So worried Iron and HB declining

Tests and investigations
1

Hi,

I need some help with blood tests. My haemoglobin levels in October were 133 a day I stopped taking iron supplements for 4 weeks now. I got retested and now my haemoglobin has dropped to 123.

Should I be concerned? Even with supplementation my HB wasn't rising, just staying stable. But now that I have stopped supplementing, it has dropped so much in a short place of time. My ferritin has also dropped to 66 from 73.

I am so stressed out about this as I haven't been feeling well at all for such a long time now. Could time be that I don't eat a lot of red meat? Is it normal for HB to drop like this?

2

Hi ZZ, should you be concerned? Probably not, since mild anemia is very common and the common causes are modest problems diet, medication side-effects, periods if you're female. BUT I can't make sense out of your results: 133 for hemoglobin isn't low, it's terribly high! Are you sure you haven't left out a decimal place, like it was 13.3 before and now it's 12.3? If it was truly very high, you should *not* be supplementing, so this doesn't make sense.

If you were supplementing because you have had low-ish hemoglobin test before, then why did you stop? Yes, diet can also help - not just red meat/liver, but other sources like spinach and other dark leafy green (take vitamin C with those non-meat iron sources, makes it easier to absorb).

Are you female and menstruating? If so, you should likely be supplementing and/or keeping your dietary intake of iron high, to make up for the blood you are losing monthly.

The drop in ferritin is very small, absolutely NOT anything to worry about or get stressed out over! Really, have you told your doc about your anxiety? That can be an illness itself, and keep you from being able to live your best life. Truly - why waste your energy worrying?

Either way, you should definitely talk to your dr's office about your concern over your test results, and see what they recommend for follow-up. A lot depends on things this forum doesn't know about you, like your age, gender, past medical history, other health complaints. Be assured, mild anemia is very common and the workup for it - including testing for all the many possible causes - is standard procedure for any medical provider.

3

Hi,

Thanks so much for the response. To clarify, I am female, 33 years old. My haemoglobin was 133, but has dropped down to 124 within 3 weeks of stopping supplements. The normal range for haemoglobin is given as 120-150 g/l.

That's why I am concerned as it's fallen so much and is towards the bottom mark.

4

In Canada the normal range for a female is 120-160 g/L. In the US, the range is 12.0-16.0g/L. Perhaps you are in a country that uses the same range as Canada?

I relate very much to your questions, as I have had the very same drop in my hemoglobin, but over the last year. I was at 13.5 (135 according to the scale you are using) last March, and since then have dropped to 12.2 (120). I have had multiple physicians assure me that this is not an issue, and my fears are mostly assauged, but I do occasionally still worry about it, especially since I have dizziness. 

Have your red blood cells dropped as well? Mine went from 4.5 to 4 in the same period of time. My platelets had been down a bit in the summer, but have now risen back up to the level they used to be at.

How are your iron levels, as in stored iron? RBC and hemoglobin reflect circulating iron; you can also have STORED iron tested. If your stored iron is low, then perhaps you have iron deficiency anemia. In that case, ask your doctor what they recommend. Iron deficiency anemia is very common for menstruating women.

Part of my concern was the fact that my stored iron, ferritin and b12 are very much in the normal range, while my RBC and hemoglobin have dropped a bit. But really, not a HUGE amount. If it weren't for the dizziness, which causes me to start looking for answers to why I don't feel better, I would not be worried, I don't think.

Perhaps you should go back to doc and get to the bottom of whether you have iron deficiency anemia (that could be the cause of the hemoglobin drop). 

Anemia can also be caused by chronic disease, but in this case the distinguishing factor is low levels of CIRCULATING iron, as in, RBCs and hemoglobin, and stored iron that is normal. 

I am NOT a doc, so please take my response with a grain of salt and talk with your doc. And if I have gotten any of the these details wrong, I apologize; all of this simply stems from my own research as a result of my own situation.