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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18427
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My hemoglobin continuously lower than the parameter on the

Customer Question

My hemoglobin continuously lower than the parameter on the other hand my CEA is higher (>5). 1st doctor said that lower hemoglobin was caused by taking blood thinner (I'm taking Plavix), another doctor who is specialist in blood and cancer said that lower hemoglobin might be caused by higher CEA but he cannot give the the diagnose before taking bone marrow. I have not done anything yet. Your opinion please.
JA: Are you keeping a personal medical record while dealing with this?
Customer: yes
JA: Anything else in your medical history you think the doctor should know?
Customer: I took angio plasty by putting a sten about 5 years ago.
Submitted: 6 months ago.
Category: Medical
Expert:  Dr. D. Love replied 6 months ago.

Hello from JustAnswer.

There are several possibilities to consider in this situation, and both doctors have stated correct possibilities.

A low hemoglobin can occur from bleeding from a variety of underlying causes or structures, such as cancer, ulcers, or diverticuli. Some of these are more worrisome. Using any blood thinner will increase the risk of bleeding from any of these underlying causes. The elevated CEA can be due to cancer, so can also be a site of blood loss.

It is also true that a definitive diagnosis can only be made after further evaluation. A bone marrow can help to clarify the cause of the low hemoglobin. But another approach would be further evaluation of the colon, such as with a colonoscopy or upper GI endoscopy.

Have you had a colonoscopy or endoscopy?

Customer: replied 6 months ago.
I had both colonoscopy and endoscopy 2 years ago, the result were good although there were some red spots
Customer: replied 6 months ago.
I was told that the parameter for CEA <5, <2 is for non smoker and <5 is for smoker. I'm not a smoker.
Expert:  Dr. D. Love replied 6 months ago.

Was the hemoglobin and the CEA at the current levels when the colonoscopy and endoscopy were done?

Customer: replied 6 months ago.
I didn't take CEA test when colonoscopy and endoscopy were done. CEA test was taken when I realized that Hemoglobin always low than the parameter.
Customer: replied 6 months ago.
I have the report at home, but presently I'm at the office.
Expert:  Dr. D. Love replied 6 months ago.

If the CEA was not checked prior to the colonoscopy and was found to be elevated subsequently, then it would be reasonable to consider another colonoscopy. You are correct about the normal range for the CEA in smokers and non-smokers. There are many different possible causes of an elevated CEA, and if there is no evidence of colon cancer on colonoscopy, then there is no reason to repeat the colonoscopy as long as the CEA is not increasing further.