What Causes Decrease In Hemoglobin Levels?

Posted on Sat, 8 Nov 2014

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 8 Nov 2014 Answered on

Mon, 24 Nov 2014 Last reviewed on

Question : I had some blood work done this week and my hemoglobin was 108g/l. My dr. did a follow up test 4 days later and it was 101 g/l - a drop of 7 points. My ferritin and vitamin b12 levels were normal. What could cause this and should I be worried?

Answered by Dr. Harshal Vora (59 minutes later)

Brief Answer:
3 possibilities as causes noted

Detailed Answer:
Hello welcome to HCM.
I have read your question and understand your concerns.

As such a common cause of anemia is iron deficiency and vitamin B12 deficiency. But there may be other reasons also..

I think there are 3 possibilities

1. I have read your history, you have blood in urine. Frequent bleeding in urine or stool can give rise to anemia(low hemoglobin) Even if your iron and vitamin B12 is normal. Do your urine and stool for blood. If it's positive then we can search for blood in urine or stool.

2.Absolute reticulocyte count is the report which needs to be done. It indicates whether your bone marrow is producing enough blood cells or not.
If reticulocyte count is normal or increased then bone marrow is producing enough blood cells.

3.Third possibility is your blood is producing enough cells but they are being destroyed by your own body . Ask your doctor about DIRECT COOMBS TEST, if it is positive than its called Hemolytic anemia.

So, if you ask your doctor about above investigations which I have been suggested then you will definitely get your answer and it will be permanently treated.

Any further questions are always welcome.
Thank you.
Have a nice day.

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Above answer was peer-reviewed by : Dr. Shanthi.E