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After noticing a recent decrease in my athletic performance, I sent a message to my doctor early last week. My primary care physician ordered blood work and sent me to a hematologist in oncology. The hematologist said it was "very unlikely" cancer and ordered more blood work. Further blood work confirmed I have iron deficiency anemia.

All my blood work was normal apart from the indices related to iron deficiency. Ferritin was low, indicating iron deficiency and not anemia of chronic disease. Bone marrow is producing a normal amount of red blood cells. I have not recently donated or lost substantial quantities of blood. I have not had any tarry stools or seen blood in my stool. A rectal exam was negative for the presence of blood. (This test involved a doctor inserting a gloved finger into my rectum and then testing the glove for blood.) I have no bruising and my blood clots normally. I have not seen any blood in my urine. I have no other ongoing health conditions.

For the last 5 years, I have run 52 miles a week. I eat very little red meat, no more than a few times a year. I do regularly eat poultry, fish, and eggs. I have had semi-frequent nose bleeds, averaging one a month, since childhood.

The hematologist put me on a high potency iron supplement -- 130mg of iron and 250mg of vitamin c per day.

All my doctors have discounted the possibility the anemia could have been caused by my running, despite there being ample evidence in medical journals that excessive exercise can lead to iron deficiency.

If it's not cancer and i'm not losing blood through my gastrointestinal tract, what is causing it? I do feel improved since starting the iron supplement on Monday, but my athletic performance is not where I'd like it to be. I don't have any further doctor visits scheduled at this time. I am to have blood work in 1-2 months to test my iron levels again.

My blood work is below:

IRON 24
TOTAL IRON BINDING CAPACITY 380
IRON/TOTAL IRON BINDING CAPACITY 6%
FERRITIN 5.6
VIT B12 549
FOLATE 17.62
RETICULOCYTE COUNT, ABSOLUTE 2.5

WBC'S AUTO 3.4
RBC, AUTO 4.52
HGB 10.6
HEMATOCRIT 34.2
MCV 75.6
MCH 23.5
MCHC 31.0
RDW, BLOOD 18.0
PLATELETS, AUTOMATED COUNT 206
MPV 8.7

CHOLESTEROL 127
HDL 43
CHOLESTEROL, NON-HDL 84
TRIGLYCERIDE 48
LDL 74

HGBA1C 5.4

GLUCOSE POST FAST 87
BUN 21
CREATININE 1.2
TOTAL PROTEIN 6.6
ALBUMIN 4.8
GLOBULIN 1.8
ALBUMIN/GLOBULIN RATIO, SERUM/PLASMA 2.7
CALCIUM 9.4
AST 21
ALKALINE PHOSPHATASE 51
BILIRUBIN, TOTAL 0.8
LDH 157
PHOSPHATE, BLD, QN 4.2
URIC ACID 5.3

TSH,BLD,QN 1.680





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