Low haemoglobin, low haemocrit but ferritin etc ok....can anyone advise?

[Temm]

I have been feeling awful for ages so hoping this is why and that it can be treated. Can anyone advise? GP appointment isn't for weeks 😫

B12 deficiency?
Are you vegan/vegetarian/have a poor diet in general?

@PickNewName B12 came back ok. I am pescetarian and eat reasonably well. Ferritin is ok so not low iron as such.

What's your ancestry? Thalassaemia trait can present like this.

the results need to be interpreted in the context of the whole FBC and your symptoms/examination. Ferritin can be affected by things other than iron; haematocrit may also not be that useful and there's quite a bit more in a standard FBC that may suggest what's going on.

@nocoolnamesleft Im white european

@Greybeardy Context is that all other FBC results were normal. I have axial spondyloarthritis, an inflammatory condition so wonder if that is relevant? No other obvious issues.

Did you also have blood film done? Transferrin? Could be the inflammatory condition makes it more difficult for your bloods to carry good amount of oxygen around. I was undiagnosed for a while with low HGB - at the time they just put it down to an ‘underlying inflammatory condition’. But I also then had a high retic count (more new blood than expected). So they then were investigating where I was losing blood from.

@Wildspace Was your low HGB treated at all? Or did they look into why it was low? Found on google that there is such a thing as inflammatory anemia so I am wondering if this is relevant to me since I have definitely been in flare since Christmas. Do you mind me asking what your 'underlying inflammatory condition' is? I have axial spondyloarthritis, an inflammatory arthritis that causes pain and fatigue. Had put my severe fatigue down to that, but the blood results have me wondering if theres more to it.

5 years later - yes I had another GP who was determined to get to the bottom of it and we went through the process of ruling everything out so I’ve been through many investigations. By that time I was post menopausal so blood renewal couldn’t be blamed on heavy periods. Found an enlarged spleen and then diagnosed with a chronic blood cancer but it’s quite inflammatory. I manage the haemoglobin with lifestyle (prioritise sleep, no alcohol, as well as supplements). While it’s responding ok I’d prefer not to medicate. How low is low for you?

But please don’t let my diagnosis worry you. It was more that it wouldn’t be a surprise that inflammatory diseases led to anemia for some people. Best to speak with your specialist about how to manage it.

anaemia isn't uncommon at all in chronic inflammatory conditions (called anaemia of chronic disease). It is different to iron deficiency anaemia but you can have both. Ferritin may not as helpful as an indicator of iron stores in chronic inflammatory illnesses.

@Wildspace My haemoglobin is 111g/l (range is 120-150) and my haematocrit is 0.34 (range is 0.37 - 0.45)

I have a horrible feeling that this may not be considered especially low. My haemoglobin was at 119 g/l a couple of years ago and I was told by a GP that he wasn't at all concerned about that since it was only just under the cut off. Despite the fact I felt rubbish. If he says that this time I may well scream. If I had the energy 😩

I hope your recovery continues to go well wildspace x

@Temm just come across this. I have AxSpa too so much sympathy. My crushing tiredness was probably my almost non existent Vit D. My FBC looks similar to yours - borderline anaemia but story of my life and normal for me (I don't store iron it would seem). Vit D has to be requested so worth asking?