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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 31650
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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I have a friend who was diagnosed . Her hemoglobin is

Customer Question

I have a friend who was diagnosed for melanoma. Her hemoglobin is playing between 6-8 with the help of iron &
JA: OK. The Doctor will need to help you with this. Please give me a bit more information, so the Doctor can help you best.
Customer: but her doctor wants her to have colonoscopy to determine whether its through the rectum. However her doctor said they can't do colonoscopy until she reach her hemoglobin level at least by 12. My friend refused a blood transfusion, only alternative blood. Can't they perform a colonoscopy to a low blood/hemoglobin patient?
JA: In general, how has your health been lately? How long have you been dealing with the issue?
Customer: Per her, she was initially diagnosed last year but she opted a naturopath therapy. She just seen a doctor 3 months ago after they found a lab test that her hemoglobin dropped to 3. Her right leg got swollen bad too.
JA: Is there anything else the Doctor should be aware of?
Customer: She has diabetes too but sorry I'm not sure all medical details because she is now in Ohilippines
JA: OK. Got it. I'm sending you to a secure page on JustAnswer so you can place the $5 fully-refundable deposit now. While you're filling out that form, I'll tell the Doctor about your situation and then connect you two.
Submitted: 6 months ago.
Category: Health
Expert:  Dr. Arun Phophalia replied 6 months ago.

Hello,
I am Dr. Arun and will be helping you today.

I am sorry that your question was unanswered for long.

A colonoscopy is usually advised as there can be polyps in the intestines (benign growths) which can bleed intermittently and can cause anemia. Colonoscopy can be done with a low hemoglobin (but the risk is increased as sedation or anesthesia given during the procedure may cause sudden breathing issue or low oxygenation).

But she would require other investigations too apart from colonoscopy. Ferritin is a blood test which evaluates for the total iron available in the body. Serum ferritin is the most useful test for diagnosing iron-deficiency anemia. Low serum ferritin (less than 12 ng/mL) is highly specific for iron-deficiency anemia. Please read this resource;

http://www.emedicinehealth.com/anemia/page5_em.htm

The most common causes of anemia are;

1) iron deficiency (with or without blood loss),

2) chronic disease/inflammation

3) chronic kidney disease

4) deficiencies of folate or vitamin B-12,

5) diseases of the bone marrow

6) hypothyroidism, hypersplenism, and hemolytic anemia

So investigations entail;

1) Complete blood count (CBC)

2) Peripheral blood film

3) Vitamin B-12

4) Folate

5) Reticulocyte count

6) LDH

7) Thyroid-stimulating hormone

8) Serum creatinine and estimated glomerular filtration rate

9) Serum ferritin

10) Serum iron

11) Total iron-binding capacity

So these investigations also need to be done for the exact assessment and long term management.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

Expert:  Dr. Arun Phophalia replied 6 months ago.

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