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What Can I Do To Improve The Quality Of My Blood?

Posted on Wed, 5 Feb 2014

Question: Hello, I have performed a full check up, and overall it is good. I just have a little low potassium (3.7), along with a little low calcium in my lumbar area and strange red blood count. I have smaller red cells and in higher quantity with few microcytes, ovalocytes, anisocytes, poikilocytes. Hemoglobin 13.7, Hematocrit 39.7. No iron or b12 deficiency. I am asking what can I do to improve the quality of my blood? I always feel fatigued, i think it is about this irregularities of my blood. I am a male and I exercise every other day, i am 37 year old. Thank you, and happy new year!

Answered by Dr. Robert Galamaga (4 hours later)

Brief Answer: Considerations Detailed Answer: Hello and thank you for submitting your question. I applaud you for maintaining good health with regular physical exercise and encourage you to continue doing so. Thank you for including your laboratory/bloodwork results. Upon reviewing the results, iron deficiency anemia is the most is suspicious cause of your red cell indices and changes. Your changes in red cell shape (a term called "poikilocytosis") which is represented by the presence of microcytes and ovalocytes, and changes in red cell size (a term called "anisocytosis") which is represented by your low MCV and increased RDW, as well as low hematocrit and MCH are all seen an iron deficiency anemia. Also upon reviewing your laboratory results, I did not see iron studies results. My recommendation is to have iron studies performed, as we cannot truly exclude iron deficiency without checking these parameters. Again, thank you for submitting your question. I hope this response is helpful. Sincerely, Dr. G

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (4 minutes later)

Hello, Thanks for your reply. Very appreciated. Actually i checked my iron levels and they seemed to be ok. What ele it can be? Ts

Answered by Dr. Robert Galamaga (13 hours later)

Brief Answer: Folowup Detailed Answer: I do not see a ferritin level. I don't think your doctor ordered a ferritin level. This is actually more important than the iron level.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (11 hours later)

Hello, Ok I will try to have my ferritin checked in few days. So, what if we find out to be low or high? Thanks.

Answered by Dr. Robert Galamaga (14 hours later)

Brief Answer: Folowup Detailed Answer: Low ferritin might indicate iron deficiency. I would recommend that when you get this checked you should do it while fasting. This will be more accurate. Hi ferratin really does not necessarily mean anything for you in this case. 13 can sometimes be elevated when there is infection or inflammation going on. I would doubt this is the case for you. I am looking more for a situation of low ferritin when there is suspicion of iron deficiency. thanks again for sending your question. I look forward to hearing back again from you. Dr. G

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (45 hours later)

I will have my ferritin results in 24 hours. I will update you then. Thanks .

Answered by Dr. Robert Galamaga (2 days later)

Brief Answer: Hello Detailed Answer: Waiting for your result. Have you got the result? Please let me know the result and the lab's reference range. Thanks,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (3 minutes later)

Hello, I have attached my last blood test, i checked also hormones, but ferritin looks to be ok. I have made a lot of research and to me it seems like thalassemia minor, my father is a carrier of thal. What do you think? I also request an hemoglobin study. Thanks.

Answered by Dr. Robert Galamaga (3 days later)

Brief Answer: Hi, Detailed Answer: This is Dr XXXXXXX from WWW.WWWW.WW We sincerely apologise for the delay in the response, Dr Galamaga was and is busy, your query has been forwarded to him. He shall answer it soon and you will read it as soon as possible. regards,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (1 hour later)

Ok i am waiting .

Answered by Dr. Robert Galamaga (11 hours later)

Brief Answer: Followup Detailed Answer: thanks again for sending the information. It is certainly possible that you have a case of thalassemia. In order to adequately determinist hemoglobin electrophoresis is the gold standard study. I would suggest this and a detailed consultation with a local hematologist for further discussion. Tell XXXXXXX is something which is generally well tolerated. There are many different types of thalassemia. Hemoglobin electrophoresis will help to finally determine exactly what might be going on. Thanks again for sending The question. I would be happy to discuss this further with you in detail when you get the results of the additional testing. Dr. G

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (3 minutes later)

Hello, yes, in the meanwhile I did the electrophoresis and I have attached the results. They confirm my thought, i am a beta thal minor. Not sure about the alpha talassemia. Also, what do you think about my ferritin level? Should i be concerned? Thanks

Answered by Dr. Robert Galamaga (3 days later)

Brief Answer: Hi, Detailed Answer: Extremely sorry for late replies. I am travelling frequently hence I am unable to respond in time. B- Thalassemia minor seems appropriate for your situation. I am not worried now about your Ferritin levels. They were found to be normal. The Transferrin saturation is also within normal limits. So it may not be Iron deficiency. It is common that sometimes physicians mistake it for Iron deficiency as the blood picture remains same. However Beta Thal minors would have high possibility of Iron deficiency. So keep checking it. I suggest to take Oral folic acid regularly for such patients. You may want to get mutational analysis/Gene testing for alpha Thalassemia and dominant genes after verifying with your doctor. Sorry again. You may discuss with any other physician if I am not answering you soon.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Robert Galamaga (35 minutes later)

Hello, No problem, thanks for your time, i also travel a lot. Actually i am worried about my high ferritin level, i also have mild fatty liver, i just dont want to end like my grand father who died of chirrosis. May i have a bit of iron over load in my liver? That's the ladt question, then i will accept your reply. Thank you.

Answered by Dr. Robert Galamaga (3 days later)

Brief Answer: Followup Detailed Answer: hello again. I don't mind answering follow-up questions at all. I want to make sure you have full understanding of your current state of health. At this point I don't really see evidence of iron overload. completely understand your concern in light of the family history of cirrhosis. As long as your doctors continue to follow you want a regular basis and check interval blood tests then we can be sure that any changes will be found early. Thanks again for sharing your health care concern with me. Again I am available to discuss this or any other issue at length with you. Dr. G

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar