Oh thank you for lab results. I love them.
The iron level has definitely changed for the better. As to why, I don't know.
(those older lab results show, how important it is to always mention UNITS of lab results and their reference range since also test methods differ)
Unfortunately the 2 older results do not state the condition of plasma, if it was hemolytic (or I am blind). Maybe it wasn't?
You definitely struggle with anaemia though.
Also platelets like to be on lower count side it seems, now even the white blood cell count is lower (leucopenia).
This again can be as simply due to missing essential nutrients like copper and zinc, but there are many other possibilities too.
Has your doc touched the spleen area and looked for enlargement?
Are you taking meds that (Aspirin, NSAIDs, anti malaria...) muddle with the bone marrow? Any infection that muddles with your system?
When you see the specialist, please mention your diet, your medications and supplements you take, all your symptoms.
This needs to be investigated.
Unfortunately yes, any nutrient intake change will take up to 3 months to show in red blood, but you might want to be in a specialist's (hematologist) hands by then or have hemolysis excluded and re-check white blood count by a sample now.
(The lower creatinine value is almost irrelevant since it is 'mildly below' 'normal range'. Normal range values are a mathematical term = found in 95% of so called 'healthy' population and creatinine is something, so 5% are already outside of range (usually slightly out of range) and still 'normal';
you produce creatinine in your muscles, hence if you don't have much muscle mass or are low in protein intake (and liver disease excluded, enzymes look fine), the incoming creatinine for kidneys to flush it out is already low; if kidneys were not good, the creatinine would increase. I am pretty sure the doc did not address creatinine as too low.)
Hematocrit as expected low....for anemia.
I think you really should see a hematologist to get down to the root cause and
if it was food/intake only,
but I really think other reasons have to be excluded
and be it absorption problem of provided food and nothing else within your body as organic cause.
The range of causes is huge and only a specialist can get to the bottom of it.
You have beautiful liver enzyme parameters btw.
What he/she might additionally check for is:
Reticulocyte count
(this are 'newborn' red blood cells in the blood stream, with a special stain they can be seen under microscope and counted and given as a % number of all red cells, hence it shows bone marrow making rate - in hemolytic anaemia that count would be high since the bone marrow tries to keep up the rate of destroyed red cells...whyever they were destroyed in the first place)
If you had hemolytic anaemia (only speculation at this point) and no red cell deformity - seen in blood smear under microscope, too - (like sickle cells or thalassaemia that explained it),
a Coombs' test should be done (it checks for antibodies that sit on the surface and destroy red cells at a point)
Usually when too many red cells were destroyed (prior sample taking = hemolytic anaemia), also too much non-conjugated bilirubin would float around, BUT as said: the presence of haemoglobin muddles up the bilirubin test (and shows lower values). If you had already visible skin/eye jaundice, that would be really high bilirubin. So one does not exclude the other (cannot say: ah, you don't have yellowing, it's fine, no hemolytic anaemia because there are different severities and causes.)
Haptoglobin can be measured: it is low in hemolytic anaemia.
You had the glucose-6-phosphate dehydrogenase (G6PD) test and was normal
(I have to say your latest report checked already quite for a number of things like vitamines, thyroid....your GP was doing really well.)
it checks for one reason for hemolytic anaemia (if they are too fragile and break down too quickly, not lasting 3-4 months as they should). Since this G6PD is a genetic disorder, it is more common around certain ethnical groups. You don't have that it seems, one thing excluded.
Exclusions bring you closer to a diagnose. It's not for nothing.
Overall you had a very good start,
but you do need further investigation if your anemia was a non-hemolytic anemia and just due to diet, or if diet was good, why the digestive system didn't get in abundance offered nutrients in (celiac?).
If those two root causes of nutrient issues from outside or digestion/uptake were excluded, further investigation and test interpretations need to be done to exclude organic reasons within your body.
You don't feel well and your report is not normal regarding blood cells itself. (hormones, enzymes tested were beautiful levels, Folate though low.)
Especially interesting would be, if this high hemolysis was just a one off occurence due to wrong sample handling after blood taking (caused in vitro).
You must not have hemolysis. In vivo hemolysis is not normal.
but so far: we don't even know that.
If you want to wait 3 months (since your results cannot change quickly as red cells live 3-4 months usually)
or go back to GP for a referral to hematologist rather now due to time span of symptoms and lab results, is up to you.
Since your iron has improved and only you know, if you changed something (iron supplements, more iron rich veggies plus vitC upon eating), this might help making the decision.
Some GPs get offended,
but point out the duration of anemia and the hemoytic result, which might not just be due to sample handling, an investigation that does not need a 3 month wait. And your symptoms, how bad you feel already.
All all the best!
Since your white cells are low, please be extra careful washing your hands and staying off sick people, you could be more susceptible for infections.
Unfortunately I can't tell you what is going on.
BTW with bit lower platelets and low white blood cell count, the menstruations tend to be heavier and longer.
