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DrRussMD
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63990
Experience:  Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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Hello I hope you can help me. I am hoping for answers relating

Resolved Question:

Hello I hope you can help me. I am hoping for answers relating to my daughter who is now 20 years old. I am an extremely anxious parent and just want answers to my questions. Three years ago she developed a purpuric rash after scratching the top of both thighs. I took her to Gp and he was not concerned and said the scratching had ruptured blood vessels. She was well other than this so I tried not to worry (but still did) three months later the same thing happened after scratching her calves (I believe after shaving her legs) I went back to gp and asked for blood tests. All came back fine. Shortly after she donated blood for the first time. Within a couple of weeks she had a nasty dizzy spell. Took her back to gp and saw a different doctor who redone blood tests this time including b12 and ferritin these both came back extremely low -b12 at 153 and ferritin at 4. Her hemoglobin had also dropped to 11.4. She was given ferrous sulphate and colbamin tablets for 3 months and retested and her levels did increase. I got her checked again last year and her hemoglobin was fine around 12.4 and her b12 was 550 I wasn't told about ferritin. It constantly plays on my mind wondering if it's still ok. I don't understand why it would be so low when all I read is how common it is in the elderly to have b12 deficiency and how rare it is in the young. I between all this she also managed to contract C. difficile which is also rare and to this day have no idea how she managed to catch it. I am constantly fearful that something is wrong even three years later. She is seemingly a healthy girl now other than suffering badly with her periods but she is also very very pale skinned and can never tan even when on holiday. I even paid to see a private Gp to look at he results and ask about the rash and she did not seem concerned and in a nice way said I was worrying over nothing. Can you help at all with any answers? I would be very grateful.
Submitted: 2 years ago.
Category: Medical
Expert:  DrRussMD replied 2 years ago.
Hello'
What has been overlooked here is the possibility of gluten sensitivity or celiac disease.

This requires a test, celiac panel and anti-gliadin antibodies.

If any of this is positive, given this story, I would go gluten free for 3 months as a test.

It is very easy to recheck a ferritin.
But ferritin is the storage form of iron, and can be low in menstrating women, without a contingent low iron. So the entire iron studies should be done. A normal iron with a low ferritin is not a big concern.

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Customer: replied 2 years ago.

Thank you for your reply. Can you give any insight into why she should become b12 deficient at such a young age? Could that be purely down to celiac/ gluten problems? Is there any relevance in the purpuric rash/ pale skin?
Expert:  DrRussMD replied 2 years ago.
Yes.
In fact I don't think deficiency was established, as she was not very low.
But absorption can be affected by celiac.
Also if she is deficient in intrinsic factor, but that was not tested for.
If she were vegan, this is another reason.

Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
Customer: replied 2 years ago.

So would anything more serious have
manifested itself by now? I just have it in my mind all the time.
Expert:  DrRussMD replied 2 years ago.
Yes
I don't think it is anything more serious, or even serious.
Use reply to let me know if you have further questions [click reply to expert].
Please do not forget a positive rating [hopefully you will click an excellent; or come back to ask me more as needed].
DrRussMD, Board Certified MD
Category: Medical
Satisfied Customers: 63990
Experience: Board certified Internal medicine and Integrative medicine. Many years of experience all areas.
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