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 DrRussMD Your Own Question
DrRussMD, Board Certified Physician
Category: Medical
Satisfied Customers: 64705
Experience:  Internal Medicine--practice all of internal medicine, all ages, family, health, prevention, complementary medicine, etc.
Type Your Medical Question Here...
DrRussMD is online now
A new question is answered every 9 seconds

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

This answer was rated:

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.
DrRussMD and other Medical Specialists are ready to help you