Q&A

Can mild anaemia cause a fast heart rate?

Question

In my last blood test, my hematocrit and hemoglobin were mildly low (as in flagged as below normal markers/below the reference range) but not like crazy. Maybe 1 point off; it was like haemoglobin = 11 and hematocrit = 33.5ish. My ferritin was 5 (apparently way out of range), but I need help understanding these results.

I had to wear a heart monitor for one week because routine COVID testing for school caused doctors to become concerned about my resting heart rate, which was always 110ish to 130. The average heart rate was 110.4 for the whole week. The cardiologist found no structural problems and just told me the pace my heart beats is just too fast. She is re-checking my iron and thyroid levels. But can just mild anaemia cause this heart rate stuff? I generally feel very tired and sometimes have a little more trouble concentrating than when I was younger (like very brain foggy), but can this even relate to that? I am not anxious, or at least not outside of normal anxiety or stress, and frankly am not concerned, but the doctors seem to be concerned.

Answer:

I am not a doctor, but I understand that a fast heart rate is a symptom of anaemia. Tiredness is extremely common, and brain fog is also a symptom. Its good your doctor is taking this seriously. Your ferritin is low.

Question:

Confused about the potassium and calcium supplements.

I was admitted to the hospital in 2020 for emergency blood transfusions due to Anemia. After that, my doctor put me on Iron tablets. Almost exactly one year later, I went to urgent care because I fainted. This time, it was due to low potassium. They called an ambulance, took me to the hospital into the ICU, gave me meds for my heart and potassium, and kept me hooked up to machines under observation. Once my potassium was safe, they let me go home. My doctor never told me to take any potassium supplements, though.

I looked at some at the store, but there were several different types, and I figured if I needed those too, my doctor would tell me which ones. I have been under extreme stress for a while now, to the point that I’ve ground my teeth until they broke. -7 teeth now. I’ve been feeling bad lately, but I assumed it was due to the stress and ongoing long-term reasons for the stress.

Blood Work and Health Concerns

I had blood work done, just routine, and my hemoglobin and potassium are both very low. I try and ask my doctor if this could mean there could be some autoimmune disease or underlying reason for both being so low and my teeth being so weak they are just crumbling, and not just because of the grinding.

When I asked him this, he looked at me sideways and said, oh, you’ve had potassium problems before? In saying all this because you said you are taking calcium and potassium with Anemia. I am going to see a specialist, but I would like to know if the reason for the potassium with calcium, along with being Anemic, had anything to do with teeth and bone loss. I’m just so confused all the time, it seems, with brain fog and memory loss, so I’m not trying to blame him for my teeth loss or anything.

Maybe I forgot to tell him I was in ICU for potassium, IDK, but I really need to know, if I would have been taking potassium and calcium supplements all this time, since the ICU, would I still have my teeth? All that just rambled on, I know, I’m sorry, I’m just really upset with my doctor, and I would like to try and save the rest of my teeth if possible, now that I’m on potassium supplements, and calcium would be a good idea too.

Answer:

Probably. You might have osteopenia. Have your calcium checked, and ask for a bone density test.

Question:

Anaemia or not?

My 5-year-old was seen by haematology as a baby for anaemia. He was diagnosed with normocytic anaemia, and we never did figure out what the cause of it was. His labs gradually stabilised over about a year. Last year, he had a panel run, and his iron was low, but that was about it. Nothing too significant. We started iron supplements, and that was that. Fast forward, he has been losing weight and has very pale skin. He is also easily fatigued and aggressive/irritable. I asked his doctor to check his levels again, and they came back with normal ferritin, normal WBC, normal platelets (low end normal but still normal), and hemoglobin was low normal at 11.5. To my concern now: his RBC and hematocrit with a slightly elevated RDW were decently low. Everything else was within range. The only other abnormality was moderate ketones in his urine.

I requested a follow-up with Hematology, and his doctor said there was no problem. Today, I got a phone call from the referral nurse telling me that haematology likely won’t take the referral because he’s not anaemic. I understand his haemoglobin is within range, but his RBC and hematocrit indicate possible anaemia… or so I thought? I asked her to send it anyway, as I would feel best if we got the “all clear” from haematology, considering our past experiences. Does anybody else have experience with those labs being low and not being anaemic?

Answer:

Yes, it indicates anaemia. Eventually, his Hemoglobin will drop. That happens to me; it appears in that order. The body tries to keep the Hemoglobin within a normal range. Good on you for wanting to speak with Hematology.

Question:

Is it likely that I have anaemia? And how long can I go untreated if I do have anaemia?

So, for over a year, I’ve started to get mild anaemic-like symptoms such as light-headedness when standing up too quickly after lying down and increased fatigue. I would’ve seen the doctor about it, but my parents told me that it was normal and that I was overreacting. My mom is a nurse, so I just assumed she was right. Recently, though, I think it’s gotten more frequent, and even if it’s not extreme, I’m starting to notice hair loss and heart palpitations. I’ve tried increasing vitamin b12 foods over the past 2-3 months, and nothing has changed.

I have a regular physical appointment at the end of this month, and I’m wondering if they could notice something during the checkup or if I’ll have to get my blood drawn the next time I’m there. Another issue I’m worried about, though, is that my appointment is scheduled around the time I have my period, and I don’t want to risk getting blood drawn during my period. I hope I’m just overreacting again. How deadly is anaemia? And am I likely to die from it or have severe levels of low iron or folate since I might be long overdue for an appointment?

Answer:

You sound like you are about 25% down the road to hospitalisation and about 5% down the road to death. When my symptoms were at your level, I was mildly anaemic. I ended up hospitalised several months later after losing blood for a few weeks. And I was on the “severe” but not fatal anaemia scale. I was actively fainting and could not stand up on the day I was taken to the hospital. You are a long way off, but it will compound over time. Get some good vitamins; the right kind is better than anything a doctor can give you (they give you vitamins).