Very low hemoglobin, extreme exhaustion

Patient : My sister has very low hemoglobin, her count was about 7 last time it was tested, and she had low iron and B12 as well (she is a vegetarian, but she eats all the recommended foods for iron and B12!) Her last doctor gave her iron supplements and sent her on her way, two weeks ago. She went back for more blood tests on Friday and this weekend she had no energy, and spent the whole day today sleeping! I am *very* worried about her!! She also got her period yesterday, very heavy and early, even though she is on birth control pills. What are the risks of low hemoglobin? What signs should she watch for before going to an emergency room for a blood transfusion?? She is 21 years old, no history of disease, although she has been vegetarian for several years and the doc said she was mildly anemic about a year ago.
Symptoms:  Extremely low hemoglobin, fatigue
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