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Dr Basu
Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 20518
Experience:  MD
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Question is on a low hemoglobin. Male 49 years old hemoglobin

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Question is on a low hemoglobin. Male 49 years old hemoglobin is 13 and hematocrit is 37.5. red blood count is 4.25 and white is 5.0 question is this bad and what are we looking for here. Also iron is total 104 iron binding 405 and % saturation 26.
Submitted: 10 months ago.
Category: Medical
Expert:  Dr Basu replied 10 months ago.

Mysticdoc :

The views expressed by me are for educational purposes only and do not establish a doctor patient relationship.

Mysticdoc :

Hi there,


I am Mysticdoc, experienced Internal Medicine Specialist.


I am here to help you with your concerns.

Mysticdoc :

The numbers do not look bad.

Mysticdoc :

But this should be compared with your prior result.

Customer:

they have always been on the low side but in range.

Mysticdoc :

If your blood count is stable without any change then this is not concerning.

Mysticdoc :

your iron store is adequate.

Mysticdoc :

Hemoglobin is still in normal range.

Mysticdoc :

white cell count also adequate.

Mysticdoc :

I do not see this concerning.

Customer:

I will give you a reference here 2011 2 years ago 13.8 hemoglobin 39.0 hematocrit red cell count 4.35 and white 5.0 iron total 106 iron binding 394 % saturation 27. Guess question why is doctor concerned. If you go back say 5 years there is a difference just example hemoglobin was 15.0 and Hematocrit was 42.7.

Mysticdoc :

Ok

Mysticdoc :

there is slow decrease in hematocrit.

Mysticdoc :

did you have any colonoscopy?

Mysticdoc :

that can be considered to rule out any blood loss from intestine.

Customer:

yes 1.5 years ago all was good on polyp removed on cancer cells.

Customer:

one.

Customer:

no cancer cells.

Mysticdoc :

ok

Mysticdoc :

that is good.

Mysticdoc :

I do not find that concerning since there is no significant drop over last 2 yrs.

Customer:

What do you look for here that would say there is a problem. They the nurse says they are checking to se about anemia or blood loss somewhere in the body?

Mysticdoc :

we look for any abnormal cells, or low platelet count or significant drop in hematocrit like below 10 or 30

Mysticdoc :

this blood test does not show that.

Customer:

platelet count is 272.

Mysticdoc :

is there any decrease?

Mysticdoc :

that is still s good number.

Customer:

in 2009 it was 243 so no.

Customer:

252 last year.

Mysticdoc :

ok

Mysticdoc :

do you have any differential white cell count?

Customer:

4.9 5.2 5.0 no none.

Mysticdoc :

ok

Mysticdoc :

so I am not certain why your doctor got concerned suddenly.

Mysticdoc :

A differential white count should be obtained to check for any immature white cells and also the absolute neutrophil count, eosinophil count etc.

Mysticdoc :

So far, I do not see anything that concerning.

Customer:

the absolute Neutrophils are 3165 and lymphocytes are 1325.

Mysticdoc :

ok

Mysticdoc :

they are normal.

Mysticdoc :

any immature cells?

Customer:

don't see that on here.

Mysticdoc :

likely none

Mysticdoc :

that is normal.

Customer:

does testosterone levels play a part in this by ageing.

Mysticdoc :

yes it does.

Mysticdoc :

Low testosterone level can cause anemia.

Customer:

Is there a test for that?

Mysticdoc :

yes serum total testosterone level can be checked.

Customer:

you say anemia what counts would be out on test?

Customer:

Red, White cells hemoglobin.

Mysticdoc :

low grade anemia is common.

Mysticdoc :

like hemoglobin in 10-12 range

Customer:

Ok thanks for your information.

Mysticdoc :

very welcome

Mysticdoc :

It was my pleasure to help you today.
Best wishes,
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Dr Basu, Experienced Specialist
Category: Medical
Satisfied Customers: 20518
Experience: MD
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