Low Hemoglobin and Its Impact on Dizziness and Menstrual Irregularities

Blood disorders

In July of this year, I was hospitalized due to a severe cold and discovered that my hemoglobin level was low, measuring 8.1.
My mean corpuscular volume (MCV) was 68.
In September, during a health check-up, my hemoglobin level was 8.6, MCV was 65.3, hematocrit was 27.8, total white blood cell count was 3.1, mean corpuscular hemoglobin (MCH) was 20.3, mean corpuscular hemoglobin concentration (MCHC) was 31.1, red blood cell distribution width (RDW) was 23.3, and platelet distribution width (PDW) was 18.0.
Due to this issue, I visited Mackay Memorial Hospital three times and had several vials of blood drawn, but no definitive diagnosis has been made.
Before these symptoms were identified, I occasionally experienced dizziness, but over the past few months, the dizziness has worsened.
I have to rely on medication or iron-rich nutritional supplements for my menstrual cycle to occur; otherwise, it may only come every two months.
However, two years ago, my menstrual cycle was very regular, with no issues of early or delayed periods.

Doctor, what could these symptoms indicate? Is the dizziness related to the delayed menstrual cycle, and could they stem from the same underlying issue? What treatment options are available? Thank you.

Li Huijing, 40~49 year old female. Ask Date: 2015/10/03

Dr. He Dongjin reply Cardiology

Hello, low hemoglobin levels have likely been present for a while.
This should not be related to dizziness or irregular menstrual periods.
The issues of dizziness and delayed menstruation may stem from the same underlying problem, which could be autonomic nervous system dysfunction or symptoms related to perimenopause.
For anemia, please consult a hematologist, and for other concerns, consider visiting a gynecologist.
Thank you for your attention from Changhua Hospital.

Reply Date: 2015/10/03

More Info

Low hemoglobin levels can significantly impact your health, particularly in relation to symptoms such as dizziness and menstrual irregularities. Hemoglobin is a protein in red blood cells responsible for transporting oxygen throughout the body. When hemoglobin levels drop, as in your case where levels were recorded at 8.1 and 8.6 g/dL, the body may not receive adequate oxygen, leading to various symptoms, including fatigue, weakness, and dizziness.

Dizziness is a common symptom associated with anemia (low hemoglobin), as the brain may not receive enough oxygen. This can manifest as lightheadedness or a feeling of faintness, especially when standing up quickly or engaging in physical activity. The severity of dizziness can vary based on how low the hemoglobin levels are and how quickly they have dropped. In your case, the worsening dizziness over the past few months suggests that your body is struggling to compensate for the low hemoglobin levels.

Menstrual irregularities can also be linked to low hemoglobin levels. The menstrual cycle is regulated by a complex interplay of hormones, and significant changes in blood volume or hemoglobin can disrupt this balance. Anemia can lead to heavier menstrual bleeding (menorrhagia) or even missed periods (amenorrhea), as the body may prioritize vital functions over reproductive health when it is under stress due to low oxygen levels. The fact that you have experienced changes in your menstrual cycle, such as periods occurring every two months, indicates that your body may be responding to the anemia.

The average red blood cell volume (MCV) and other parameters you mentioned, such as hematocrit and red blood cell distribution width, can provide further insights into the type of anemia you may be experiencing. For example, low MCV (microcytic anemia) often indicates iron deficiency, while normal or high MCV may suggest other types of anemia, such as those related to vitamin B12 or folate deficiencies.

Given that multiple blood tests have not yet identified the underlying cause of your anemia, it is crucial to continue working with your healthcare provider. They may consider additional tests, such as iron studies (serum iron, ferritin, total iron-binding capacity), vitamin B12 and folate levels, and possibly a bone marrow biopsy if necessary. These tests can help determine whether your anemia is due to iron deficiency, chronic disease, or another underlying condition.

In terms of treatment, addressing the underlying cause of your anemia is essential. If iron deficiency is confirmed, iron supplements and dietary changes to include more iron-rich foods (such as red meat, leafy greens, beans, and fortified cereals) may be recommended. If your anemia is due to other deficiencies, appropriate supplementation or dietary adjustments will be necessary. Additionally, managing any underlying conditions that may be contributing to your anemia is vital.

For the dizziness, staying hydrated, avoiding sudden movements, and ensuring you have a balanced diet can help manage symptoms. If dizziness persists or worsens, it is essential to seek medical attention promptly.

In conclusion, low hemoglobin levels can lead to dizziness and menstrual irregularities, and addressing these issues requires a comprehensive approach to identify and treat the underlying cause. Regular follow-ups with your healthcare provider are crucial to monitor your condition and adjust treatment as necessary.

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