From the Guidelines
The most recent lab results from May 5,2025, indicate mild iron deficiency anemia, and I strongly recommend increasing dietary iron intake and considering an over-the-counter iron supplement. The patient's mean corpuscular hemoglobin (MCH) has been consistently low across all measurements, currently at 26.2 pcg (reference range 27.0-34.0), suggesting their red blood cells contain less hemoglobin than normal 1. Additionally, the red cell distribution width (RDW) is elevated at 14.9% (reference range 11.0-14.8%), indicating variation in red blood cell size, which is a common indicator of iron deficiency anemia 1. Some key points to consider in the management of iron deficiency anemia include:
- Increasing dietary iron intake through foods like lean red meat, spinach, beans, and fortified cereals
- Considering an over-the-counter iron supplement, such as ferrous sulfate 325mg once daily, taken with vitamin C to enhance absorption
- Monitoring the patient's symptoms, such as fatigue, weakness, or shortness of breath, and consulting their healthcare provider for further evaluation if necessary
- Checking iron studies and potentially prescribing a higher dose iron supplement if symptoms persist
- Monitoring the low white blood cell (WBC) count with a follow-up complete blood count in 1-2 months, as it could indicate a mild immune system depression 1. It is essential to note that the diagnosis and management of iron deficiency anemia should be based on the most recent and highest-quality evidence, and the patient's healthcare provider should be consulted for personalized advice and treatment 1.
From the Research
Blood Test Results Analysis
- The provided blood test results show several abnormal values, including low WBC, low Hemoglobin, low MCH, and high RDW.
- The low Hemoglobin level is consistent with anemia, which can be caused by iron deficiency or other factors 2.
- The high RDW (Red Cell Distribution Width) indicates a large variation in red blood cell size, which can be seen in iron deficiency anemia or other conditions.
Iron Deficiency Anemia
- Iron deficiency anemia is a common condition that can be diagnosed by low iron stores and a hemoglobin level two standard deviations below normal 2.
- The study suggests that supplemental iron may be given initially, followed by further workup if the patient is not responsive to therapy.
- The provided blood test results show low Hemoglobin and MCH levels, which are consistent with iron deficiency anemia.
Differentiating Iron Deficiency Anemia from Combined Iron and Vitamin B12 Deficiency
- A study published in the International Journal of Hematology found that the platelet count/mean corpuscular hemoglobin ratio can distinguish combined iron and vitamin B12 deficiency from uncomplicated iron deficiency 3.
- The study suggests that a high PLT/MCH ratio may indicate combined iron and vitamin B12 deficiency.
- However, the provided blood test results do not include sufficient information to calculate the PLT/MCH ratio.