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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18532
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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When you are given blood and iron and you go from 7 to 8

Customer Question

when you are given blood and iron and you go from 7 to 8 Hemoglobin in one day and then drop to 7 the next day….what are the chances of it going up again with no more treatment?
JA: In general, how has your health been lately?
Customer: He had a lung transplant 3 years ago and has struggled with counts, but never dropped this fast after treatment.
JA: Anything else in your medical history you think the doctor should know?
Customer: Chrons disease
Submitted: 10 months ago.
Category: Medical
Expert:  Dr. D. Love replied 10 months ago.

Hello from JustAnswer.

You are correct that when the hemoglobin increases from 7 to 8 with treatment and then drops to 7 the next day, that is unusual and need further investigation.

It is possible that rapid changes in hemoglobin levels may represent fluid status. If someone gets a low fluid status, it will result in a higher hemoglobin, even if not overtly dehydrated. And then if the fluid status in increased then the hemoglobin will drop. It is also possible that conditions that increase fluid retention, such as congestive heart failure, may lower the hemoglobin, and then treatment of the fluid overload may raise the hemoglobin.

However, in most situations, a drop in hemoglobin is more likely related to a problem with the blood, and the most common reasons for a rapid decrease in hemoglobin would be blood loss or a break down of red blood cells (called hemolysis). In your situation, the hemolysis can also be specifically affecting the red blood cells in the blood you were given. In these situations in which the problem is with the blood, it typically will not improve spontaneously.

So, when you ask what are the chances that it may improve again with no more treatment, that is essentially asking the chances that the drop is due to fluid retention. Overall, this would be a low likelihood, but if there is other evidence of fluid retention, such as swelling, then that may indicate that it is the cause for you.

Generally speaking, it is better to find the specific reason for the decrease in hemoglobin than to make assumptions, and your doctor can help you determine the cause.

If I can provide any additional information, please let me know.

Expert:  Dr. D. Love replied 10 months ago.

Please let me know if I can provide any further assistance.