Have you ever been told that an older relative has anemia, and wondered about anemia symptoms?
Or perhaps you noticed the red blood cell count flagged as “low” in the bloodwork report? Or noticed “low hemoglobin” in a doctor’s report?
Anemia means having a red blood cell count that is lower than normal, and it’s very common in older adults. About 10% of independently living people over age 65 have anemia. And anemia becomes even more common as people get older.
But many older adults and families hardly understand anemia.
This isn’t surprising: anemia is associated with a dizzying array of underlying health conditions, and can represent anything from a life-threatening emergency to a mild chronic problem that barely makes the primary care doctor blink.
Still, it worries me that older adults and families don’t know more about anemia. If you or your relative has this condition, it’s important to understand what’s going on and what the follow-up plan is. (I’ve so often discovered that a patient didn’t know he or she had had anemia!) Misunderstanding anemia can also lead to unnecessary worrying, or perhaps even inappropriate treatment with iron supplements.
And since anemia is often caused by some other problem in the body, not understanding anemia often means that people don’t understand something else that is important regarding their health.
Fortunately, you don’t have to be a doctor to have a decent understanding of the basics of anemia.
This post will help you understand:
- How anemia is detected and diagnosed in aging adults.
- Symptoms of anemia.
- The most common causes of anemia, and tests often used to check for them.
- What to ask the doctor.
- How to get better follow-up, if you or your relative is diagnosed with anemia.
Defining and detecting anemia
Anemia means having a lower-than-normal count of red blood cells circulating in the blood.
Red blood cells are always counted as part of a “Complete Blood Count” (CBC) test, which is a very commonly ordered blood test.
A CBC test usually includes the following results:
- White blood cell count (WBCs): the number of white blood cells per microliter of blood
- Red blood cell count (RBCs): the number of red blood cells per microliter of blood
- Hemoglobin (Hgb): how many grams of this oxygen-carrying protein per deciliter of blood
- Hematocrit (Hct): the fraction of blood that is made up of red blood cells
- Mean corpuscular volume (MCV): the average size of red blood cells
- Platelet count (Plts): how many platelets (a smaller cell involved in clotting blood) per microliter of blood
(For more information on the CBC test, see this Medline page. For more on common blood tests, see Understanding Laboratory Tests: 10 Commonly Used Blood Tests for Older Adults.)
By convention, to detect anemia clinicians rely on the hemoglobin level and the hematocrit, rather than on the red blood cell count.
A “normal” level of hemoglobin is usually in the range of 14-17gm/dL for men, and 12-15gm/dL for women. However, different laboratories may define the normal range slightly differently.
A low hemoglobin level — meaning, it’s below normal — can be used to detect anemia. Clinicians often confirm the lower hemoglobin level by repeating the CBC test.
If clinicians detect anemia, they usually will review the mean corpuscular volume measurement (included in the CBC) to see if the red cells are smaller or bigger than normal. We do this because the size of the red blood cells can help point doctors towards the underlying cause of anemia.
Hence anemia is often described as:
- Microcytic: red cells smaller than normal
- Normocytic: red cells of a normal size
- Macrocytic: red cells larger than normal
Symptoms of anemia
The red blood cells in your blood use hemoglobin to carry oxygen from your lungs to every cell in your body. So when a person doesn’t have enough properly functioning red blood cells, the body begins to experience symptoms related to not having enough oxygen.
Common symptoms of anemia are:
- fatigue
- weakness
- shortness of breath
- high heartrate
- headaches
- becoming paler, which is often first seen by checking inside the lower lids
- lower blood pressure (especially if the anemia is caused by bleeding)
However, it’s very common for people to have mild anemia — meaning a hemoglobin level that’s not way below normal — and in this case, symptoms may be barely noticeable or non-existent.
That’s because the severity of symptoms depends on two crucial factors:
- How far below normal is the hemoglobin level?
- How quickly did the hemoglobin drop to this level?
This second factor is very important to keep in mind. The human body does somewhat adapt to lower hemoglobin levels, but only if it’s given weeks or months to do so.
