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Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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I seem to be having a persistent problem with anaemia. My g.p

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I seem to be having a persistent problem with anaemia. My g.p wants to refer me to a haematologist. Can you tell me what a haematologist will do about this problem of mine?
Hello from JustAnswer. It would depend upon what has already been done. Your GP has likely already checked for many of the common tests for anaemia, but if not yet done, the first tests would be tests of nutrients that affect the red blood cells, as well as tests to indicate whether there is increased breakdown of red blood cells. If the various blood tests do not indicate the cause of the anaemia, then it may be necessary to perform a bone marrow biopsy. If you have details of what blood tests have already been done, I can review them to see if there are other blood tests that would be useful. If I can provide any additional information, please let me know.
Customer: replied 1 year ago.
No, all that's ever been done is that I've been given iron tablets and then when my iron levels are normal again, I come off the iron tablets. However after awhile, my iron levels drop down again. I am a vegetarian and wonder I this is the problem? If so how can I get help to eat the right food that would help my iron levels. But I just wanted to know what to expect when I see a haematologist? Will he/she first of all get my blood analysed a lot? What would be the usual procedure?
If your GP has already done all of the blood tests, then the Haematologist will typically not repeat them. However, if you have documented recurrent iron deficiency, there should be further evaluation for the iron deficiency, beyond the blood tests. Being a vegetarian can contribute to iron deficiency, since meat is an excellent source of iron and provides the iron in a form that is more readily absorbed. But being a vegetarian, by itself, will not cause iron deficiency, so it is not the sole problem. Do you have the results of the most recent iron blood tests, including the iron saturation and the ferritin level?Have you had any other evaluation for the iron deficiency, such as a colonoscopy and endoscopy?
Customer: replied 1 year ago.
Yes have had colonoscopy & endoscopy and they did not reveal any problems. So, if being a vegetarian is not the real problem, what else could it be? What are the possible causes if none of the above, are?
The body holds on to iron extremely well, so it is virtually impossible to become iron deficient solely by inadequate intake. Or more accurately, someone will typically become deficient in other nutrients before they become iron deficient. Iron deficiency usually indicates that there is somewhere that there is a loss of iron, and more specifically a loss of blood. If there is some uncertainty about the diagnosis, then a bone marrow may still be necessary to look at iron stores in the bone marrow, but this is usually not necessary, but that is why I asked about the iron tests. If the blood tests clearly show iron deficiency, then the evaluation would be for identification of where the body is losing blood. The evaluation to identify where there is a loss of blood usually is within the GI tract, because that is where blood is usually lost that is not obvious. If the colonoscopy and endoscopy does not show a source for loss of blood, then tests to look at the remaining portions of the GI tract would usually be next, such as a capsule endoscopy or a CT scan of the abdomen.
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Customer: replied 1 year ago.
Thanks for that. I also have a problem with my thyroid apparently (this showed up in the same blood tests). What I really do not understand and find extremely baffling is that I have all the symptoms of an under active thyroid: sluggishness; lack of energy; depression; anxiety; and am overweight & find it almost impossible to lose weight. Yet the blood test shows that I am the other way I.e overactive. How on earth can this be possible? Isn't it very odd?
It is not the common presentation but is not considered very odd. There are some people that have symptoms opposite to what would be expected from the thyroid blood tests. In your case, though, it is complicated by the fact that some of thse symptoms may be due to the anaemia and iron deficiency or the underlying cause of the iron deficiency, particularly the sluggishness and lack of energy.