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Low haemoglobin
I have been ppi for 7 years. 4 months ago my haemoglobin was 14.8 but yesterday it was found that haemoglobin is now 12.8. I am having shortness of breadth due to gas or anything else I don't know. Also I am getting tired after some work. Is it normal for haemoglobin to drop by 4 in 4 months ?
Answers (20)
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It is still normal
Consult nearby gastroenterologist for physical examination
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Hello,
A drop in hemoglobin from 14.8 g/dL to 12.8 g/dL within 4 months is not "normal" and warrants a medical evaluation, especially since you are experiencing symptoms like shortness of breath and easy fatigability.
Clinical Correlation
Your long-term use of PPIs (7 years) is a key factor here. Chronic use of these medications can lead to:
Malabsorption: PPIs reduce stomach acid, which is necessary for the optimal absorption of Vitamin B12 and Iron from your diet.
Occult Blood Loss: It is important to ensure there isn't a slow, unnoticed loss of blood from the gastrointestinal tract that might be causing the hemoglobin to drop.
Recommended Action Plan
To identify the cause of this drop, I suggest the following:
Complete Blood Count (CBC) with Peripheral Smear: To look at the size and shape of your red blood cells (Microcytic vs. Macrocytic).
Serum Ferritin & Iron Studies: To check for iron deficiency.
Vitamin B12 & Folic Acid Levels: Long-term PPI use very commonly leads to B12 deficiency.
Stool for Occult Blood: A simple test to rule out any internal blood loss.
Consult a Gastroenterologist: They can evaluate if your long-term PPI use needs adjustment and if further investigations like an endoscopy are required given your symptoms of "gas" and shortness of breath.
Immediate Advice
Do not stop your medications abruptly, but discuss a "step-down" plan with your doctor.
Increase your intake of iron-rich foods (spinach, beetroot, lean proteins) and Vitamin C (citrus fruits), which helps with iron absorption.
Avoid taking tea or coffee immediately after meals, as they can further inhibit iron absorption.
Summary: While your current level isn't dangerously low, the trend of the drop is the concern. Please get the blood work mentioned above to catch any deficiency early.
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Taking long term ppi may lead to malabsorption.you may get your lipid profile done.apt for healthy lifestyle.
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Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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Hi dear,
Chronic PPI therapy makes you prone to develop Iron malabsorption syndrome. Although fall in Hb from 14.8 to 12.8 i.e. by 2 gm% is significant. That too even after such a. Chronic therapy of 7 years and a recent fall in Hb raises suspicion. It could be due to any cause of occult blood loss most commonly of Gastrointestinal in origin or intestinal parasite infestation.
Next Steps
Consult a gastroentrologist and get evaluated for possible occult blood loss.
Health Tips
look for brown/tar like discoloration of stools.
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The decrease in Hb 4gm in 4 months is significant,needs to be evaluated.Prolonged use of PPI could affect the absorption,may result in reduced Hb.Get your serum iron profile, vitamin b 12, folic acid levels ,stool analysis, consult a physician in your area
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Long term use of ppi may be the cause.
Go for cbc, thick n thin blood slids exam by hematologist.
AFTER RESULT THE CAUSE IS ILLUSTRATED.
TREATMENT IS ACCORDING TO THAT. YOU CAN USE,
RB TONE SYR10 ML AFTER DINNER FOR 3WEEKS.
AB PHYLLINSR200 ONE AT NIGHT FOR 10 DAYS.
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A drop in Hemoglobin from 14.8 to 12.8 within 4 months is significant, especially in a male patient. Long-term use of PPIs (7 years) can lead to Malabsorption of Iron and Vitamin B12, as these require stomach acid for proper absorption. This often leads to 'Iron Deficiency Anemia' or 'Megaloblastic Anemia,' which explains your tiredness and shortness of breath (exertional dyspnea). While 12.8 is borderline, the rapid trend of decline needs investigation to rule out any occult (hidden) GI blood loss due to chronic gastritis."
Next Steps
"I recommend getting a Serum Ferritin and Vitamin B12 level test done along with a Peripheral Blood Smear. This will confirm if the drop is due to malabsorption. Also, discuss with your doctor about tapering off the PPIs or switching to H2 blockers, and include iron-rich foods like spinach, beetroot, and pomegranate in your diet. Taking Vitamin C (Lemon/Amla) can also help improve iron absorption
Health Tips
Shortness of breath and fatigue should not be dismissed as just 'gas.' If you notice any dark-colored stools or if the breathlessness increases even at rest, please consult a Gastroenterologist immediately. Long-term PPI use should always be monitored by a professional to avoid bone density issues and nutrient deficiencies."
Do consult
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Consult a Physician for Assessment.
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Hb is borderline. Hemoglobin is low due to ppi intake of longer use but there is another causes also.maintain your diet well and do regular excercise. Eat more fibrous food and includes green vegetable in your diet more and keep hydrated.
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Hb is 12.8
Its normal range in females
Want to know more history for the proper diagnosis and plan of action
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The drop is 2 gm/dl in 4 month.
Need through history and personal habits to evaluate the drop in HB.
Next Steps
Can help you out if the history is still more detail.
Health Tips
Look for blood loss in stool
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No it is not at all normal for the hemoglobin to fall so rapidly. PPI could be one of the reasons but you will need other investigations as well in order to clarify what is causing drop in your hemoglobin.
Next Steps
Kindly book a consultation for further investigations and other details regarding your history.
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Dr. Sohan Kulria
General Physician
5 yrs exp
Firozabad
If you want to discuss your problem in more detail, feel free to message me on WhatsApp at nine one one nine two five five six nine nine for a detailed discussion
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Dr. Vetsa Sri Krishna Chaitanya
General Physician
7 yrs exp
Rajahmundry
Need a few more details please consult for further evaluation and treatment
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Dr. Suraj Sharma
General Practitioner
4 yrs exp
Jaipur
Do consult
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Dr. Nazia Begum M.G
General Physician
15 yrs exp
Belgaum
Consult online will guide you further
Need proper history and evaluation for further suggestions
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Dr. Gaurav Jaiswal
General Physician
6 yrs exp
Jhansi
Kindly do connect and consult
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