So this means that if someone’s hemoglobin drops from 12.5gm/dL to 10gm/dL (which we’d generally consider a moderate level of anemia), they are likely to feel pretty crummy if this drop happened over two days, but much less so if it developed slowly over two months.
People sometimes want to know how low the hemoglobin has to be for anemia to be “severe.” This really depends on the past medical history of the person and on how fast the hemoglobin dropped, but generally, a hemoglobin of 6.5 to 7.9 gm/dL is often considered “severe” anemia.
People also sometimes want to know how low can hemoglobin go before causing death. In general, a hemoglobin less than 6.5 gm/dL is considered life-threatening. But again, how long the body can tolerate a low hemoglobin depends on many factors, and including whether the hemoglobin is continuing to drop quickly (due an internal bleed, for instance) or is slowly drifting down. A study of Jehovah’s Witnesses who died after refusing transfusions found that those with hemoglobins between 4.1 to 5 gm/dL died, on average, about 11 days later.
The most common causes of anemia in aging adults
Whenever anemia is detected, it’s essential to figure out what is causing the low red blood cell count.
Compared to most cells in the body, normal red blood cells have a short lifespan: about 100-120 days. So a healthy body must always be producing red blood cells. This is done in the bone marrow and takes about seven days, then the new red blood cells work in the blood for 3-4 months. Once the red blood cell dies, the body recovers the iron and reuses it to create new red blood cells.
Anemia happens when something goes wrong with these normal processes. In kids and younger adults, there is usually one cause for anemia. But in older adults, it’s quite common for there to be several co-existing causes of anemia.
A useful way to think about anemia is by considering two categories of causes:
- A problem producing the red blood cells, and/or
- A problem losing red blood cells
Here are the most common causes of low hemoglobin for each category:
Problems producing red blood cells. These includes problems related to the bone marrow (where red blood cells are made) and deficiencies in vitamins and other substances used to make red blood cells. Common specific causes include:
- Chemotherapy or other medications affecting the bone marrow cells responsible for making red blood cells.
- Iron deficiency. This occasionally happens to vegetarians and others who don’t eat much meat. But it’s more commonly due to chronic blood loss, such as heavy periods in younger women, or a slowly bleeding ulcer in the stomach or small intestine, or even a chronic bleeding spot in the colon.
- Lack of vitamins needed for red blood cells. Vitamin B12 and folate are both essential to red blood cell formation.
- Low levels of erythropoietin. Erythropoietin is usually produced by the kidneys, and helps stimulate the bone marrow to make red blood cells. (This is the “epo” substance used in “blood doping” by unethical athletes.) People with kidney disease often have low levels of erythropoietin, which can cause a related anemia.
- Chronic inflammation. Many chronic illnesses are associated with a low or moderate level of chronic inflammation. Cancers and chronic infections can also cause inflammation. Inflammation seems to interfere with making red blood cells, a phenomenon known as “anemia of chronic disease.”
- Bone marrow disorders. Any disorder affecting the bone marrow or blood cells can interfere with red blood cell production and hence cause anemia.
Problems losing red blood cells. Blood loss causes anemia because red blood cells are leaving the blood stream. This can happen quickly and obviously, but also can happen slowly and subtly. Slow bleeds can worsen anemia by causing an iron-deficiency, as noted above. Some examples of how people lose blood include:
- Injury and trauma. This can cause visibly obvious bleeding, but also sometimes causes people to bleed into a space inside the body, which can be harder to detect.
- Chronic bleeding in the stomach, small intestine, or large bowel. This can be due to many reasons, some common ones include:
- taking a daily aspirin or non-steroidal anti-inflammatory drug
- peptic ulcer disease
- cancer in the stomach or bowel
- Frequent blood draws. This is mainly a problem for people who are hospitalized and getting daily blood draws.
- Menstrual bleeding. This is usually an issue for younger women but occasionally affects older women.
There is also a third category of anemias, related to red blood cells being abnormally destroyed in the body before they live their usual lifespan. These are called hemolytic anemias and they are much less common.
