My Latest CBC Result.

Patient

Q: My latest CBC was as follows:


WBC Previous Results of First 9/23/2014 Result = 5.4 & Subsequent 10/14/2014 Result = 4.8 Now = 8.5
RBC 9/23/2014 = 3.6 and 10/14/2014 = 3.6 Now = 3.53 Flagged Low
Hemoglobin 9/23/2014 = 9.1 and 10/14/2014 = 9.2 Now = 10.9 Flagged Low
Hematocrit 35.0 - 47.0 % 9/23/2014 = 29.7 and 10/14/2014 = 30.3 Now = 33.7 Flagged Low
MCV 9/23/2014= 82 and 10/14/2014 = 83 Now = 96
MCH Previously Low at 9/23/2014= 25.1 and 10/14/2014 = 25.2 Now- 31.0
MCHC Previously Low at 9/23/2014= 30.6 and 10/14/2014 = 30.4 Now = 32.3
RDW Previously High at 9/23/2014= 16.2 and 10/14/2014 = 16.2 Now = 12.9
Platelet Count Previous 9/23/2014= 303 and 10/14/2014 = 355 Now = 307
Differential Type Automated
Neutrophil % 49.0 - 74.0 % 75 H Previous in range results of 9/23/2014= 68 and 10/14/2014 = 67 Now= 75 Flagged High
Lymphocyte % 26.0 - 46.0 % 12 L Previous also Low results of 9/23/2014= 17 and 10/14/2014 = 22 Now = 12 Flagged Low
Monocyte % 11 Previous High result of 9/23/2014= 13% and normal previous of 10/14/2014 = 8% Now = 11
Eosinophil % 2 Previous of 9/23/2014= 3 and 10/14/2014 = 2 Now= 2
Basophil % 0 All tests have equaled 0
Abs Neutrophil % 6.4 Previous results 9/23/2014= 3.6 and 10/14/2014 = 3.2 Now = 6.4
Abs Lymphocyte 1.0 Previous Low result of 9/23/2014= 0.9 and in range result on 10/14/2014 = 1.1 Now = 1.0
Abs Monocyte 0.0 - 0.80 K/uL 0.9 H Previous within range results of 9/23/2014= 0.7 and 10/14/2014 = 0.4 Now = 0.9 Flagged High
Abs Eosinophil 0.2 All results in range 9/23/2014= 0.1 and 10/14/2014 = 0.2 Now = 0.2
Abs Basophil 0.0 All three tests = 0,0,0. Now = 0

Dr. prescribed 650mg / day of Iron and has diagnosed me with anemia. Negative result on three day blood in stool test. Dr. prescribed the 650/mg day of Iron for three months total. I've completed one month of iron. Also prescribed 5000 units/day of D3, and also Zofran. Dr wants to blood test for Celiac. I no longer consume wheat and am a vegetarian.

Upon resuming the iron, both days I had severe stomach pain. Pain centered in my ribs on both sides and doubled me over in tears. I vomited despite taking Zofran and had diarrhea. My stomach hurt so badly, I'm apprehensive to resume the iron. Are my blood results a cause for concern?

Symptoms:  Bruising, coldness, tiredness, breathlessness, nausea, cold hands/feet, skin rashes, scalp flakiness, anxiety, depression.
Doctor

A:   Hello.
Welcome to Ask The Doctor.

I understand your concern.
This hemoglobin level is very low.
You require evaluation of the cause of this severe anemia.
I would advise you to get Anti TTG Antibody test done to rule out celiac disease.
Also, iron supplements cause gastritis.
You can ask your Doctor to give your iron syrups that cause relatively less gastritis.
Sodium Feredetate is also known to cause less gastritis, so you can ask your doctor to prescribe that.

I hope it helps.
Stay Healthy

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