
Initial Hemogram Submitted Recent Hemogram Submitted Moderate Gastritis No Active

recent hemogram submitted
moderate gastritis no active bleeding, negative colonoscopy, heavy ppi use many years
what is my diagnosis, advice
Considerations
Detailed Answer:
Hello and thank you for sending the question.
I have reviewed all of your laboratory studies and I can say that the complete blood count is most suggestive of iron deficiency. It is possible that you have been losing some iron if you have had gastritis going on. Gastritis can lead to a mild bit of upper gastrointestinal bleeding. I would recommend that you discuss this with your primary care physician.
In addition, your prior history of surgery involving the stomach can sometimes make it difficult to absorb iron adequately. If this is the case, your doctor might recommend referral to a blood specialist or hematologist who could consider giving you intravenous iron supplementation.
The elevated GFR in your case does not show any type of disease process. We usually worry if the GFR is very low.
Also your doctor checked the PTH level. Yours is only very slightly elevated. This is something that would generally be checked again in 2 or 3 months. Your prolactin level was slightly elevated as well. This finding can sometimes suggest that an MRI of the brain might be reasonable to look for problems with the pituitary gland. Sometimes a small growth in the pituitary gland or adenoma can cause elevations of the prolactin level which can affect the PTH level as well.
Thank you again for sharing her laboratory results. I think the main thing is to help restore your iron levels. This will improve your hemoglobin count and it will also help to restore your platelet count back to normal. Interestingly, the platelet count can rise in the setting of iron deficiency.
I wish you all the best and continued excellent health.
Sincerely,
Dr. Galamaga


Thank you


Follow-up
Detailed Answer:
Hello again. The platelet count will sometimes go up in the setting of iron deficiency. It is not always easy to predict. In addition it is difficult to predict when the platelet count will return to normal. Often this occurs over a number of months. Your body has to get used to the iron supplementation and come to a new steady state.
There is not always a direct correlation between low ferritin and high platelet count. However, this is a phenomenon that I have observed in my practice.
It is possible that your prior gastrointestinal bleeding depleted your iron stores. However, I think it is important to make sure that you discuss with your doctors whether there might be a concern about some type of ongoing slow bleeding going on which would explain your low iron levels.
Thank you again for sharing your health care concerns.
Sincerely,
Dr. Galamaga

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