A major study of causes of anemia in non-institutionalized older Americans found the following:
- One-third of the anemias were due to deficiency of iron, vitamin B12, and/or folate.
- One-third were due to chronic kidney disease or anemia of chronic disease.
- One-third of the anemias were “unexplained.”
How doctors evaluate and diagnose anemia
Once anemia is detected, it’s important for health professionals to do some additional evaluation and follow-up, to figure out what might be causing the anemia.
Understanding the timeline of the anemia — did it come on quickly or slowly? Is the red blood count stable or still trending down with time? — helps doctors figure out what’s going on, and how urgent the situation is.
Common follow-up tests include:
- Checking the stool for signs of microscopic blood loss
- Checking a ferritin level (which reflects iron stores in the body)
- Checking vitamin B12 and folate levels
- Checking kidney function, which is initially done by reviewing the estimated glomerular filtration rate (included in most basic bloodwork results)
- Checking the reticulocyte count, which reflects whether the bone marrow trying to produce extra red blood cells to compensate for anemia
- Checking levels of an “inflammation marker” in the blood, such as the erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
- Evaluation of the peripheral smear, which means the cells in the blood are examined via microscope
- Urine tests, to check for proteins associated with certain blood cell disorders
If the anemia is bad enough, or if the person is suffering significant symptoms, doctors might also consider a blood transfusion. However, although even mild anemia has been associated with worse health outcomes, research suggests that transfusing mild to moderate anemia generally isn’t beneficial. (This issue especially comes up when people are hospitalized or acutely ill.)
What to ask the doctor about anemia
If you are told that you or your older relative has anemia, be sure you understand how severe it seems to be, and what the doctors think might be causing it. This will help you understand the plan for follow-up and treatment.
Some specific questions that can be handy include:
- How bad is this anemia? Does it seem to be mild, moderate, or severe?
- What do you think is causing it? Could there be multiple causes or factors involved?
- How long do you think I’ve had this anemia? Does it seem to be stable or is it getting worse?
- Is this the cause of my symptoms or do you think something else is causing my symptoms?
- Could any of my medications be involved?
- What is our plan for further evaluation?
- What is our plan for treating this anemia?
- When do you recommend we check the CBC again? What is our plan for monitoring the anemia?
Be sure to request and keep copies of your lab results. It will help you and your doctors in the future to be able to review your past labs related to anemia and any related testing.
Avoiding common pitfalls related to anemia and iron
A very common diagnosis in older adults is iron-deficiency anemia. If you are diagnosed with this type of anemia, be sure the doctors have checked a ferritin level or otherwise confirmed you are low on iron.
I have actually reviewed medical charts in which a patient was prescribed iron for anemia, but no actual low iron level was documented. This suggests that the clinician may have presumed the anemia was due to low iron.
However, although iron deficiency is common, it’s important that clinicians and patients confirm this is the cause, before moving on to treatment with iron supplements. Doctors should also assess for other causes of anemia, since it’s very common for older adults to simultaneously experience multiple causes of anemia (e.g. iron deficiency and vitamin B12 deficiency).
If an iron deficiency is confirmed, be sure the doctors have tried to check for any causes of slow blood loss.
It is common for older adults to develop microscopic bleeds in their stomach or colon, especially if they take a daily aspirin or a non-steroidal anti-inflammatory drug (NSAIDs) such as ibuprofen. (For this reason — and others — NSAIDs are on the Beer’s list of medications that older adults should use with caution.)
Bear in mind that iron supplements are often quite constipating for older adults. So you only want to take them if an iron-deficiency anemia has been confirmed, and you want to make sure any causes of ongoing blood loss (which causes iron loss) have been addressed.
Key points on anemia in older adults
Here’s what I hope you’ll take away from this article:
1.Anemia is a very common condition for older adults, and often has multiple underlying causes.
2. Anemia is often mild-to-moderate and chronic; don’t let the follow-up fall through the cracks.
3. If you are diagnosed with anemia or if you notice a lower than normal hemoglobin on your lab report, be sure to ask questions to understand your anemia. You’ll want to know:
- Is the anemia chronic or new?
