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Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 63757
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
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I am a 40 year old female with no prior health problems. At

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I am a 40 year old female with no prior health problems. At a routine physical in late June, my primary found my hgb at 8.1 and b-12 of 299, (low mpv, high rdw) Microcytic, hypochromia, anisocytosis = IDA. I have been on 3 iron pills a day and 1000mcg of b12 daily for 10 - 12 weeks. I have been on birth control pills since March that induces amenorrhea, so no heavy periods. All (upper and lower) GI and gyno u/s testing negative. Mammogram and bone scan and chest xray negative. No celiac disease and absorption is good. RA and Thyroid work ups were negative.

Further bloodwork over the past 2 months have shown low alkaline phosphatase, low reticulocytes in addition. Other significant symptoms have been drenching night sweats, fatigue, occasional low grade temps and chills, muscle weakness, stiffness and pain. I developed a heart murmur and tachycardia from the anemia and have occasional shortness of breath.

I just had bloodwork done last week. My hgb/hct/mvc are in normal range now but it showed high rdw, slightly above normal rbcs, neutrophil bands and basophilia. I am still symptomatic.

My hematologists' plan is to now take only 2 iron pills a day and re-check a cbc in two months.
My question is:
Is this the typical diagnostic approach for my case? If so, why? Is a bone marrow aspiration not indicated? Is this just an over response from the bone marrow because of the supplements or does this look like a possible MDS or CML? What do you recommend?
This was typical of iron deficiency
What was the original iron, TIBC, ferritin?
Customer: replied 3 years ago.

Iron - 16

TIBC - 561

Saturation - 3%

I don't have original ferritin but August 10th it was 16

This is iron deficiency anemia

Is that what your doctors diagnosed?
Customer: replied 3 years ago.

Yes that is the diagnosis but they can't find the cause. They are continuing to look for the cause and I am just concerned about waiting to see instead of doing a bone marrow. Being there is some bone marrow production issues.


Didn't you have heavier periods before

Customer: replied 3 years ago.

Before March I had Normal periods. Could that have caused it?


That combined with diet can do this.
If you have no blood in the stool, infact, I would not be concerned with further work up.

Please let me know if you have further questions.
Use reply as needed.
Please do not forget a positive rating.

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