Google Answers Logo
View Question
Q: blood anemia ( Answered,   1 Comment )
Subject: blood anemia
Category: Health > Conditions and Diseases
Asked by: jobo007-ga
List Price: $75.00
Posted: 14 May 2003 20:10 PDT
Expires: 13 Jun 2003 20:10 PDT
Question ID: 203916
I am a adult male, age 54, with red blood cell anemia starting with a
Hct 42.7,Hbg 16.6 on 28 apr. 2000 which on 10 apr 2003 is Hct 34.5,Hbg
12.1 what is cause.

Request for Question Clarification by justaskscott-ga on 14 May 2003 21:10 PDT
Did you ask this question to a doctor?  What did the doctor say?

Request for Question Clarification by synarchy-ga on 14 May 2003 22:59 PDT
Hello -

I would be glad to help you with this question, but I would require a
little more information to provide you with the best answer.

Do you have any of the other values from your blood test - ie, MCV
(mean corpuscular volume), MCH (mean corpuscular hemoglobin), etc... -
these values will help greatly in suggesting possible causes.  Do you
have any iron study lab results?

Also, have you had any recent injuries, surgeries, blood transfusions,
or received IV fluids for any reason?  Do you have any other medical
conditions, kidney dysfunction, diabetes, lupus, etc...

What was the purpose of the blood draws in 2000 and 2003 that showed
this change?

While an answer to this question should not substitute for seeing a
physician, if you provide the above information I could certainly
suggest possible causes.
Subject: Re: blood anemia
Answered By: kevinmd-ga on 15 May 2003 08:21 PDT
Hello - thanks for asking your question.     
Although I am an internal medicine physician, please see your primary
care physician for specific questions regarding any individual cases –
please do not use Google Answers as a substitute for medical advice.
I will be happy to answer factual medical questions.  
What you are describing is anemia.  This is defined as a reduction
below normal in the number of red blood cells (RBCs) in the
circulation.  There are many, many causes for this, and I will briefly
describe the major causes as well as suggest a recommended course of

Loss of RBC cells is generally from one of three mechanisms: 
decreased RBC production, increased RBC destruction, and RBC loss.

1) Decreased RBC production
Causes of decreased RBC production include the following:
- Lack of nutrients, such as iron, B12, or folate
- Primary involvement of the bone marrow, such as occurs in aplastic
anemia, pure RBC aplasia, myelodysplasia, or infiltration with tumor
- Suppression of bone marrow function secondary to drugs, cancer
chemotherapy, or irradiation.
- Low levels of hormones which normally stimulate RBC production, such
as EPO in chronic renal failure, thyroid hormone, and androgens.

2) Increased RBC destruction
Causes include various types of hemolytic anemias (i.e. when the bone
marrow is not able to produce enough red blood cells to offset the
loss of red blood cells).  Diseases include the following:
- Inherited hemolytic anemias (eg, hereditary spherocytosis, sickle
cell disease, thalassemia major)
- Acquired hemolytic anemias (eg, Coombs'-positive autoimmune
hemolytic anemia, thrombotic thrombocytopenic purpura-hemolytic uremic
syndrome, malaria)

3) RBC loss
Blood loss is the most common cause of anemia.  Causes of this
includes the following:
- Obvious bleeding, such as traumatic blood loss, melena (symptomatic
of an upper GI bleed), hematemesis (blood in the vomit), or
menometrorrhagia (excessive menstrual periods)
- Occult bleeding (symptomatic of a lower GI bleed), such as that seen
in a slowly bleeding colonic polyp or carcinoma
- Iatrogenic bleeding, such as from repeated blood draws in patients
undergoing a medical evaluation, blood losses associated with repeated
hemodialysis procedures, or excessive blood donations

This is clearly a large list of causes.  So, what to do next?  There
should be a systematic approach closely coordinated by your primary
care physician to properly evaluate the cause of anemia.  A detailed
history and physical is an obvious first step.  Questions such as
medication use, your ethnicity and country of origin, and time course
of the anemia will help narrow down the cause.

UptoDate suggests the following laboratory tests in the initial
"Initial testing of the anemic patient should include a "complete"
blood count (CBC). This routinely includes HGB, HCT, RBC count, RBC
indices, and white blood cell (WBC) count. A WBC differential,
platelet count, and reticulocyte count are not part of a routine CBC
in some medical centers; these may have to be ordered separately.
Thus, to avoid confusion, the clinician should specifically request a
CBC with platelets, WBC differential, and reticulocytes." (1)

A blood smear should be ordered to determine if the shape of the RBCs
can tip off any of the aforementioned diseases.

Based on the tests above, the following supplemental tests may then be
ordered if indicated by your physician:

1) More complete evaluation for iron deficiency is indicated when the
history and preliminary laboratory data support this diagnosis. In
this setting, the plasma levels of iron, iron binding capacity, and
ferritin should be measured

2) Hemolysis should be considered if the patient has a rapid fall in
hemoglobin concentration and/or abnormally shaped RBC on the
peripheral smear. The usual findings of hemolysis are an increase in
the serum lactate dehydrogenase (LDH) and indirect bilirubin
concentrations and a reduction in the serum haptoglobin concentration.

Again, these tests should be coordinated by your primary care
physician.  A hematology referral may be indicated depending on the

This answer is not intended as and does not substitute for medical 
advice - the information presented is for patient education only.
Please see your personal physician for further evaluation of your
individual case.      
Please use any answer clarification before rating this answer. I will
be happy to explain or expand on any issue you may have.            
Kevin, M.D.    

Search strategy:
No internet search engine was used in this answer.  All sources are
from physician-written and peer-reviewed sources.    
1) Schrier.  Approach to the patient with anemia.  UptoDate, 2003.

Medline Plus - Anemia

Mayo Clinic - Anemia
Subject: Re: blood anemia
From: jbf777-ga on 14 May 2003 21:16 PDT
Many diseases are the direct result of dietary issues.  Have you
examined your diet?  The body is completely interdependent.  If some
of your organs are failing as result of not eating properly, this can
be reflected in your blood.  I would suggest seeing a nutritionist.

Important Disclaimer: Answers and comments provided on Google Answers are general information, and are not intended to substitute for informed professional medical, psychiatric, psychological, tax, legal, investment, accounting, or other professional advice. Google does not endorse, and expressly disclaims liability for any product, manufacturer, distributor, service or service provider mentioned or any opinion expressed in answers or comments. Please read carefully the Google Answers Terms of Service.

If you feel that you have found inappropriate content, please let us know by emailing us at with the question ID listed above. Thank you.
Search Google Answers for
Google Answers  

Google Home - Answers FAQ - Terms of Service - Privacy Policy