Anemia and Longevity: Understanding the Impact of Acute & Chronic Anemia

Question
I think this would have to do with my daughter's (22 years old) longevity.  She was recently hospitalized with severe anemia and she had to get 2 units of blood.  It was determined to be due to being a vegetarian and not getting much iron and then for a few months getting her period every 3 weeks.  They assumed her hemoglobin was probably 8.5 for a long time (she's small and thin and athletic) and then dropped to 6.5.  When I heard she had to go to the hospital, I called my dr who said the hosp should give her an endoscopy and a colonoscopy to be sure what was wrong.  The hospital didn't do this.  Now, I wonder if they made the correct diagnosis.  Would the CBC blood test and hemecrit test have told them if they had to do more tests?  THANKS

Answer
Lauren,

It would be standard care to find out the root cause or etiology of her anemia.  With a Hb of 6.5 that is very low and usually anything under 8.0 requires transfusion.  The fact that she was transfused with 2 units of packed RBCs alone is of concern that this anemia needs to be worked up.  A vegetarian diet in actuality is not a very healthy diet.  Besides lack of iron there are issues with reduced B12 and folic acid.  She should have tests to determine her iron stores as well as levels of B12 and Folate (serum Iron, TIBC, Transferrin, Ferritin, blood B12 and folate(folic acid) levels).  Also she should be screened for acute blood loss via the gut (GI Bleed) with some simple tools like a stool sample for blood (Hemocult/Guaiac test).  If the Hemocult test is positive (+) then upper and lower endoscopy would be the next reasonable test to rule-out occult GI bleed.  She probably needs to eat better, take supplements after her blood tests and be checked regularly by her doctor.  

For more on longevity and living healthy her your daughter read my book on Adaptogen Herbs:  "Wonder Herbs: A guide to three Adaptogens"  Available online at Amazon.com or www.xlibris.com/wonderherbs and also have her read my blog at www.docsaleeby.blogspot.com for articles on diet and exercise, etc.

Best in Health,

JP Saleeby, MD
www.saleeby.net