Brief Answer:
Complete blood counts, liver and kidney functions, autoimmune workup needed

Detailed Answer:
H! Welcome to HealthcareMagic! Thanks for sharing your concerns with us. We will try to help you in best way possible.

Based on the history you have shared, to start with, basic blood workup like complete blood count is needed to rule out anemia or condition with low hemoglobin as it can lead to such symptoms and if confirmed, it needs a detailed work up for the cause of low hemoglobin with peripheral film examination, iron levels and it's binding capacity, liver functions to look for any signs of blood breakdown, LDH and folic acid and B12 levels , alongwith keeping bone marrow in plan for later stages to look for any cause of abnormal blood production etc.

Other posibilities like endocrine should be kept in mind and thyroid profile and electrolytes and blood sugars should be monitored as well.

The autoimmune basic work up like ESR, CRP, ANA at start and ENA profile at later states may also be needed. Muscles enzymes like CPK and LDH may also be needed.

Esssential vitamin defficiencies should also be ruled out alongwith any signs of malabsorption. Anti TTG antibody alongwith folic acid, B12, iron etc like we have discussed may also be needed.

Hope this has answered your query, if you have any more questions, feel free to ask. Regards.

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Brief Answer:
Seems like Megalblastic Anemia

Detailed Answer:
Hi! Thanks for the feedback. Like we discussed it to be the prime possibility and diagnosis of Anemia made most sense. Now on the current laboratory reports basis it is most likely megalblastic anemia due to B12 deficiency which can be wither due to low dietary intake or abnormal absorption. Regards.

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