Low Hemoglobin: Which Specialist Should You See?

Q: Low Hemoglobin: Which Specialist Should You See?

Hello： Your blood test report indicates that you have microcytic anemia, which is commonly caused by the following： 1. <br>Thalassemia 2. <br>Iron deficiency anemia. <br>Thalassemia is genetically inherited, while iron deficiency anemia is usually due to blood loss. <br>Common ca

Blood report (Hemoglobin 6.8)

Hello, doctor.
Here is my health check report, and I would like to ask which specialty I should consult.
Could the thyroid cyst or uterine fibroid be causing my anemia? (I have no bleeding or pain, and my menstrual flow is normal.) Which department should I visit? Thank you.
(Highlighted in red) Hb Hemoglobin 6.8 Hct Hematocrit 24.1 MCV Mean Corpuscular Volume 56.6 MCH Mean Corpuscular Hemoglobin 15.9 MCHC Mean Corpuscular Hemoglobin Concentration 28.1 RDW Red Cell Distribution Width 20.3 MO Monocyte Percentage 11.7 Thyroid ultrasound examination: left cyst 2 cm, uterine fibroid 8.5 cm.

G, 30~39 year old female. Ask Date: 2023/05/10

Dr. Lin Zhebin reply Family Medicine

Hello: Your blood test report indicates that you have microcytic anemia, which is commonly caused by the following: 1.
Thalassemia 2.
Iron deficiency anemia.
Thalassemia is genetically inherited, while iron deficiency anemia is usually due to blood loss.
Common causes of bleeding include heavy menstrual periods and gastrointestinal bleeding.
Generally, thyroid cysts are not likely to cause anemia; however, uterine fibroids can lead to heavy menstrual bleeding, which may indirectly result in iron deficiency anemia.
Since your hemoglobin level is only 6.8, this is considered severe anemia, and it may be necessary to consider other hematological disorders.
It is recommended that you see a hematologist as soon as possible for further evaluation of the cause of your anemia, and you may need to undergo blood transfusion therapy.
Additionally, if you experience symptoms related to anemia such as fainting, dizziness, shortness of breath, or chest tightness that cause extreme discomfort, it is advisable to go directly to the emergency department, as you may require urgent blood transfusion and hospitalization for further evaluation and treatment.

Reply Date: 2023/05/10

More Info

Based on your health report, it appears that you are experiencing significant anemia, as indicated by your low hemoglobin (Hb) level of 6.8 g/dL and hematocrit (Hct) of 24.1%. These values are considerably below the normal ranges, which typically are around 13.8 to 17.2 g/dL for men and 12.1 to 15.1 g/dL for women for hemoglobin, and 38.3% to 48.6% for men and 35.5% to 44.9% for women for hematocrit. Your mean corpuscular volume (MCV) is also notably low at 56.6 fL, which indicates microcytic anemia, commonly associated with iron deficiency or thalassemia.

Given your symptoms and the findings from your report, it is crucial to identify the underlying cause of your anemia. You mentioned the presence of a thyroid cyst and a uterine fibroid, but you have not experienced any bleeding or pain, and your menstrual flow is normal. While these conditions can sometimes contribute to anemia, they are not the most common causes, especially in the absence of other symptoms.

To address your question about which specialist to see, I recommend starting with a hematologist. A hematologist specializes in blood disorders and can provide a thorough evaluation of your anemia. They will likely conduct further tests, including iron studies, vitamin B12 and folate levels, and possibly a bone marrow biopsy if necessary, to determine the exact cause of your low hemoglobin levels.

Additionally, it may also be beneficial to consult with a gynecologist regarding the uterine fibroid, especially since it is relatively large at 8.5 cm. While you are not currently experiencing symptoms, large fibroids can sometimes lead to complications or contribute to anemia if they cause heavy menstrual bleeding in the future. A gynecologist can evaluate the fibroid and discuss potential treatment options if needed.

It is essential to address your anemia promptly, as low hemoglobin levels can lead to fatigue, weakness, and other complications. Treatment may involve iron supplementation, dietary changes to increase iron intake, or addressing any underlying conditions that may be contributing to your anemia.

In summary, I recommend that you first see a hematologist to investigate the cause of your anemia. Depending on the findings, you may also need to follow up with a gynecologist regarding the uterine fibroid. Early intervention is key to managing your health effectively, so please make an appointment as soon as possible.

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