- Is it mild, moderate, or severe?
- What is thought to be the cause? Have you been checked for common problems such as low iron or low vitamin B12?
4. If you are diagnosed with low iron levels: could it be from a small internal bleed and could that be associated with aspirin, a non-steroidal anti-inflammatory medication such as ibuprofen, or another medication?
5. Keep copies of your lab reports.
6. Make sure you know what the plan is, for following your blood count and for evaluating the cause of your anemia.
Note: We have reached over 200 comments on this post, so comments will now be closed. If you have a question, chances are it’s already been asked and answered. Thank you!
You may also find it helpful to read these related articles:
Understanding Laboratory Tests: 10 Commonly Used Blood Tests for Older Adults
How to Avoid Harm from Vitamin B12 Deficiency
This article was first published in 2016 & minor updates were made in May 2024. (The fundamentals of anemia in older adults don’t change much over time.)
Nik says
I m 19 yrs… And my haemoglobin had fallen to 6.5 suddenly… What can be the reason for this
Leslie Kernisan, MD MPH says
Sorry to hear of your hemoglobin drop. I have listed the main reasons in the article. The more common causes are a little different in people your age than in older adults. I would recommend you ask your doctor to explain what might have caused your anemia. good luck!
john says
Perhaps I should have finished info on my recent iron panel: Iron level 151mcg/dL
Iron Binding Capacity 231/ mcg/dL; Iron level 151 mcg/dL; Ferritin 79; Transferrin 165.
Thanks, john
Leslie Kernisan, MD MPH says
Hm, this is the only comment I see from you. Not sure what your question is, but in general your iron level and ferritin appear to be in normal range, so if you’re concerned about anemia, iron-deficiency would seem less likely as a cause. I would recommend discussing your questions with your usual health providers.
john says
This is my third attempt to re-post the preamble of the above:
I am 63 year old Hemochromatosis pt. Routine phlebotomies over the past three years resulted in a drop in ferritin from 1300 to below 50. However, I have not been able to continue my treatment in the past year due to low HCT (38.6%) and HGB (13.2). My ferritin is up to 79 with Iron Binding Capacity 231/ mcg/dL; Iron level 151 mcg/dL; Transferrin 165. I had recent neg. occult blood test. My blood pressure fluctuates between low and high. Recently it has mostly been low 110/62. But in the past month it has gone as high as 160/99. (all resting readings). I feel mildly anemic or maybe just old. I have otherwise maintained athletic physical condition (normal BMI). I push myself. Should I be concerned? I have taken B-12 for past year. I have also maintained a ketogenic diet for past three years. Recently I would call it low carb/high fat diet. That is, I don’t worry about staying in Ketosis anymore.
I hope this post finally shows up. I am eager to hear another opinion.
john says
I am also wondering if I would be considered “Iron Avid” at this point. My physiology works at storing rather than using iron. Possible?
Leslie Kernisan, MD MPH says
Sorry if you’ve had difficulty posting to the site; we are planning to eventually change the commenting system but it’s not something that can be changed easily.
Unfortunately, I don’t know much about hemochromatosis. I would recommend that you consult with a hematologist or other expert with training in the management of this condition. In general, if your blood count is trending downward, that does sound like an issue that merits further investigation. Keep asking your doctors lots of questions and good luck!
Debra says
My 90 year old mother has fallen twice within the last 6 weeks. Her most recent fall needed a trip to ER (CT scans and exams were performed). She was sent home with tx of ice packs for swelling on her cheekbone. 4 days ago, after her re-check w/her internist, she was sent to ER ASAP due to the 6.2 g/dl hemoglobin result (CBC drawn that morning). Two pints blood transfusion given. She is an Alzheimer’s pt. with hx of TIA, hypertension and adult onset diabetes. Among other meds, she is on Plavix and aspirin. My father, mother and I are seeing her MD in 6 days and I am hoping you can advise me of some pertinent questions to ask him.
