tests run?

    The 11.8 was taken during the end of my period. So I had been bleeding for about 4 days but I don't have very heavy periods especially after the first day. The 11.4 was taken a few days before the start of my period.

    Am I on the mend? I know it was a mild anemia but it has been affecting my life--dizzy, tired, no libido, diminished concentration etc. Some of my symptoms have decreased or disappeared (rapid heart rate, headache) while some seem to ebb and flow a bit (dizziness, fatigue).

    Thanks for your time!

    Heather

     
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    Old 02-14-2008, 03:17 PM   #2
    FLFLOWERGIRL
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    Re: Question about lab ranges

    Heather--This is the way I see it from my own experience. The anemia is in proportion to the specific lab value. You are mildly anemic.

    In Dec, your Hgb was 11.8 with a botton line as 12.0 that is 2/10's below range.
    Today, your Hgb is 11.4 with a bottom line as 11.5 that is 1/10th below range.

    So in reality, no your Hgb hasn't dropped, you have gone up 1/10th of a point since your last labs. It's just easier using the same lab values.

    I would not worry so much about the periods and numbers. If you do track a period you have to know the value before and after, which is harder to do, but I have done that too.

    I would say yes you are on the mend because you are showing that your body is indeed absorbing iron. In my opinion (and I am just a patient), is that 1X 65 mgs is not enough and you should have made more positive progress. I would try 2X 65 and see what happens but I would talk it over with your doc or call. Have you had your feritin tested because if not you should have that number to reference. You should see faster results if there is nothing else doing on. Be sure to take iron with vitamin C and take it on an empty stomach. Do not drink or eat things that may inhibit absorption. Good luck. Keep us posted. FLFLOWERGIRL

     
    Old 02-14-2008, 04:46 PM   #3
    hfm123
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    Re: Question about lab ranges

    Thanks for the info. I am happy to hear that the lab ranges are relevant. My intention had been to drink orange juice with my iron but we mostly buy it with calcium so I had not been having vitamin C with my iron. I have started to take 1000mg with my dose now and will increase to 2 tabs daily. Can I take them together or it better to take them at different times?

    Should I get another CBC in a month or so to see if my hemoglobin has popped into the normal range?

    Thanks so much for all of your experienced information and taking the time to answer all of my questions!

    Heather

     
    Old 02-14-2008, 05:23 PM   #4
    FLFLOWERGIRL
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    Re: Question about lab ranges

    Heather--I would not ever take them together, your asking for GI problems. I would take 1 in the morning and 1 in the evening. One hour before a meal is the best time. You can ease into the second dose i.e., split the dose in half and take more often until your body can handle it all at once. Then I would recheck in 1 months time. You should always consult your doctor about the amount of iron you are taking. It isn't good to take iron if your body doesn't need it (iron overload) so always recheck. Do get a ferritin if you haven't already, it's really important.

    When I was anemic it took me 2.5 months to get to non anemic stage. This of course is different for everyone. Your body should respond in a months time if everything else is okay. FLFLOWERGIRL

     
    Old 02-15-2008, 12:32 PM   #5
    hfm123
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    Re: Question about lab ranges

    Hey FLFLOWERGIRL--

    I just got my labs back and am a little confused.

    RBC 3.68 (3.8-5.1)
    Hgb 11.4 (11.5-15.0)
    Hct 33.2 (34.0-44.0)
    MCV 90 (80-98)

    TIBC 167 (250-450)
    UIBC 91 (150-375)
    Iron 76 (35-155)
    Iron Saturation 46 (15-55)
    Ferritin 57 (10-291)

    Retic Count .4 (.5-3.0)

    So it looks like my iron is fine. My ferritin is maybe not optimum but it is obviously not low. So does this look like iron deficiency anemia? I will still continue with the iron since my iron level is not super high and my ferritin could be higher from what I've read. Will this continue to help with fatigue and other symptoms?

