Sudden Drops in Hemoglobin Levels: Causes and Solutions

Hemoglobin levels can drop suddenly due to several reasons, including: 1. Acute blood loss: This can occur from trauma, surgery, or gastrointestinal bleeding. 2. Hemolysis: Conditions that cause the destruction of red blood cells, such as autoimmune hemolytic anemia or certain infections. 3. Bone marrow disorders: Diseases like apl

I have always had the habit of donating blood, but since the beginning of this year until recently (the past six months), during the finger prick stage of the interview, I was told that my hemoglobin was insufficient, so I underwent testing.
The results are as follows: white blood cells 10,420, red blood cells 5.10, hemoglobin 10.40, hematocrit 35.9, mean corpuscular volume 70.40, mean corpuscular hemoglobin 20.40, and mean corpuscular hemoglobin concentration 29.00.
I am indeed anemic.
Currently, it is uncertain whether it is iron deficiency anemia or thalassemia, but my lifestyle habits have not changed significantly (e.g., I have always stayed up late...).
Therefore, I would like to ask what could be the possible reasons for a sudden drop in hemoglobin if it is thalassemia (or iron deficiency).
The doctor who analyzed the report mentioned that taking hemoglobin soft capsules for a month should improve the values, but I would like to know how to maintain this improvement.
Thank you, doctor.

jean, 20~29 year old female. Ask Date: 2017/08/25

Dr. Chen Bozhang reply Family Medicine

Dear Ms.
Jean,
Regarding your recent blood test indicating anemia, here is the analysis: The mean corpuscular volume (MCV) of your red blood cells is 70.40 fL, which is low (normal range is 80-100 fL).
Your red blood cell count is 5.10 x 10^6, which is high (normal range is 3.5-4.5 x 10^6).
There is a significant possibility of thalassemia.
However, thalassemia itself typically does not cause fluctuations in hemoglobin levels, so it is likely that this test also indicates the presence of iron deficiency anemia, meaning that both a congenital and an acquired form of anemia may coexist.
Iron deficiency anemia can arise from several causes, including blood loss (from the gastrointestinal tract, reproductive tract, urinary tract, or other traumatic bleeding), decreased iron absorption (due to gastrointestinal diseases or surgeries, diarrhea, or malnutrition), and increased iron demand (such as during pregnancy).
If you have not had any recent illnesses affecting iron absorption and are not pregnant, the most likely cause for females is transient iron deficiency anemia due to menstrual bleeding during your period.
Of course, bleeding from organs such as the gastrointestinal tract cannot be ruled out.
I recommend that you avoid scheduling your follow-up appointment within two weeks before or after your menstrual period.
Please visit a family medicine or general internal medicine physician for a re-evaluation, along with tests for hemoglobin electrophoresis (to confirm thalassemia) and iron studies (to confirm iron deficiency anemia), to clarify the cause of your anemia.
I hope this information is helpful to you.
Sincerely,
Dr.
Po-Chang Chen
Department of Family Medicine, Keelung Hospital, Ministry of Health and Welfare

Reply Date: 2017/08/25

More Info

Understanding sudden drops in hemoglobin levels is crucial for identifying underlying health issues and implementing appropriate solutions. Hemoglobin (Hb) is a protein in red blood cells responsible for transporting oxygen throughout the body. A normal hemoglobin level typically ranges from 13.8 to 17.2 grams per deciliter (g/dL) for men and 12.1 to 15.1 g/dL for women. Your reported hemoglobin level of 10.40 g/dL indicates anemia, which can arise from various causes, including nutritional deficiencies, chronic diseases, or genetic conditions.

In your case, the sudden drop in hemoglobin levels could be attributed to several factors. One of the most common causes of anemia is iron deficiency, which can occur due to inadequate dietary intake, malabsorption, or chronic blood loss. Given your history of regular blood donation, it is possible that your iron stores have been depleted over time, leading to a decrease in hemoglobin production. Additionally, if you have been experiencing any gastrointestinal issues, such as ulcers or bleeding, this could further contribute to iron deficiency.

Another potential cause of your anemia could be thalassemia, a genetic blood disorder that affects hemoglobin production. Thalassemia can lead to microcytic anemia, where red blood cells are smaller than normal and contain less hemoglobin. If you have a family history of thalassemia or related conditions, it may be worth discussing this possibility with your healthcare provider.

To address your anemia, the doctor has recommended taking iron supplements, which can help replenish your iron stores and improve hemoglobin levels. It is essential to follow the prescribed dosage and duration of supplementation, as excessive iron intake can lead to toxicity. In addition to supplements, consider incorporating iron-rich foods into your diet, such as red meat, poultry, fish, lentils, beans, and fortified cereals. Consuming vitamin C-rich foods (like citrus fruits, tomatoes, and bell peppers) alongside iron sources can enhance iron absorption.

Maintaining healthy hemoglobin levels requires a multifaceted approach. Here are some strategies to consider:
1. Regular Monitoring: Schedule follow-up blood tests to monitor your hemoglobin levels and overall blood health. This will help you and your healthcare provider assess the effectiveness of your treatment plan.

2. Balanced Diet: Focus on a well-rounded diet that includes a variety of nutrients. In addition to iron, ensure you are getting adequate amounts of vitamin B12 and folate, both of which are essential for red blood cell production. Foods rich in these vitamins include leafy greens, eggs, dairy products, and fortified grains.

3. Hydration: Staying well-hydrated is vital for overall health and can help maintain blood volume. Aim to drink enough fluids throughout the day, especially if you are physically active.

4. Avoiding Blood Loss: If you are prone to heavy menstrual periods or have any conditions that may cause bleeding, discuss management options with your healthcare provider to minimize blood loss.

5. Lifestyle Modifications: While you mentioned that your lifestyle habits have not changed significantly, consider evaluating factors such as sleep quality, stress levels, and physical activity. Poor sleep and high stress can impact overall health and may contribute to fatigue and anemia.

6. Consultation with Specialists: If your hemoglobin levels do not improve with iron supplementation or if there are concerns about thalassemia or other underlying conditions, consider consulting a hematologist for further evaluation and management.

In conclusion, understanding the causes of your sudden drop in hemoglobin levels is essential for effective treatment. By following your healthcare provider's recommendations, making dietary adjustments, and monitoring your health, you can work towards maintaining healthy hemoglobin levels and overall well-being. If you have any further questions or concerns, do not hesitate to reach out to your healthcare team for personalized guidance.

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