Thank you in advance for any guidance you can offer us and for your website.
Leslie Kernisan, MD MPH says
Well, a hemoglobin of 6.2 certainly is quite low. Since she had been evaluated at the ER four days prior, I would guess they’d checked her CBC then as well, and so her blood count dropped after that first ER visit? Some questions you could ask:
– What do they think is the cause of her drop in hemoglobin? Has this resolved? What is the plan for following this?
– Blood-thinners such as Plavix and to a lesser extent aspirin are risky for older adults who fall, because they increase the risk of bleeding after a fall. How important is it for your mother to continue these medications? Why is she on them? What would be the risks to her health if she were to stop taking those medications? Has your mother perhaps reached a stage in her life and health in which the risks of these medications (which tend to go up as people get older) may be outweighing the likely benefits (which tend to get smaller as people get older and frailer)?
– What do they think is causing or contributing to your mother’s falls? Has she been evaluated for causes that could perhaps be corrected or addressed, such as medication side-effects or low leg strength?
We have more articles on evaluating and preventing falls: Preventing Falls in Aging Adults
You don’t say how far along your mother’s Alzheimer’s is. I do have an article on anticipating future decline, it may give you ideas on what to discuss with her doctors: How to Plan for Decline in Alzheimer’s Dementia:A 5-Step Approach to Navigating Difficult Decisions & Crises with Less Stress.
Good luck, I hope these ideas help!
Michael Reed says
Hi,
I am 60 years old, and have anemia. Numbers have been in steady decline for a year or more. I started low calorie dieting Sept 28 of last year. I tracked cals, carbs, fat, fiber, & protein, and kept all in balance, albeit low. I switched from loss mode to maintenance mode in March of this year. I dropped from 265 to 160. During that time my hct went from 43.4 to 37.8, hgb 14.9 to 12.8,rbc from 4.74 to 3.87 mcv from 91.5 to 97.6. My stool cards last month were normal. I take a multi vit daily, as well as a b complex, osteo biflex, calcium magnesium & zinc, & vit C, twice a day fish oil & vit E. I also take a low dose aspirin, 100mg diclofenic, amlodipine 5mg, hydrochlorothiazide 25mg, rosuvostatin 5mg, & omeprazole 40mg, once daily. Iron is at 55, no previous to compare, B-12 is at 477, Folic acid is above 20, actual number not given, feritin at 247. Latest bloodwork was done this week. Docs office called me last night, wants me to get fully scoped, both ends, ASAP, said the surgeons office would call me today to schedule. The girl that called me got very very insistent when said I might be hard to reach today, due to work.
Bottom line, now I’m scared. What am I likely facing?
Leslie Kernisan, MD MPH says
Well, it’s impossible for me to say what you are likely facing. I can certainly see why it’s alarming to have the medical office being so insistent in this way, hopefully they will explain themselves soon. Losing 100 pounds in 9 months is a lot of weight loss, I wonder if that is part of their concern.
I would recommend you ask them to explain what is their current thought regarding the cause of your anemia. You can also ask if they are concerned that your weight loss might be due to something other than your dieting, and you can ask them to clarify what is the purpose of the scoping they are proposing. Good luck!
Michael Reed says
Thanks 🙂
Testing is the 29th, guess I’ll find out then. I’ve come to terms with it, it will be what it will be & I’ll dael with whatever it ends up being, jus had me rattled for a bit, I’m ok now, thanks again.
Carolyn says
I was diagnosed with anemia after my hemoglobin reached a red flag level. On looking at my history my hemoglobin had actually been dropping slowly over a period of years. I suffered from exhaustion and sob with minor exertion. Last year I also had severe GERD esophagitis with probable bleeding. It was treated and after total scopes, there was no bleeding found.
I am now taking iron, folic acid and B12 as of a few weeks ago. I still have the sob but am not as tired. My doc says it took some time to get to the present stage and that it may take some time before my system returns to normal.
Does that sound reasonable and I should give it time? My heart and lungs have both been checked out and are normal.
Thank you for all the wonderful information you provide for us ol’ folks!!
