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Hi, I am new to this forum and would appreciate any advice. Here is my story:

I am a 31 year old female who has had iron deficiency anemia since I was about 18. I have been on and off iron pills since then. Last September i was referred to a gi doctor for an endoscopy to r/o any gi source for the deficiency. The reults of the endoscopy showed possible early Celiac Disease. I was on a gluten free diet for three months. I just had my levels re-checked. My ferritin had actually dropped on the gluten free diet, as had my hemoglobin. Although i have not followed up with the gi doc, i am guessing this means that Celiac Disease is not the source of my iron problems. I am on the birth control pill and do not have heavy periods. I exercise almost daily, but do not think i exercise enough to cause low iron levels. Also, while on the Celiace diet for the past three months, i ate almost exclusively red meat (there were not many other options for me to eat!!) yet my ferritin levels went down, so it is not for a lack of iron in my diet. I do have autoimmune hypothyroid, which i have read can effect ferritin, but my TSH is well sontrolled with Synthroid. The lowest my ferritin has been is 2, the lowest my iron has been is 15, and the lowest my hemoglobin has been is 10. The iron pills seem to help, but once my levels are in the normal range and i go off of them, i quickly become deficient.

My question is when should I see a hematologist about the anemia? Would a hematologist do anything different besides give me iron pills? The gi doc mentioned that if the Celiac diet didnt work, he thought I should see one. My PCP, however, has never mentioned it. I have read that the "gold standard" for iron anemia test is a bone marrow aspiration - has anyone needed one of these? Are there any hidden causes of iron deficient anemia that I am missing? Thanks for your help!

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