Hi,

Thanks for the query. I shall try my best to provide a comprehensive view of your condition.

It would have been better if you had specified how low your white blood cell (WBC) is count and the hematocrit value.

C-reactive protein (CRP) is a non specific marker of inflammation and values under 0.5 is considered normal. So I am not worried with the CRP value of 0.5

As far as tiredness is concerned, it is again a non specific complain associated with multiple clinical condition. Depression, infection, anemia, peri/post menopause and so on can result in easy tiredness.

From the details provided, the following are my conclusion:

1. Low hematocrit is part of iron deficiency anemia; and anemia can cause tiredness.
2. You have history of depression - this also would be making you tired.
3. At the age of 44, I believe you might be nearing or completed menopause. Estrogen reduction during this period can also cause tiredness. I see you are on estradiol which is good.
4. Transient WBC count reduction is part of viral illness which again can cause tiredness.

I suggest you to discuss about all these parameters with your treating doctor. Treatment can be started under his or her guidance. You may be treated as follows:
1. Adequate rest and sleep
2. Iron supplement such as ferrous sulphate capsule for possible iron deficiency anemia
3. Adjustments in antidepressant drugs if other symptoms of depression have worsened
4. Repeating blood counts with hematocrit, let say after 2 weeks and further after 2 months if required.
5. Mild physical exercise and a healthy diet is always beneficial

In all, I would say that I do not find any major concerns. As far as your reports and tiredness is concerned, further evaluation and treatment as suggested above is warranted.

Hope I have provided you with useful information pertaining to your query. If you have any other specific queries, I will be glad to answer them.

Wish you good health

Regards

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