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I'm glad I found this board. I recenly had a routine CBC show up with rather significant anemia (Hemoglobin 7.6 with an MCV of over 100). Three years ago, I had a series of surgeries for Ulcerative Colitis which removed my colon and formed a pouch out of the end of my small intestine. I was doing very well until I learned of this anemia. I had severe anemia when I had U.C., but it felt very different from the way I'm feeling now. I could barely walk 10 feet. The U.C. got really bad really quickly and I ended up needing lots of transfusions. Once I had the 3 surgeries and the U.C. was pretty much cured, I had to take iron pills for a few months, but then my anemia was resolved. My PCP originally thought the anemia was related to a nutritional deficiency brought on by my surgeries and referred me to my surgeon. She also gave me a B-12 shot because my B-12 was on the very low end of normal. My surgeon, however, doesn't think the anemia has to do with my digestive tract at all, but he's ordering a small bowel barium test to rule out Crohn's. I have that test tomorrow morning. He also referred me to a hematologist, who I will see on Wednesday afternoon. I've been doing research online and have found some rather scary types of anemia, including Autoimmune Hemolytic Anemia, which seems like it can be hard to treat and requires some rather undesirable drugs for treatment. The only symptoms I have are slight pallor and very mild fatigue that I hesitate to even call fatigue. No aches, pains, jaundice, or unusual bleeding. I don't know how my hemoglobin got so low with so few symptoms. I'm having another CBC on Wed. at the hematologist's office to see if the hemoglobin is getting any lower. I'm really scared going into this appointment. Does anyone have any insights/words of wisdom for me? BTW, I'm a 31 y.o. female and I'm also being treated for hypothyroidism.

Kris
Hi Sparkles,

He hasn't ordered the intrinsic factor test, but he did at one point mention getting un upper endoscopy to look at my stomach. He mentioned that an endoscopy would show celiac too. I think he wants to try the B-12 for a few weeks and see if it continues to raise my Hgb/HCT. As of this morning, the B-12 tests hadn't come back from the lab, so he didn't have official word that it was the B-12, but judging by how my Hgb is continuing to climb, he strongly suspects B-12 deficiency plays a significant role in my anemia. Maybe when the B-12 test comes back he may have me do the endoscopy.

As for my MCV, it was over 100 so it's macrocytic, which means B-12 is more responsible for my anemia than iron, but doc is having me take iron because it was a little low. When I was treated for iron before, by my GP, I don't believe I had a serum ferritin test. My anemia was very mild then (Hgb was 11.3) so they just told me to take iron pills. This time, my ferritin was 13, which is in the normal range but still low.

Still waiting for the results of my GI tests (upper GI, small bowel follow through, and pouch biopsy). My colorectal surgeon is supposed to let me know about those.





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