Sudden anaemia in teenage dd

[Pleasedontdothat]

Dd (17) has been having regular blood tests because of medication she’s on. Everything’s been fine, apart from the last test showed a sudden drop in her iron levels, below the threshold for anaemia, when previously she’d been well above it. Her consultant asked for the blood test to be repeated in case the first one was a mistake, but her latest results show her iron levels have dropped even further. DD’s on the pill (necessary for the other medication she’s on) so her periods are very light so it can’t be that. She has been very tired recently and has had a few spells of dizziness but I’d put that down to stress/anxiety (she’s recently been diagnosed with ASD).

Any ideas what could be causing this? Her consultant has referred her to haematology and has asked us to go to the GP on Monday but I’m now facing a weekend of worrying and want to avoid googling ...

It does make sense, her iron levels will have started depleting when she started her periods (even if they are light). She’s got away with a low iron diet for years and it’s just caught up with her.

Vegetarian. Her diet has caught up with her after spending years depleting her iron stores.

She needs to re-look at her diet as she isn't getting enough iron from it. I was vegetarian throughout my teens-twenties and continually anaemic/borderline anaemic. I gave it up eventually.

Also she may think her periods are light but are they really? It's one of those things that you just don't know because you don't see other peoples. I'd have said mine were light. They were not

Tofu, pulses, nuts, leafy green veg, fortified cereals, bread, eggs - all good sources of iron for non meat eaters.

And yes, I know her periods are light - she only had her first period at 14 and it was more than six months before her second. After that they were only every 3-4 months until she started on the pill just before her 16th birthday. Her periods now last 3-4 days and are definitely anyone’s definition of very light. She’s had several normal blood tests since starting her periods too, all of which showed a stable level of haemoglobin so I just don’t think that the scenario of her diet causing steadily depleting iron levels, exacerbated by menstruation can possibly be the case here. The first abnormal test was in October (the last normal one was in April), so whatever’s causing the drop, it’s been quite sudden.

We haven’t got a date for the haematologist yet but I’m speaking to the GP again tomorrow. Thanks for the link ruby29 - the dermatologist didn’t think the roaccutane was the cause but sadly it does appear to be a recognised side effect

So as a female vegetarian her RDA is 32 mg/day.
An egg is 1.9 mg of iron. She'd need the equivalent of 17 eggs/day to get RDA only from eggs. Or 6.7 cups of lentils, or 31 slices of wm bread.
Is she consuming that much iron?

I Doubt she’s consuming enough iron. Plant based sources of iron are hard to digest and vitamins are not a replacement for a healthy diet.

I work with The Iron Clinic. If you want to send her bloods and history to us, a doctor can review them for free.

Agree with what others have said about vegetarian diet being a major factor.

How frequent are her periods? I didn't have very heavy periods but my cycle got a bit messed up and became much shorter (went from 35+ days to 20-25). Nothing else particularly changed in my diet and I'd always had pretty good iron levels but I became anaemic relatively quickly and it's been very difficult to get my iron levels up again.

Her periods are every 28 days as she’s on the pill for roaccutane - very occasionally she skips a period and runs two packets together so she’s certainly not having them more frequently than normal.

Yes she’s vegetarian but she eats a very healthy, varied diet - and up until 3 months ago she was nowhere near being anaemic - I can’t see how her diet could be fine for years, including when she started menstruating, and then suddenly cause her iron levels to plummet. It’s not like it’s been a gradual decline.

Could you ask the consultants to look into whether she could have TTC, it is where the blood cells stop making iron. It is pretty rare but I know of someone who had this not that long ago

Apologies for the typo, I meant TEC