• Martin Cane, M.D.
    Health Pro
    August 31, 2008
    Martin Cane, M.D.
    Health Pro
    August 31, 2008




    Thanks for your question.  Sorry to hear that you're having a problem.


    A hemoglobin of 10.0 is low, but not dangerously low.  A person's tolerance for anemia depends on their age and general health.  Heart and Lung disease patients do not tolerate anemia well.  If the hemoglobin falls below 9 grams, then, depending on your underlying health, intervention might have to be considered, such as transfusions.  The issue to concentrate on is what is the cause of your anemia? 


    Anemia is caused by three different mechanisms.  The first is blood loss, which means that you are bleeding somewhere in your body.  In some cases, it's very obvious such as heaving menstrual periods, or blood in your urine or stool.  In many cases, the blood loss is very slow and the bleeding is not seen.  When there is blood loss, then iron is constantly used to produce more blood, until a person eventually becomes iron deficient.  Without iron, less blood is produced, and any cells produced are much smaller in size, which helps doctors determine whether blood loss could be a cause.  Lisa Nelson's answer to your question gives great suggestions to help this type of situation.


    A second mechanism is destruction of blood cells within the vascular system, called hemolysis.  This can be caused by many different problems such as medication, genetic disorders, diseases like lupus, and in some situations, no identifiable cause is found.  There are several different specialized blood tests to identify this type of anemia. 


    The third mechanism for anemia is less production of blood by the bone marrow.  As in blood loss, this could be due to iron deficiency, with other causes such as stomach and intestinal disorders that cause failure of iron absorption.  Certain key vitamin deficiencies could also slow down production such as Folic Acid and B12.  Bone marrow disorders must also be considered.  Many chronic diseases can cause anemia, especially kidney disease.  When kidney function declines, an important hormone, erythropoietin, produced by the kidneys also declines.  This hormone stimulates the bone marrow to produce blood, and without it, kidney patients are usually anemic. 


    As you can see, anemia and finding the cause can be very difficult and involved.  If your doctor has done all that he can, I suggest you ask for a consultation with a hematologist, or blood specialist, who will work with your physician to help determine the cause.  If everyone thinks this is blood loss, and you have gone through a complete work up, you might have to repeat the search.  The hematologist will be able to assist in taking the search to a higher level.  Continue to work with your doctors in getting to the bottom of this problem.


    I hope this has been helpful.  Feel better.


    Martin Cane, M.D.

    • Chadwyck
      August 31, 2009
      August 31, 2009

      I'm so glad that I found someone else's concern about low hemoglobin levels.  First, I have Alpha Thalassemia.  The severity level is still not known.  I had eye surgery 3 months ago and the report of my blood work showed a hemoglobin level of 11.1 g/dl. My question is, since diabetics can check their glucose levels anytime they want with a device, can people like us purchase a hemoglobin monitor for the household so that we know how we're trending with our levels?

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  • Lisa Nelson
    Health Pro
    August 31, 2008
    Lisa Nelson
    Health Pro
    August 31, 2008

    Hi Launsu,


    I understand your worry and frustration that test results are not finding the problem.  I recommend that you continue to work with your MD on narrowing down what is causing your anemia.


    In the mean time, be sure to provide your body with plenty of good iron sources.


    High iron sources:


    meats - beef, pork, lamb, liver, and other organ meats

    poultry - chicken and turkey (especially dark meat)

    leafy greens of the cabbage family, such as broccoli, kale, turnip greens, and collards

    legumes, such as lima beans and green peas; dry beans and peas, such as pinto beans, black-eyed peas, and canned baked beans

    iron-enriched white bread, pasta, rice, and cereals


    Vitamin C helps your body absorb iron.  Therefore, when you take your multivitamin or iron supplement take it with a glass of juice or piece of fruit.  The more you combine vitamin C and iron sources in your meals and snacks the better for your body trying to replace your iron stores.


    All the best,


    Lisa Nelson, RD, LN

    The Heart of Health ezine


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