Haemoglobin 67 g/l -do I need to go to a&e

[lillyrose32shp]

Hi,
I logged into my app to see my blood test result. - I can my haemoglobin is really low. I tried to contact my GP but unable to get through. Would be reasonable for me to a&e or should I wait?

With the additional information - if the GP didn't request the blood test it is not surprising that they don't know about it. Results should be notified to the requesting dr.

There are guidelines from the Royal College of Pathologists (pathologists also deal with lab tests, not just autopsies or looking at biopsies) about the level of results that should trigger an alert.

They suggest that only Hb less than 50 should be notified urgently to the referrer, and Hb below 70 to be notified ONLY if normocytic + normochromic i.e. the rest of the tests do not suggest that it is iron deficiency that has caused this (the OP's case appears to be likely iron deficiency), so no-one in the lab is being careless either.

There is a lot of talk about transfusion, but even for GPs, things have changed hugesly since they were doing the part of their training that was in hospital : I can remember being told when I started training that we should transfuse until Hb reached 100, then 80, and now there is no specific level (in fact in some situations there is evidence that transfusing above 80 can cause harm.

OP, unless you are much more unwell, I'd get some iron tablets and some vitamin C (helps iron absorption) and contact the dept that took the bloods after the weekend.

I’d say A&E but don’t drive yourself, my sister had similar and got a right bollocking off the doctor when they found out she’s driven herself to the hospital. She needed blood transfusions.

Please read the very informative post immediately prior to yours.

Don't go to A&E op.

OP can I just add that if you go and get some iron tablets, make sure you get higher strength ones. You can get ferrous sulfate over the counter after answering a few questions.

No don’t go to A&E, it isn’t an emergency.

People often don’t believe me but at its lowest my HB level was 2.8! I had a full blood test for fertility reasons and got a call from my doctor asking why I hadn’t keeled over dead. We concluded that as I was still walking and functioning fine that my levels had gradually dropped over many many years so that I’d just adjusted to it. I didn’t have a transfusion given I was feeling relatively ok and I took very high doses of iron and had monthly blood tests to monitor me, it took around 6 months for my levels to get up to around 10/11. I now sit at around 8 … I can’t be dealing with the side effects of iron and I feel ok at this level.

Do you mean your iron level as opposed to your hb which is haemoglobin?

No GP's don't

No, that was my HB level. Which is crazy looking back but I genuinely didn’t feel that bad.

They've moved the decimal point in recent years so could it be 28? Not that that sounds feasible either tbh!

28g/L or 2.8g/dL is definitely feasible. It's unusual, but not impossible by any means.

Are you symptomatic? Short of breath, tired, wobbly?

People have very different thresholds for becoming symptomatic; I admitted a man with a Hb of 34 onto my ward, he was chatting away in full sentences and joking around with me, I was absolutely astonished that he was even breathing, let alone the rest. Conversely, my own Hb was 90 after my emergency C-section and I passed out in the shower! Regardless, a Hb of 67 is very abnormal (transfusion threshold is usually around 80) so you really do need to be seen.

That’s why I said in my first post people often don’t believe me! My GP was flabbergasted that I was walking around relatively normally but we ultimately concluded that my levels must just have dropped very slowly over the course of a number of years (20 odd years of vegetarianism at that point probably the main cause). My levels have never been higher than 11 since I’ve been tested. I think I just don’t do HB very well! 🤷‍♀️

Do you know what your ferritin level is out of interest?

Thank you all for your responses. I spoke to the GP. I will going to a&e/ambulatory care tommorrow. I will need to get an iron infusion.

I had similiar and had a level of 43.
Was admitted at height of covid to hospital as emergency and given four blood transfusions.

I was at a private consultants when my results came in.

They told me my GP would be trying to get hold of me to call an ambulance and to let them know I was already in hospital.

My gp actually called me four days later to ask to retest as the results were so low they decided test had been corrupted.

Op, go to A and e

Good, just to say, it does take around 3 weeks to suddenly feel a lot better with an iron infusion, it's not immediate. Glad you're getting that help OP.

I had a level of 4 and was rang by doctor to who had already made apt for transfusion for the next day as he said it was classed as very dangerous (I felt fine, I really did, just a bit tired). GP said he was surprised I was still able to walk but suspected my body was just used to it being so low. Ambulatory care apt on a Saturday morning at 9.00 am, checked my weight again, sent for the infusion, agreed to split it over two weekends so side effects were not as bad as first time I had one a few years before (I have absorption issues hence anaemia).

I left the hospital at around 11.45 am ish. You’ll feel fine straight after - take it easy for a few days and just be kind to yourself.

about 36 hours after having a trx my joints feel like I have barbed wire wrapped round them and I have a couple of hours where I sit and cry because every position is uncomfy. A warm bath and a nice cuppa and painkillers and then try and sleep through as much as you can. You’ll wake up feeling right as rain, but it’ll take time for the transfusion to take effect.

Good luck - in a month or so you’ll look back and realise how truly shit you feel at the moment!

I hope all went well for you today xx