    Thanks,

    Heather

     
    Old 02-15-2008, 03:10 PM   #6
    ChristineVA
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    Re: Question about lab ranges

    No, it doesn't look like iron deficiency at all. Your TIBC is too low for that. Your MCV is good. Nothing here is pointing toward iron deficiency.

     
    Old 02-15-2008, 04:10 PM   #7
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    Re: Question about lab ranges

    Heather--I would be confused too because your iron levels look ok. I really think that you should go in and see your doc and follow up on these results especially since you have symptoms.

    Did you have your B-12 and Folate checked yet? FLFLOWERGIRL

     
    Old 02-15-2008, 04:14 PM   #8
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    Re: Question about lab ranges

    When you were diagnosed, did your doctor tell you that you had iron deficiency anemia? FLFLOWERGIRL

    Last edited by FLFLOWERGIRL; 02-15-2008 at 04:16 PM.

     
    Old 02-15-2008, 07:06 PM   #9
    hfm123
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    Re: Question about lab ranges

    I only had a CBC to go on when I found out I was anemic. My labs were pre-op labs and I didn't have (and never have had as far as I know) any iron labs except a ferritin 7/06 which was 34.

    My doctor said to start iron when I showed her my pre-op labs with mildly low Hgb, Hct, and RBC. She told me to get labs a couple of weeks after starting iron (along with regular physical-type labs).

    She called and left a message saying my labs looked fine except my Hgb was 11.4 so I was a little anemic and she left it at that. I thought it was a little strange that she didn't say anything about keeping with the iron and seeing if it all corrected in a month or so.

    With the fact that my Hgb has gone up slightly, should I just keep on with the iron and see if I feel all better in a month or so? The fatigue is bad on some days and much better on others, but I get dizzy very easily. I did a somersault with my son yesterday and was very dizzy. Is this common with anemia?

    Thanks for continuing to answer my questions and offering your advice!

    Heather

     
    Old 02-15-2008, 07:15 PM   #10
    hfm123
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    Re: Question about lab ranges

    I just wanted to add that I am also hypothyroid. I had my thyroid labs run and they are the best they've ever been:

    TSH .458
    Free T3 3.5 (2.3-4.2)
    free T4 1.22 (.61-1.76)

    In doing some research my anemia looks more like anemia of chronic disease. If my hypothyroidism is being well-managed, can it still affect me and cause anemia?

    Thanks!

     
    Old 02-16-2008, 04:25 AM   #11
    ChristineVA
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    Re: Question about lab ranges

    Heather,

    I think you need some further testing. I'm not sure how I feel about continuing the iron. The change in your hemoglobin is negligable and not significant at all (people's hemoglobin changes all the time). Considering your ferritin is not low, if for some strange reason iron was the culprit, the CBC numbers would have probably shot up a lot. But everyone is different.

    The more telling number is the TIBC. If your body is truly iron deficient, it is going to try to *work* to get oxygen and iron to your red blood cells. The part of your system responsible for TIBC would kick into overdrive and your TIBC would be high in an attempt to fix you. It is a lot like the TSH number with thyroid issues. If you don't have enough thyroid hormone, the pituitary gland kicks into high gear and pumps out LOTS of TSH to try to motivate your thyroid to work. So, the TIBC is the same. Your TIBC is actually on the lower side which indicative of another type of anemia (I've seen it on the internet before but cannot remember).

    So you are either dealing with a B12/folate issue (which could explain your dizziness) or you are dealing with another disease process (usually autoimmune) that is destroying your red blood cells (but those were actually okay weren't they??).

    As for the thyroid issue, long-standing, untreated hypothyroidism can cause anemia. You don't appear to have that and your thyroid numbers are pretty good. How long did you go untreated?

    As for the somersault making you dizzy, well, I know a lot of people that would happen too! I don't know how old you are but you do get to a point where things like that start bothering you and you kind of freak out because "I always used to do this stuff with no problem" Been there, done that. There really could be a simple explanation for that.

    Now if you are just standing around and getting dizzy, then yeah, you would want to look at anemias for that. Or sinus issues.

