Chronic Anemia with Unknown Etiology - Labs Included


Q: Chronic anemia of unknown origin (> 10 years)

34 y/o female
Roux en y gastric bypass 7 years ago (no complications, SW: 278 lbs, LW: 145 lbs, CW: 160 lbs)
"MY" normal Hgb is between 6-8
Ulcerative colitis diagnosed approx 15 years ago
On no meds

Yesterday's Labs 9/20/15 (only the abnormal values)


Symptoms:  Tired/Exhaustion, GI distress at times, General "not feeling good"

A:   Thank you for writing to us.

I do not think that the question is completed. Please complete the question. Also, I think that you want to talk about a report, please attach the report.

Thank you. We are here to help.

Comments / Follow Ups

Patient: Ferritin
Patient: Ferritin
Patient: It is showing my labs results when I comment but then when I press the comment button, it deletes them
Patient: Ferritin
Patient: Plus, the add files is not working. (I'm not computer illiterate either ... I'm a social media and marketing director. I work with computers all day long)
Patient: Ferritin less than 6 (normal 10-120)
Iron Saturation 1% (20-50)
Hemoglobin 6.6 (11.7-15.3)
Hematicrit 24.2 (35.3-47.8)
Iron 5 (55-170)
Patient: It did not like the less than sign. However, I'm still unable to add my labs.
Doctor: Please send your picture to

I will look at the lab reports and get back to you. Could you also ask a question to which I can respond. Thank you.
Patient: I am looking for possible reasons for the anemia. No one has been able to tell me 'why'. I'm unable to take iron pills, as the side effects are too extreme. I just emailed my labs. Thank you.
Doctor: Thank you for the email.

I looked through the lab reports.

One thing that is interesting is the raised Lymphocyte count. Chronic infection is a possible cause of anemia. You will need to explore that deeper.

One more reason that this is supported is because the Iron Binding capacity is normal. It is not normal in the other causes of microcytic anemia (RBC being smaller shown in the low MCV level).

Causes of lymphocyte increase are usually viral infections or some diseases like Tuberculosis. If you have not had 10% of body weight loss in the last 6 months then Tuberculosis is unlikely.

I strongly recommend that you talk to a MD General Medicine doctor and try to find out exactly which chronic disease you have.

Follow up for more information.
Patient: Could Hep C possibly cause that? My ex husband was a carrier.
Doctor: Yes, viral infections generally cause an increase in lymphocyte levels.

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