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What Do These Lab Reports Indicate?

Posted on Tue, 8 Aug 2017

Question: Hello Dr,
please advise what all tests or diagnosis to be done to identify underlying problem for my sister. Her haemoglobin was 6.5 to 7 and vitamin b12 around 135. None of the Dr able to identify the actual reason why it is reduced. This is second time happening with her. Yesterday she had heavy vomiting.
Please let me know how critical with these low numbers and what has to be done. attached report

Answered by Dr. Deepak Sundriyal (37 minutes later)

Brief Answer:
Hello. She requires treatment.

Detailed Answer:
Hello dear. I have gone through the details. So. She has combined iron and vitamin b12 deficiency. Most common cause of this is nutritional deficiency. She requires iron and vitamin b12 supplementation. Vitamin b12 is usually given as intramuscular injection while iron can bw given orally.
Thanks and regards
Feel free to ask further

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Deepak Sundriyal (12 minutes later)

Thanks doctor for quick response. she has been prescribed following medication. Not sure what all these for. Is her situation very critical?
Ascolifext
Leewell forte
Petalife d
Sukrafilm

What other diagnosis she should go for? since it happened for second time. Her abnormal haemoglobin screening test report yet to come.

Answered by Dr. Deepak Sundriyal (42 minutes later)

Brief Answer:
HELLO. INTRAVENOUS DRUGS WILL BE BEST FOR HER

Detailed Answer:
HELLO. AS SHE IS SICK AND HAVING VOMITING, SHE WILL NOT TOLERATE ORAL DRUGS. INTRAVENOUS IRON THERAPY CAN BE GIVEN EASILY TO HER ALONG WITH VITAMIN B 12 INJ. DISCUSS THESE WITH YOUR DOCTOR. NO NEED TO GIVE ORAL AS SHE WILL NOT TOLERATE AND ALSO ORAL DRUGS WILL TAKE TIME TO RESPOND.
THANKS AND REGARDS

Above answer was peer-reviewed by : Dr. Remy Koshy

Follow up: Dr. Deepak Sundriyal (3 days later)

Thanks a lot doctor. She has been admitted in hospital and undergoing haemoclytic package test and medi package tests. Also she had iron therapy. Few reports yet to come.Most of the report indicates iron deficiency. Now doctor asking her to do endoscopy.But she is scared to do. Is there any alternative? Is endoscopy required? Sh
ould she also do colonoscopy? .

Thanks again

Answered by Dr. Deepak Sundriyal (3 hours later)

Brief Answer:
Hello. It is safe.

Detailed Answer:
Hello dear. Endoscopy and colonoscopy are safe procedure to look for the reason for deficiency. They can be done.
Thanks and regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Deepak Sundriyal (20 hours later)

Thank you doctor. The reports have come for endoscopy and it is normal. Doctor saying that they are not able to understand what's going on. . since they are saying even after giving iron therapy for 2 days why haemoglobin increased just till 8.2 as they were expecting 10. Not sure doctor what to do next..Please advise doctor

Answered by Dr. Deepak Sundriyal (1 minute later)

Brief Answer:
Hello. It will take time

Detailed Answer:
Hello. Nothing to worry. It takes time after iron injection for hemoglobin to build up. Yiu can take few more shots of iron.
Thanks and regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Deepak Sundriyal (1 hour later)

Thanks for very quick response doctor. I really appreciate for your valuable advise. Makes us feel much better. I forgot to mention Ferritin is just 9. Not sure what could be the reason and how to bring up the level. Thanks Doctor for all your help .

Answered by Dr. Deepak Sundriyal (52 minutes later)

Brief Answer:
Hello. It just represent low iron stores

Detailed Answer:
Hello. Again nothing to worry. Low ferritin represents low iron stores. Iron therapy will restore it.
Thanks and regards

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Deepak Sundriyal (42 hours later)

Thank you so much doctor for all your help.

Answered by Dr. Deepak Sundriyal (3 minutes later)

Brief Answer:
Hello. You are welcome

Detailed Answer:
Hello again. Please note that intravenous iron should be followed by oral iron therapy and a iron rich healthy diet.
Thanks and regards

Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Remy Koshy