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  • Low RBC, Hemoglobin, Hematocrit

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    Old 09-01-2011, 09:22 PM   #1
    Desertlover
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    Low RBC, Hemoglobin, Hematocrit

    What is the significance of simultaneously low values of RBC, Hemoglobin, and Hematocrit when all other CBC values are within their normal range? B12 and iron values are normal also.

     
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    Old 08-16-2013, 07:45 PM   #2
    minran5
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    Re: Low RBC, Hemoglobin, Hematocrit

    I know this an old thread, but I'd sure love to know too. I'm facing the same. I had my last chemo on 2/13/12. All numbers are good but my RBC, hemoglobin & hematocrit took a nosedive recently. Heck, my RBC were better during chemo! I really don't understand the role Ferritin plays in all of this. Vit B12 looks fine. So does iron. Does this mean I have internal bleeding as in colon or ulcers' I know my onc wants me to do a colonoscopy very soon. I used to be so good about tests, but after my diagnoses in July of 2012 I'm.. well, gun-shy. My mind wanders to the worst case scenario. Somebody said since my ferritin is well within range it should be okay. (internal bleeding( I'm usually a quick study, but can't wrap my head around this one. ANY response would be SOOOOO appreciated. Did I mention MCV, MCH & MCHC are all well within the normal range?

    From all I've read, this leads me to believe even though I'm anemic due to the 3 low levels it has nada to do with lack of iron, since that level is fine, too. I sure wish I knew more. Throw very real chemo-brain into the mix and I find myself most obtuse in figuring out this lab & the true role it plays with the normal levels. I feel like it must be loss of blood internally. Darn it. During chemo I did have blood in my stool from bearing down hard since it was so constipating. I'm trying hard not to worry. My only symptom has been extreme, and I do mean EXTREME fatigue. I hold down a full time job and am extremely grateful I can even do so. It helps pay this 5K medical deductible plus the outlandish rate hike in my monthly premiums.

    Again, TIA for any light you are able to shed. Not looking for sugar coating the issues.. simply need real facts. The colonoscopy needs to happen regardless, I'm hung up my 51 ferritin level from what I was told- that if it was fine there was no bleeding, and if that's even true. BTW, I've been postmenopausal for almost 8 years.

    Sorry for such a long drone. Wishing all a lovely weekend.

     
    Old 08-23-2013, 11:38 PM   #3
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    Re: Low RBC, Hemoglobin, Hematocrit

    It sounds like you have anemia of chronic disease (ACD) and not iron deficiency anemia.

    In anemia of chronic disease without iron deficiency, ferritin will be high and transferrin will be low. In iron deficiency anemia, ferritin is low and TIBC (total iron binding capacity) is high, reflecting the body's effort to produce more transferrin and bind up as much iron as possible. With anemia of chronic disease, iron is stored and ferritin is being produced, but the cells are not releasing their iron.

    Oral iron supplements are ineffective for patients with anemia of chronic disease.

     
    Old 08-24-2013, 12:01 AM   #4
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    Re: Low RBC, Hemoglobin, Hematocrit

    One more thing...

    Anemia of chronic disease is usually a normocytic anemia -- the red blood cell size (mean corpuscular volume or MCV) is normal. Iron deficiency anemia is typically microcytic -- small red blood cells.

    That could explain why your MCV is normal.

     
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    Old 08-24-2013, 12:08 PM   #5
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    Re: Low RBC, Hemoglobin, Hematocrit

    I'm facing the same problem. Iron, B12 normal. But my doctor says a fraction of the red blood cells are large, indicating young and immature red cells.

    He's calling it dysfunctional bone marrow, which probably means aplastic anemia. I have an appointment with a hematologist on the 29th, and am not looking forward to it.

     
    Old 08-24-2013, 12:27 PM   #6
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    Re: Low RBC, Hemoglobin, Hematocrit

    In aplastic anemia, it's not just the red blood cell count that is down. White blood cells and platelets will also be down. Because your platlets are down, you'll bruise more easily, gums will bleed, and cuts may not clot quickly.

    Aplastic anemia is different from both iron deficiency anemia and anemia of chronic disease.

     
    Old 08-28-2013, 06:09 PM   #7
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    Re: Low RBC, Hemoglobin, Hematocrit

    Erik - Yes, I figured it was one of a chronic disease. I had breast cancer in 2011.. treatment ended (chemo) in Feb 2012, surgery in March. I was hoping some of the health drama would end for a while.

    Thank you so much for taking the time to answer Erik... and best of luck to you desertlover!

    I'm dreading all the testing.. both my mom and brother died with leukemia- different types.

    It's a difficult time for me right now. Just as my life was getting back to normal.

    Take care all.

     
    Old 08-28-2013, 06:12 PM   #8
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    Re: Low RBC, Hemoglobin, Hematocrit

    My hemoglobin is 11.2. Ferritin is only high by the lab's values at 51, so not excessively so. % saturation is 23. Total iron 60. Iron binding capacity on the low end of normal at 264.(250-450)

    I'm trying really hard not to think the worst.

    Hoping the best for you Fizz. I can relate to not looking forward to the road ahead- but at least you have the ball rolling now. Hopefully whatever it is will be very treatable.

    Last edited by minran5; 08-28-2013 at 06:36 PM. Reason: Sorry, repititious

     
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