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Dr Basu
Dr Basu, Experienced Specialist
Category: Endocrinology
Satisfied Customers: 29251
Experience:  I have special training and certification in Diabetes management for last 10 yrs.
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You may be my last resort for a answer, all other tests have

Customer Question

You may be my last resort for a answer, all other tests have found nothing. I have a longstanding history of iron deficiency anaemia first found in FBC test which found I had Prostate Cancer in 2013. On Active Surveillance until second biopsy in September 2015.
Robotic prostate surgery October 2015. All follow-up PSA tests showing clear. Recent colonoscopy/endoscopy tests show clear. CTCV revealed a small adrenal mass possible adenoma on my adrenal gland. GP advises daily iron tablets for the future as treatment but he gives up on the cause of my low iron. I am male. DOB 11/10/1945. Non-smoker, Non-drinker, healthy diet, I visit Gym three times per week for general fitness workouts. symptoms are fatigue, night sweats, tiredness, constipation, cannot lose weight pre op 12st 7lbs now 13st 7lbs.
Submitted: 1 month ago.
Category: Endocrinology
Expert:  Dr Basu replied 1 month ago.

Hi there,
This is Dr Basu, experienced Internal Medicine Specialist.
I am here to address your concerns and provide great service.

What is your hemoglobin level, MCV, RDW values from blood count test?
Also do you know your ferritin and TIBC levels?

Adrenal mass can suggest kidney problem related anemia.

Deficiency of erythropoietin can be an issue.

Erythropoietin is produced by the kidney to stimulate red blood cell production in the bone marrow.

Hence low erythropietin level can cause chronic anemia.

Treatment is with eythropoietin injection in that case.

Also bone marrow infiltrative disease like multiple myeloma, or MDS can cause anemia.

Other cell lines like platelets and whete blood cell count also get affected over time.

Dr Basu and other Endocrinology Specialists are ready to help you
Customer: replied 1 month ago.
Dr. Basu,
Thank you for your answers, I am doing on-line research and giving lots of thought to my problem at the moment. I have a follow-up appointment with a haematologist on 14th Sept, he is carrying out some thirteen blood tests for me, though he thinks it unlikely that my low iron readings will be within his domain. He has referred me to an Endocrinologist in my area for a 15 minute consultation on 21st Sept. and I await with his recommendation an appointment for a video capsule endoscopy to check my small bowel for any disease or angiodysplasia, With these appointments I feel somewhat unsure of my next step.
with you as a seven day trial consultation with you now maybe better after all these tests if I don't get my condition resolved by them.
Still, you asked about some of my previous blood tests, so here we are,
FERRITIN READINGS: OCT 2016 JAN 2017 MARCH 2017 MAY 2017 AUG 2017
6 27 NO RESULT? 19 26SERUM IRON LEVEL 3 52 27 17 8
SATURATION IRON 75 65 55 60 66
BINDING & PERCENTAGE 4% 80% 49% 27% 13%
IRON SATURATION
MAY 2017 Last known MCV reading 81.2That is as much as I can find at the moment. I appreciate any help and advice you can offer.Kind regardsGerry
Expert:  Dr Basu replied 1 month ago.

Hi Gerry,

Thanks for additional info.

Your ferritin level is currently considered low normal.

Iron studies do not show any iron deficiency.

MCV is also normal.

Hence this is considered anemia of chronic disease.

This can be seen with kidney disease, low testosterone level commonly.

Hence your next step will be to get a kidney specialist consultation if your endocrinologist cannot find anything wrong with hormones and your endoscopy comes back normal.