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Low FERRITIN levels even with BLOOD TRANSFUSIONS.

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My iron has been low in July 2012. I had an emergency blood transfusion as my hemoglobin was very low. Since then I have had numerous iron infusions. I get 3 done in a 1 week period every few months. The iron infusions make my ferritin go to approximately 35 but then it drops back down to 8 or 9 within a few week's time. My periods are not heavy. In fact they are extremely light. I take daily liquid iron supplements. My entire body aches all over, like my bones hurt. My hair is not falling out, in fact it is very thick and healthy and grows quite fast. My nails are not brittle and are very nice so I am not having these particular iron deficiency side effects. I do get tired easily, and sleep a lot as my job is physical. I have had a colonoscopy and gastropy - both negative for anything.

I have attached my most recent report which are very typical results that I have had for the past year. I have received fecal test results and they are negative for any blood. Why isn't my body storing iron? Even with iron infusions, it drops back down so quickly. I am fustrated my doctor keeps brushing me off as it being "female problems" . I eat healthy, I eat meat and regular meals that I pick specifically for being high in iron. I take my liquid iron supplement with orange juice to aid in absorption. I'm puzzled.

Tested for Thalassemia 3 times and it covered alpha, beta, fetal hemo, hb c, s, A2 and variant. They all came back negative. I do not drink, I do not smoke or do any kind of drugs. EPO tested last month and I have attached the report for that test too.CRP always high at 22 (normal range for this lab doing test is no higher than 5) and ESR always high at 28 (lab range I believe is no higher than 13 is normal) no matter when it is tested. Negative for ANA, RF, other antibodies.

Category: Hematologist

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Dr. Prasad Eswaran
Category: Hematologist
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Expert:  Dr. Prasad Eswaran
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Hello.
Thank you for your query at DoctorSpring.com
I went through your reports and understand that your HB has been improved to 10 after blood transfusions. Other blood cell counts seems to be ok. Have you done a peripheral smear study ?
You may have to undergo a set of tests which includes total serum iron, transferrin, TIBC, bone marrow evaluation and folate levels. Other causes such as antibodies to red blood cells needs to be evaluated. I hope your doctor would have prescribed you anti helminthic ( de worming ) tablets already.
Getting tired and sleeping due to exhaustion may be the reason. It includes a differential of sign of anaemia too. Hence you need another thorough evaluation so as not to miss any diagnosis at early stages. Please let me know after you have done other investigations.
Please don't ignore these symptoms.
Regards.


Patient replied :

My blood transfusion was in 2012 - which was the start of my low iron. My peripheral smear is microcytic hypochromic. Ena, ana, rf, and other antibodies are negative and have been tested several times for those. I will get the other tests done.


Expert:  Dr. Prasad Eswaran
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Hello.
Kindly revert back once all investigations are done. Wishing you a speedy recovery.
Regards.


Patient replied :

TIBC normal Iron saturation low b12 normal total serum iron low


Expert:  Dr. Prasad Eswaran
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Alright. Kindly let me know the bone marrow and periheral smear study results have been done.
A peripheral smear and bone marrow study can throw light on the probable cause.
Since your total iron level is still low, please increase dietary supplementation of iron.

Regards.


Patient replied :

I am not able to get a req for a bone marrow study from my family doctor. My peripheral smear showed microcytosis, hypochromia, and eliptocytes. I want to know what is causing this. Could it be a type of cancer or bone marrow failure causing this? Is it a hemolytic anemia? My results from a blood test I got yesterday showed same results as the other one, but my WBC is up to 12.1 now. I have also tested negative for celiac.


Expert:  Dr. Prasad Eswaran
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Hello,
Your consult has been temporarily disabled owing to the withdrawn payment from Paypal. The same was communicated you by our support staff, could you please withdraw the dispute to continue further.
Thank you
In-house Physician

Dr. Prasad Eswaran
Category: Hematologist
Experience: 
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
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