Q&A

Stela

Question:

I’m 99% certain I am anaemic and have been for years at this point; doctors said my labs were “fine”. What do?

Normally, I’d trust my doctor, but she is older and sometimes drops the ball on my care. Only notices things she should sometimes.

Symptoms and Signs Suggesting Possible Anemia

Reasons I think I have it:

  • Sometimes I stand up, and I feel so dizzy and awful I think I’m going to pass out
  • Feet & hands are frequently cold
  • I get these tiny red dots (petechiae) all over my legs and arms, and while researching those, I realised they are a symptom of anaemia. I told my doctor about those, and she just wanted to cut them off and biopsy them.
  • I bruise INSANELY easily and bruise for a long time. I currently have a 3-month-old bruise on my knee that hasn’t gone away.
  • I’ve been told by every nurse and piercer I’ve been to that I’m a “bleeder”. I’ve been asked if I take blood thinners, drink coffee, or take Advil, all of which is a no.
  • Constantly tired. Can sleep 20 hours and still be tired
  • Hair loss
  • Shortness of breath
  • I feel very weak all the time
  • Very pale

Period-Related Symptom Worsening

I also feel like my symptoms get worse around my period. Also, I have an INSANELY heavy period, and I always feel worse when it happens. I also know I lack a lot of nutrients because I eat nothing. What I do eat is non-nutritional frozen/packaged processed shit that gives me nothing. I realise this is an issue I need to work on; I just haven’t been able to. Most food genuinely tastes awful to me, but anyway.

I have many good reasons to believe I’m anaemic, but my doctor won’t listen to me. Do you have any advice on how to proceed here? I’m not looking for a diagnosis or advice on treating it, but how do I get my doctors to check these things out and listen to me thoroughly? What do you think I should specifically be asking about? Do you think I should be asking for a copy of my results? I feel like my issues are being ignored, and even if it’s not anaemia, something is wrong. Any advice is super appreciated; thanks!

Answer:

Tom B.:

Could you wait to have labs run to check iron, iron saturation, & ferritin? That’ll indicate whether or not you have an iron deficiency with or without anaemia. If you have anaemia, haemoglobin would be low, and if you’ve had recent bloodwork, you can call and ask for those results, or they may be available online through something like LabCorp. Just demand the blood work test for iron, iron saturation, and ferritin after explaining your issues with heavy menstruation and your symptoms. You could also lie and say anaemia runs in your family so that someone takes you seriously. But if your doctor won’t test you, look for a new doctor Or look online to see if you can purchase the iron deficiency test yourself. I know LabCorp has them. Other labs will have them, too, but you must pay out of pocket.

Stela:

My doctor would run all those tests if I asked, so thankfully, there was no problem. I’m mostly worried about her not looking at them thoroughly, so I’m hoping I can learn what I’m supposed to be looking for and look through my results myself if that’s the case. I’m in a rural area, so I’m still determining my options outside my family doctor/clinic. I could see another doctor to review the results, but I need clarification. The clinic is pretty strict about you seeing your designated “family doctor”.

I’ll definitely book some new labs and see where it leads. I hate the medical system!

Tom B.:

It’s quite binary.

Could you get the tests run?

You can request the results from the hospital, etc., as a printout, which typically shows your levels and the accepted ranges for each value.

So if your doc says you aren’t anaemic – you likely aren’t, but you might be iron deficient or have other issues.

However, low iron is often a symptom, so you should focus on why you are low. Heavy periods can be a sign of a hormone imbalance, as can hair loss, fatigue, etc. It could also be malnutrition via malabsorption due to a digestive issue, e.g., celiac disease.

Anaemia reasonably rarely occurs in a vacuum.

Stela:

When I last ran tests, it was also for deficiency in any vitamin; I don’t remember the specifics. I didn’t get results for that just got told, “It looked fine”. I’ve also had my hormones regularly checked since the age of 16, normal there. I have something going on, but unfortunately, the doctors are not interested in exploring any further. That’s why I asked here for things to check out and look for specifically so I can at least rule it out if that’s the case.

Tom B.:

“Hormones” are fairly meaningless things to test for if you don’t specify which. Each hormone panel tests specific hormones, but rest assured, we aren’t testing every hormone in your body or performing all possible tests routinely. Many tests alone can’t confirm a hormone issue. Take PCOS, for example—it often takes people years to receive a diagnosis, even with extensive bloodwork and other assessments.

We are not machines, we cannot get values and expect that they mean a specific thing.

Even the ranges of values are so broad because there is a huge spectrum, and they can all be associated with a healthy or unhealthy person.

If you ensure you get iron, iron saturation, and ferritin done, then it’s fairly unlikely they will show normal results unless you are and there is another issue. But again, even if you are iron deficient or have an iron issue of some type, what is important is to understand WHY.

It’s like saying I am COLD. No one believes me. Ok fine, eventually it is agreed upon that you are cold. Great. Why. Do you know if the window is open? Are you outside in January? Are you wearing summer clothes? Do you have poor circulation? Are you losing muscle? Etc. The reason matters.