Hematology questions

Thread view:

Enable EMail Alerts

Start New Thread

Thread rating:

bae@cs.toronto.no-uce.edu - 02 May 2005 17:15 GMT

I have a question about hematocrit and hemoglobin.

I'm a 54-year-old premenopausal woman in good health. I've been
donating blood and blood components since I was 18 or so. While I'm
not entirely vegetarian, I don't eat much meat. I've lived at low
elevations all my life.

My hemoglobin and hematocrit have always been near the low end of
normal, hemoglobin around 125-128 and hematocrit 36-39. I'm not
concerned about this for health reasons, but when my hematocrit is
below 38, my donations are deferred. These days I donate platelets,
and if there's ever a good match with a patient, it would be good if I
could donate more often.

I'd like to know if there's something I can do that will raise my
hematocrit a little. I presently take a multivitamin with 10mg of iron
daily, and I tried taking an iron supplement (300mg ferrous gluconate =
35 mg elemental iron). The iron supplement didn't appear to make any
difference in my hematocrit.

So what would work? Living on a mountain top? Aerobic exercise? I
mostly walk and commute by bicycle for exercise, but maybe I can pedal
faster or longer or something. Suggestions?

Incidentally, one of the nurses once told me that a higher yield of
platelets is associated with lower hematocrit, presumably as some kind
of compensatory measure -- i.e. people with low hematocrit can't
"afford" to lose as much blood, so clotting is more important. They
always get a good yield from me. Are there any health implications to
this for me? Does it mean I'm more likely to be susceptible to
problems associated with undesirable clotting?

If anyone would like to send me email rather than post, please delete
the "no-uce." from my email address above.

Reply to this Message

David Rind - 03 May 2005 02:00 GMT

> I have a question about hematocrit and hemoglobin.
>
[quoted text clipped - 30 lines]
> If anyone would like to send me email rather than post, please delete
> the "no-uce." from my email address above.

The only common cause of anemia that is associated with an elevated
platelet count is iron-deficiency anemia, so if your platelet count has
truly been elevated you are likely iron deficient. The easy way to
answer this is with a blood test. If iron levels are indeed low, then
taking iron supplements should raise the hematocrit. A single iron
supplement a day may not be enough to make a difference, though.
Usually, for iron deficiency, supplements are taken three times per day
if tolerated.

On a related note, other than in premenopausal women, unexplained iron
deficiency is usually an indication for colonoscopy. Of course being 54
is also an indication for some sort of screening for colon cancer, and
in a place where colonoscopy is readily available I think most doctors
would recommend colonoscopy in a 54-year-old premenopausal woman with
iron deficiency anemia.

Signature

David Rind
drind@caregroup.harvard.edu

Reply to this Message

bae@cs.toronto.no-uce.edu - 03 May 2005 20:35 GMT

Thanks very much for your knowledgable reply.

>The only common cause of anemia that is associated with an elevated
>platelet count is iron-deficiency anemia, so if your platelet count has
[quoted text clipped - 4 lines]
>Usually, for iron deficiency, supplements are taken three times per day
>if tolerated.

I don't know if my platelet count is elevated or just in the upper part
of the normal range. I'll ask next time I go in to donate. I suspect if
it were abnormal, they would tell me and reject my donation. They are
extremely cautious about donors these days.

I'll try a higher dosage of iron, since it doesn't seem to cause me any
problems.

>On a related note, other than in premenopausal women, unexplained iron
>deficiency is usually an indication for colonoscopy. Of course being 54
>is also an indication for some sort of screening for colon cancer, and
>in a place where colonoscopy is readily available I think most doctors
>would recommend colonoscopy in a 54-year-old premenopausal woman with
>iron deficiency anemia.

I believe my hematology results have been pretty constant for the past
several decades, but I'll bear this in mind. My last checkup included
a fecal occult blood test (3 samples over 5 days) which was negative.
All the lab work was in normal range, with hemoglobin and hematocrit
in the lower part of normal, as usual, 128 and 38, IIRC. AFAIK, I've
never been anemic.

If it turns out that my platelet levels are actually elevated, i.e.
it's not just the nurses telling me I gave a good donation to be
pleasant and encouraging, or there's been some pattern of change over
the past few years, I'll ask my doctor whether a colonoscopy would be
of value, or whether I should have some other blood test to determine
if I've got iron deficiency anemia.

Thanks again for your time and effort in replying.

I'll append my original posting in case there's anything anybody wants
to refer to:

bae@cs.toronto.no-uce.edu wrote:

Reply to this Message