From the Guidelines
Your blood work indicates that you have anemia, as shown by your low hemoglobin and hematocrit levels, and small red blood cells (MCV 69.1), which is likely caused by iron deficiency or anaemia of chronic disease, as suggested by the European consensus on the diagnosis and management of iron deficiency and anaemia in inflammatory bowel diseases 1. I recommend starting iron supplements (ferrous sulfate 325 mg twice daily with vitamin C to improve absorption) and vitamin D supplements (2000-4000 IU daily) to address the low vitamin D level, and we should recheck your levels in 6-8 weeks to see if they're improving, while also considering further evaluation for underlying chronic disease or other causes of anaemia, as outlined in the classification of anaemia by MCV and reticulocytes 1.
From the Research
Blood Work Results
- Your blood work results show a Free T4 level of 0.58, which is within the normal range, and a normal TSH level, indicating that your thyroid function is normal.
- Your vitamin B12 level is 184, which is within the normal range, and your vitamin D level is 20, which is considered deficient 2, 3, 4, 5.
- Your cholesterol level is 201, which is slightly elevated, and your hemoglobin level is 9.6, which is below the normal range, indicating anemia.
- Your hematocrit level is 30.0, which is also below the normal range, and your MCV and MCH levels are 69.1 and 22.1, respectively, which are indicative of microcytic anemia.
Association between Vitamin D and Anemia
- Studies have shown that vitamin D deficiency is associated with an increased risk of anemia 2, 3, 4, 5.
- The mechanism underlying this association is not fully understood, but it is thought to involve the reduction of proinflammatory cytokines by vitamin D and the direct suppression of hepcidin mRNA transcription 4.
- Maintaining sufficient vitamin D status may be important in preventing anemia, particularly in diseases characterized by inflammation 4.