     
    Old 02-16-2008, 05:05 AM   #12
    hfm123
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    Re: Question about lab ranges

    Hi Christine--

    I was diagnosed about 4 years ago with hypothyroidism. I think I could have had better treatment, but at this point, my numbers are pretty good--maybe a little room for an increase and maybe that will help.

    The dizziness I feel with movement is extreme even for me. I hear you about getting older and not being able to do the spinny things I used to. I have never been good with things that go around in circles but I could at least do one rotation without feeling too disoriented. I actually felt a little sick to my stomach after the somersault. I guess it is just getting worse the older I get. Forty (I was 40 in November) has not been a good year for me!

    As for B-12--I had a level done 1/05 at it ws 907 (200-900). I was taking b-12 supplements at the time but it appears I don't have problems with absorption. I had a folate level done 11/04 and it was >24 and again was likely taking a supplement.


    With the fact that I am just slightly anemic, could it be something that can self-correct? I will continue with one iron for a little while (another month?) and take some b-12 and folate probably in a multi-vitamin. I haven't been taking any supplements so a multi at least is probably a good idea anyway.

    Should I talk to my doctor now or do you think I should take supplements for a month and then ask for a repeat CBC and retic?

    Thanks,

    Heather

     
    Old 02-16-2008, 05:41 AM   #13
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    Re: Question about lab ranges

    Heather--Regarding iron, I have read that if it is not the problem all the iron that you take is not going to help. When anemia is revealed it should ~always~ be investigated.

    One of the reasons could be B-12 and/or folate. It does take years to lower this number where it would give you symptoms, but is a possibility. A simple test would rule it out. I would not take additional supplements until you have further testing because it can skew the results that may give you more answers.

    I would not wait because it looks like this has been an ongoing problem. I would go in and see if you can get some answers about your iron stats, CBC and Retic count. If not, I would see a Hematologist and explain your history. FLFLOWERGIRL

    Last edited by FLFLOWERGIRL; 02-16-2008 at 05:42 AM.

     
    Old 02-18-2008, 01:16 PM   #14
    hfm123
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    Re: Question about lab ranges

    Sorry to keep harping on and on about this! I was away this weekend and talked with a friend who is a GP about my anemia. He told me he wouldn't even consider me anemic and that I wouldn't have any symptoms with a Hgb just slightly under the norm. I asked him if I might have symptoms if my usual Hgb (from previous labs) was over 13 and he still said, no.

    His reaction coupled with my doctor's phone call make me think I am blowing this out of proportion, but my research and how I feel make me think that this is something that needs further investigation.

    I know you both have told me to follow up so I just need to do that. I just don't want my doctor thinking I am looking for something that isn't there because of the internet.

    I guess it comes down to the fact that my TIBC was so low. If my ferritin were low I would be happy to take iron for a number of months but it doesn't appear that my mild anemia is related to low iron. My numbers look more like anemia of chronic disease. If my thyroid numbers sucked, I would still not be very worried but they look good.

    I just don't want to put off something that may continue for a couple of months before it becomes significant enough for my doctor to take seriously. So, I guess I'm just looking for you guys to reassure me that I do indeed have anemia and that I shouldn't blow it off just because my hgb isn't under 10.

    Thanks,

    Heather

     
    Old 02-18-2008, 04:23 PM   #15
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    Re: Question about lab ranges

    You do have mild anemia. I *know* what your friend GP says--I had my own GP tell me that my 11.7 hemoglobin would not cause the fatigue that I was feeling. He told me that it is a "myth" that anemia and/or mineral deficiencies cause fatigue. I believed him and didn't pursue it, despite feeling like absolute crap.

    I then went to another GP who bothered to check my ferritin (even though my hemoglobin was just below normal). He was shocked at the results and immediately started working on getting the ferritin up.

    So, I've heard what your GP friend says. I'm here to tell you that there is a WORLD of difference in how I feel from having a 11.7 to having a 14.

     
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