Iron Deficiency Anemia: Severity, Risks, and Treatment Concerns

Iron deficiency anemia

Hello, doctor.
I would like to ask about my previous blood test results: Hb: 10.2, HCT: 32.6, MCV: 71.2, MCH: 22.3, PLT: 408, RDW-CV: 17.5, Ferritin: 4.5.
Are these anemia values considered severe? What would happen if I don't address this? During my last follow-up, the doctor recommended iron injections, but halfway through the treatment, I experienced fever, cold extremities, shivering, and a heart rate over 100.
Is this situation normal, or is my body not suitable for iron injections? Thank you for your response, doctor.

Ru Ru, 30~39 year old female. Ask Date: 2021/09/23

Dr. Xiao Yongxun reply Family Medicine

Dear Miss Ruru,
1.
The information you provided indicates that you have microcytic anemia; due to your Ferritin level of 4.5 ng/ml being low (normal values are 23.9-336.2 ng/mL for males and 11.0-306.8 ng/mL for females), this may suggest iron deficiency anemia.
A definitive diagnosis requires consideration of other data and symptoms, and differential diagnoses may include thalassemia, chronic disease, tumors, etc.
2.
Common symptoms of anemia include pallor, dizziness, fainting, tachycardia, and exertional dyspnea.
In severe cases, it can lead to cardiac hypertrophy, pulmonary congestion, and even tissue hypoxia.
3.
Iron supplementation is primarily available in oral and injectable forms; the choice of administration route varies by individual.
In your case, it is essential for you to thoroughly discuss and examine your situation with your attending physician before making a decision.

Reply Date: 2021/09/23

More Info

Iron deficiency anemia (IDA) is a common type of anemia that occurs when the body lacks sufficient iron to produce hemoglobin, the protein in red blood cells that carries oxygen. Your blood test results indicate a hemoglobin (Hb) level of 10.2 g/dL, hematocrit (HCT) of 32.6%, mean corpuscular volume (MCV) of 71.2 fL, mean corpuscular hemoglobin (MCH) of 22.3 pg, and ferritin of 4.5 ng/mL. These values suggest that you are indeed experiencing significant iron deficiency anemia.

To break it down further:
- Hemoglobin (Hb): Normal levels typically range from 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women. Your level of 10.2 g/dL is below the normal range, indicating anemia.

- Hematocrit (HCT): Normal ranges are approximately 38.3% to 48.6% for men and 35.5% to 44.9% for women. Your level of 32.6% is also low.

- Mean Corpuscular Volume (MCV): Normal values range from 80 to 100 fL. Your MCV of 71.2 fL indicates microcytic anemia, which is often associated with iron deficiency.

- Mean Corpuscular Hemoglobin (MCH): Normal values are between 27 to 31 pg. Your MCH of 22.3 pg is low, further supporting the diagnosis of iron deficiency anemia.

- Ferritin: This is a marker of iron stores in the body. Normal ferritin levels range from 20 to 500 ng/mL, depending on the laboratory. Your ferritin level of 4.5 ng/mL is critically low, indicating severe iron deficiency.

Severity and Risks
Given these results, your anemia is considered severe. If left untreated, iron deficiency anemia can lead to several complications, including:
- Fatigue and Weakness: Due to insufficient oxygen delivery to tissues.

- Heart Problems: The heart may work harder to pump oxygen-rich blood, potentially leading to an enlarged heart or heart failure.

- Pregnancy Complications: In pregnant women, severe anemia can increase the risk of premature birth and low birth weight.

- Cognitive Impairment: In severe cases, it can affect cognitive function, particularly in children and the elderly.

Treatment Concerns
Your experience of fever, chills, and rapid heartbeat during iron infusion raises some concerns. While some side effects can occur during iron infusions, such as mild allergic reactions or infusion-related reactions, the symptoms you described could indicate a more serious reaction. It is crucial to report these symptoms to your healthcare provider immediately. They may suggest:
- Monitoring: Close observation during future infusions.

- Alternative Iron Supplementation: Oral iron supplements may be an option if infusions are not tolerated.

- Testing for Underlying Conditions: It’s important to investigate the cause of your iron deficiency, which could be due to dietary insufficiency, gastrointestinal bleeding, or other underlying health issues.

Conclusion
In summary, your lab results indicate severe iron deficiency anemia, which requires prompt treatment to prevent complications. If iron infusions are not tolerated, discuss alternative treatment options with your healthcare provider. Regular follow-up and monitoring of your blood levels are essential to ensure effective management of your anemia. Always communicate any adverse reactions during treatment to your healthcare team for appropriate adjustments to your care plan.

Similar Q&A

Understanding Iron Deficiency Anemia: Causes, Treatment, and Concerns

Hello, doctor! I have a question. I have iron deficiency anemia, and my hemoglobin was initially only 8. The doctor recommended intravenous iron therapy, and after more than a year of treatment, my levels are approaching normal. However, my ferritin remains very low, fluctuating ...

Dr. Hong Yuanbin reply Internal Medicine
Hello, women tend to lose a significant amount of iron due to menstruation. When combined with irregular daily routines, imbalanced diets, high stress, and lack of exercise, it can lead to long-term iron deficiency. It is advisable to first test for occult blood in the stool. If ...

Understanding Anemia: Iron Deficiency vs. Thalassemia in Blood Tests

Hello, Doctor. Here are my routine blood test results from my health check-up. I would like to ask whether I have iron deficiency anemia or thalassemia. Additionally, if it is iron deficiency anemia, would you recommend intravenous iron supplementation? Would there be any severe ...

Dr. Ye Qianyu reply Family Medicine
Hello! Based on the information you provided, it is indeed possible that you have iron deficiency anemia. Supplementing with iron is not an issue; however, iron injections may raise concerns about allergic reactions. Given your recent test results, oral supplementation should suf...

Managing Iron Deficiency Anemia in Patients with Thalassemia

Hello Doctor: I have thalassemia and previously experienced frequent dizziness, so I underwent blood tests at the hospital, which revealed that I also have iron deficiency anemia, with serum iron levels at 21 µg/dL. The doctor prescribed iron supplements for me to take one in the...

Dr. He Dongjin reply Cardiology
Hello, it is a misconception that individuals with thalassemia should not take iron supplements. Both conditions are classified as microcytic anemia, which is why some physicians may not differentiate between them and may prescribe iron supplements. It is not that they cannot tak...

Understanding Iron Deficiency Anemia: Treatment Challenges and Concerns

Hello Dr. Chen, I have been experiencing issues since over five years ago, with my blood test reports showing normal hemoglobin levels and white blood cell counts around 13,000. Two years ago, I underwent partial gastrectomy due to gastric adenomatous polyps. Since then, I have ...

Dr. Chen Yunfang reply Oncology
Hello: If you have undergone gastric resection, it may partially affect the absorption of oral iron supplements, so it is common to switch to injectable iron. How long it takes to improve anemia depends on the dosage of iron you receive each time and the frequency of injections, ...