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Dr Basu
Dr Basu, Experienced Specialist
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Experience:  MD
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My hemoglobin (HGB) is 11.4 g/dl. It was 11.8 g/dl

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My hemoglobin (HGB) is 11.4 g/dl. It was 11.8 g/dl in Jan. A year ago it was 12.5 g/dl. The indicies are normal. RBC is 3.87 x 10/6, which is low. My Iron, TIBC, and erythropoietin are normal. I am taking a multi vitamin.I don't seem to have any symptoms, should I be pursuing the low hemoglobin? I am a medical labortorian.

Submitted: 4 years ago.
Category: Medical
Expert:  Dr Basu replied 4 years ago.

Thanks for your question.

Also get checked for vitamin B12 and folate deficiency --other common causes of anemia.

Hereditary hemoglobinopathies ( abnormal hemoglobins) can also cause mild anemias.

A hemoglobin electropheresis can rule that out.

Another possibility is the bone marrow failure for some reason.

This should be ruled out.

Hence, you should consider seeing a specialist like hematologist for further work up.

JACUSTOMER-if5nwa0c- :
I also had a B12 and folate, and they were normal. What tests would a hematologist run?

Mysticdoc :
Then the next possibilities like abnormal hemoglobins ( thalassemia trait for example) or bone marrow issues should be ruled out. Hemoglobin electropheresis, a peripheral blood smear to look for abnormal cell morphologies and a bone marrow examination if needed

JACUSTOMER-if5nwa0c- :
The peripheral smear is normal, I doubt that the Hgb electrophoreis would show any abnormalities. Does a 11.4 Hgb warrant a bone marrow?

Mysticdoc :
It is not the number as per se, but the gradual decrease should be concerning. This does not warrant bone marrow right now. This can be observed for 6 months with repeat CBCs.

JACUSTOMER-if5nwa0c- :
Would taking an iron pill be helpful?

Mysticdoc :
You can try iron pills. Also get your ferritin level checked. Try with vitamin C pills 500 mg daily.

JACUSTOMER-if5nwa0c- :
Thanks, ***** ***** verified my thoughts. Are there tumors that would cause this?

Mysticdoc :
Multiple myeloma is one example. myelodisplastic syndrome. This causes change in bone marrow composition making red cell and other cell production ineffective.

JACUSTOMER-if5nwa0c- :
Actually, my father died from multiple myeloma. My proteins have been normal.

Mysticdoc :
ok good. Most likely this is not concerning but you should be aware of this and if further change in numbers, then consult a hematologist.

JACUSTOMER-if5nwa0c- :
Thanks!

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