Q: I am a female of 37. I am suffering from anaemia and I have gone through several tests and I am giving the details. I was suffering from a bit of cold and greenish cough and for that I went to the doctor and he prescribed 7 days 250mg Althrocin course. And after 7 days too, I was feeling bit restless with a short of gasping problem. I feel a bit short of breath in lungs. He prescribed to go for blood test and the result was Haemoglobin: 7.5 gm/dl Total Leukocyte count: 6400/ml RBC count: 3.7 million ESR: 50 mm /1st hr PCV/haematocrit: 27.2 Platelet count: 5.1 lakh MCV: 72.97 MCH: 20.27 MCHC: 27.57 Neutrophils: 55% Lymphocytes: 43% Monocytes: 01% Eosinophils: 01% Basophils: 0% After that on the next day we have gone through the following tests with the following results: Ferritin Serum: 2.83ng/ml(N: 12-150) Stool for occult blood: positive (neither have piles nor seen any blood pass) IRON: 4 (35-150) Total Iron Bind Capacity (TIBC): 433 (250-450) % Saturation: 0.9 (13-45) Some of the parameters are very below the reference limit. I am taking iron capsule - Livogen2 and folic acid tablet since 7 days. Now please suggest me the apparent cause and the best management of the disease and as per your opinion what may be the cause and tell me about the seriousness of the position of the patient. Further patient diet is quite normal and she does not feel much difference and she has tendency of much flow at the time of period.

A:From your reports it is apparent that you are suffering from iron deficiency anaemia for which you will need to take at least 100 mg of elemental iron per day till your haemoglobin value comes close to 12 g/dl and then continue it for at least 3-4 months more so that your iron stores (reflected in serum ferritin value) are repleted. As important as treating the iron deficiency is to find the cause for it because it is this which leads to an iron deficient state. You have a single report of occult blood positive in stool and there is also history of excessive blood loss during periods, which is the most common cause of anaemia in this age group. Occult blood may be positive if you take a meat-rich diet or are on iron tablets. You need to consult a gynaecologist and then a gastroenterologist to find the cause of blood loss. It is not a serious state in the sense that once you begin taking iron, the haemoglobin will go up and you will symptomatically feel much better. But it should not be neglected and the cause for blood loss needs to be treated.