Hello, I couldn t establish any diagnosis with the information you ve provided but I ll share some thoughts with you about her condition. Very low hemoglobin values in an otherwise fairly stable patient can be caused by low vitamin B12 values. Vitamin B12 is necessary for blood production. Without B12 the red blood cells become bigger (high mean corpuscular volumes - MCV) and the hematocrit falls. The white blood cells can be affected as well (low numbers and hyper-segmentation). Many patients (usually old) present with a very low hematocrit (and hemoglobin) moaning only about tiredness. If this condition is prolonged then neurological symptoms may ensue. This condition is easily managed with supplemental B12. Neurological symptoms may not be always reversible. Other potential causes exist of course but I could not say for sure, with the limited data you ve provided. I ve just presented you a rather common situation (megaloblastic anemia). I hope I ve helped! If you need further information, I ll be glad to help. Kind Regards!