How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask Dr. Thomas, MD Your Own Question

Dr. Thomas, MD
Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56418
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
24257177
Type Your Medical Question Here...
Dr. Thomas, MD is online now
A new question is answered every 9 seconds

I am a 40 year old female with no prior health problems. At

Resolved Question:

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?
Submitted: 11 months ago.
Category: Medical
Expert:  Dr. Thomas, MD replied 11 months ago.
Hello
This was typical of iron deficiency
What was the original iron, TIBC, ferritin?
Customer: replied 11 months ago.

Iron - 16


TIBC - 561


Saturation - 3%


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

Expert:  Dr. Thomas, MD replied 11 months ago.
OK
This is iron deficiency anemia

Is that what your doctors diagnosed?
Customer: replied 11 months 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.


 

Expert:  Dr. Thomas, MD replied 11 months ago.
Didn't you have heavier periods before

Customer: replied 11 months ago.

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


 

Expert:  Dr. Thomas, MD replied 11 months ago.
Yes
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.

Dr. Thomas, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 56418
Experience: Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
Dr. Thomas, MD and 9 other Medical Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
< Last | Next >
  • I feel so much better today, and upon further investigation believe that there is a chance that the responses I got saved me from a serious, even life threatening situation. I am very grateful to the experts who answered me. Susan O. USA
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/DrThomasMd/2012-7-25_134438_Imagess1.64x64.jpg Dr. Thomas, MD's Avatar

    Dr. Thomas, MD

    Board Certified Physician

    Satisfied Customers:

    46349
    Internal Medicine--practice all of internal medicine, all ages, family, also Integrative, CAM, etc
  • http://ww2.justanswer.com/uploads/MY/mysticdoc/2012-6-8_15615_mysticdoc3.64x64.jpg Dr. D.J.'s Avatar

    Dr. D.J.

    Board Certified Physician

    Satisfied Customers:

    14679
    MD
  • http://ww2.justanswer.com/uploads/agketch/2008-7-14_184046_drketchresized.jpg Dr. Ketch's Avatar

    Dr. Ketch

    Board Certified Physician

    Satisfied Customers:

    76
    Medical Degree, Former Assistant Professor at School of Medicine at Yale University
  • http://ww2.justanswer.com/uploads/FA/FamilyPhysician/2013-8-31_191624_JA550x500Photo.64x64.jpg Family Physician's Avatar

    Family Physician

    Doctor

    Satisfied Customers:

    2562
    Emergency Medicine and Family Practice for over 26 years
  • http://ww2.justanswer.com/uploads/DR/drappapo/2013-8-16_22576_drdavid.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    224
    Treat children/young adults, former chief resident, multiple publications
  • http://ww2.justanswer.com/uploads/DrDLove/2009-08-12_141522_DrDLove.jpg Dr. D. Love's Avatar

    Dr. D. Love

    Doctor

    Satisfied Customers:

    11961
    Family Physician for 10 years; Hospital Medical Director for 10 years.
  • http://ww2.justanswer.com/uploads/CO/commissure/2011-4-15_192514_REISD20080926JR1090.64x64.jpg Dr. David's Avatar

    Dr. David

    Board Certified Physician

    Satisfied Customers:

    10667
    Experienced Physician trained in New York City. I'm ready to help.