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Persistent anemia, poor response to oral
Key results (23 May 2026):
• Hb 10.9 | MCV 72.3 | MCH 22.4 | RBC 4.87 (high-normal)
• Ferritin 4 ng/ml (critically low)
• Vitamin D3 33.29 nmol/L (deficient) — on 60,000 IU weekly tablet, was not taking consistently
• LFT, RFT, glucose, lipids — all normal
Currently on Ferozinc. Hb has been 8–10 for years despite multiple iron supplements. Symptoms: constant dizziness, fatigue, severe hair fall.
Questions:
1. Does this CBC pattern (low MCV/MCH + high-normal RBC) warrant HPLC to rule out thalassemia trait?
2. Is IV iron indicated given ferritin 4 and non-response to oral iron?
Answers (12)
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Women in menstruating age group with iron deficiency anaemia usually is from monthly blood loss. Daily oral iron long term is a solution.
If any bowel symptoms then can have coeliac antibody test initially.
No indication for Hb electrophoresis yet.
Free online consultations for age 50 years and older.
Best wishes
www.jgsr-health-education.in
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Consult a hematologist who is a super specialist. They will do detail assessment and guide you further.
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Both your questions are clinically valid. The low MCV, low MCH with high-normal RBC count is a pattern that can be seen in both iron deficiency and thalassemia trait â and since your anaemia has persisted for years despite multiple iron supplements, an HPLC test to rule out beta-thalassemia trait is absolutely warranted. Regarding IV iron â with a ferritin of just 4 ng/ml and documented poor response to oral iron, you are a strong candidate for IV iron infusion, which bypasses gut absorption issues entirely.
Next Steps
Please consult me directly on Practo for a detailed evaluation â I can review your full reports and guide you on getting HPLC done and whether IV iron is the right next step for you.
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Iv gives better results
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Hi,
This pattern can involve thalassemia trait or absorption issues, which is why response is poor.IV iron is effective in such cases after proper evaluation.
Feel free to consult for further guidance. 👍
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Kindly do connect and consult with me for better treatment plan and advice on your case
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Dr. Ravi Kumar Nadella
General Physician
18 yrs exp
Hyderabad
Yes
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Dr. Gaurav Jaiswal
General Physician
7 yrs exp
Jhansi
Avoid fried and spicy food
Water intake more
Green leafy vegetables more
Fiber meal
Walk
Do connect and consult
Will help you
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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. Shreya Pradip Gudka
General Physician
9 yrs exp
Mumbai
Consult on WhatsApp -816953983 eight
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Dr. Anuj Mothsra
General Physician
6 yrs exp
Jhunjhunu
Can help you, kindly consult and provide detailed history for proper diagnosis and further management
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