Leslie Kernisan, MD MPH says
Yes, shortness of breath (SOB) can be caused by anemia, but it can also be caused by any number of heart or lung conditions, so it’s good you had those evaluated.
You don’t say whether your hemoglobin has returned to a normal level or not. If your red cell count is normal, then I’m not sure you should assume that any fatigue or shortness of breath with exertion is due to your past anemia, because as far as I know, those symptoms resolve fairly quickly once the blood count is normal.
There are, of course, many other reasons to feel fatigue. And some people feel short of breath with exertion because they are out of shape. In fact, if you were slowly getting more anemic over years, you may have been restricting your activity and so even if your heart and lungs are “normal,” it would be possible to have low cardiovascular fitness.
I would recommend discussing your current symptoms with your doctor. Good luck!
Carolyn says
My hemoglobin has returned to the bottom edge of the normal range but I still suspect that since it had been dropping for years that my iron was so low that it has not nearly returned to normal.
My doc suggested that I try some walking – just a short time and try to add time. I know that have not been physically active for some time so even if anemia was the base cause, I know that I am now deconditioned also.
Thank you for all the time you give to helping us deal with the perils of aging. Bless you!!!
Jeff Wren says
Hello
In late October 2017 I was diagnosed with Anaplasmosis. I spent 4 nights in the hospital-the first 4 of my now 69 years. My CBCs revealed very low numbers for red cell, hemoglobin, iron etc along with near critical white cell and platelet counts. With antibiotics things got turned around. They said that the stamina related #s (anything related to red cells) would be slower to come back than the others. They continued to do CBCs until mid December. Things moved in the right direction but were still low. I was changing primary care doctors at this time due to a retirement. I had a physical scheduled with him in early March. They took blood at that time but did not do a CBC! I was told that since I was moving in the right direction in December, they didn’t see a need. I am well known for my stamina among my friends and peers. For example, in October 2016 I did a Rim-to-Rim hike in the Grand Canyon without ever sitting down. I can do stuff like that, normally. I m very active and know my body, and I know it isn’t right. I finally requested a CBC in April. Most of the numbers were lower than in December. The doctor immediately prescribed iron. (I had been taking a vitamin with iron since October). I started that but then I looked closer at the test results and noted that my iron is no longer low, it is toward the high end of normal (160). The hemoglobin is 12.1. My transferrin saturation is 53% with was indicated as high. A quick internet search says that high transferrin saturation is a sign of iron overload. So I am wondering whether I should be taking iron? Is the slow recovery of red cell related numbers to be expected with Anaplasmosis? I know my body is not right. Thank you if you are able to help.
Leslie Kernisan, MD MPH says
Anaplasmosis is an uncommon disease caused by a bacteria carried by ticks. I don’t have any experience with it, so not able to say what is usual during recovery. You may need to contact an expert in this disease to get your questions answered.
I do agree that the iron test results you share aren’t consistent with iron deficiency. I would recommend discussing this with your doctor and asking them whether you still should take iron. Good luck!
Jeff Wren says
Thank you very much for your reply. It seems that you have a lot of company regarding experience with Anaplasmosis. It has been a real challenge to find any definitive information. You mentioned that I may want to consult an expert on this disease. Do you have any suggestions as to where I might find one?
Leslie Kernisan, MD MPH says
You could try calling the hematology and also infectious disease departments of your local academic medical center, to see if any of the clinicians specialize in this condition. You can also search Pubmed to see which doctors are publishing research on anaplasmosis. good luck!
Jaime says
Hi,
I am a 41 year old female recently diagnosed with iron deficiency anemia. I was very fatigued, had horrible sensations in my head, dizziness, insomnia, heart palpitations, and my legs hurt really bad. I had two iron infusions and my levels returned to normal. I am no longer fatigued, I have no more palpitations and my legs don’t hurt anymore, however, I am still having those sensations in my head accompanied by some dizziness. How long should this last? How long does it take after your blood returns to normal for all symptoms to subside?
Leslie Kernisan, MD MPH says
Sorry to hear of your recent anemia. I’m not a hematologist and I’m not very familiar with the type of head symptoms you are describing. For more typical anemia symptoms (fatigue, shortness of breath, high heart rate), these improve quite quickly once the red blood cell count is brought back up.
I would recommend asking your doctors about your persisting dizziness and head sensations. You may also want to talk to them about why you became iron-deficient in the first place. If your doctors aren’t sure, you may want to consult with a hematologist. Good luck!
Pooja says
Hello,
My dad is 84 years old of Indian origin. He is hypertensive and also has angina. A few weeks back he had diarrhoea which led to dehydration and was thus hospitalised. The stool test confirmed salmonella and following antibiotic treatment he recovered. However follows this episode he had atrial fibrillation with heart rate reaching 150 at times. The doctor started him on digoxin and eliquis for blood thinning. His appetite was affected and he lost almost 5 kg due to this illness. His last blood report showed haemoglobin 119 where normal was 138 and above, his iron was 10.3 whereas normal is between 10.4-28. Now the thing is he’s always been slightly anaemic when he was in India the doctors in England have referred him to a colorectal specialist for investigation. I understand this is protocol but his reports of last two years show the same haemoglobin level and there hasn’t been any change. So my question is does he need to see a specialist for investigation or since he’s been through the salmonella infection this iron level is expected. Thanks
Leslie Kernisan, MD MPH says
Hm, a hemoglobin of 119 doesn’t really make sense but perhaps you mean 11.9. That is a little low for a man and could be consistent with his history of “always been slightly anemic.” His iron level is quite close to the normal range as well.
I don’t know if the salmonella infection would be expected to affect his iron levels. I would recommend asking his doctors this question, and also asking them to explain in more detail why they think further evaluation is likely to benefit him. You may also want to ask if they are concerned that he might bleed due to his new blood thinner.
For the most part, if you are hesitating about pursuing additional evaluations recommended by health providers, the thing to do is ask “what is the downside of not doing this, or not doing this now? Is there another way to monitor things for now?”
Good luck!
Dorothy STainbrook says
Hi there (and thank you for the informative article and responses).
I am a 65 year old female and in great health (I thought). Out of curiosity I started taking my blood tests and have become concerned about anemia. I am quite active and not tired at all but my Hb ranges from 8.1 to 14 and my HCT ranges from 26% to 38%. This seems quite low, but with no obvious symptoms or fatigue or weakness I wonder if I need to explore it further? I have always had fairly low blood pressure.
I climb mountains, work on a farm, exercise regularly and am fairly lean. I do practice a low carb diet. I am confused about my feeling of good health and yet the low blood markers. Can you help me understand?
Leslie Kernisan, MD MPH says
Hm. It is normal for everyone’s blood counts to fluctuate a bit, but what you describe is a really big range. (You don’t say over how much time these results have been gathered.)
A hemoglobin of 14 is normal but a hemoglobin of 8 would be considered pretty substantial anemia. (It would also often cause symptoms, like fatigue on exertion.) If someone usually has normal numbers but has a single low value, we often attribute it to lab error, and in fact, for any abnormal result of concern, a common next step is to repeat it to make sure it is “real.”
Especially if your recent results have been abnormal, I would encourage you to discuss it further with your usual health provider, even if you are feeling well. They will probably want to consider what the trend has been with your results and how fast it has been changing. They can then advise you as to what the next steps should be. Good luck!
Auriol Hayes says
I have been told I have anemia blood count 10.00 I am 71, I have had a sigmoidoscopy, a virtual colonoscopy I am due to have a gastrostomy next week, the sigmoidoscopy was OK, have had the results of the scan yet, I also have bad nights sweats could you give me any advice
Leslie Kernisan, MD MPH says
I don’t have any advice beyond what I have written in the article and other comments. Ask your doctors to explain what they think is the cause of your anemia and you may want to ask if you show signs specifically of iron deficiency. There are many potential causes for night sweats, you should discuss with your doctor and you can ask if your doctor thinks it’s likely to be related.