Anemia should be checked by physician


April 19, 1994|By Dr. Simeon Margolis | Dr. Simeon Margolis,Special to The Sun

Q: For more than a month now I have felt weak and tired, just like 30 years ago when my doctor treated me for iron deficiency anemia in my late twenties. My husband insists on my seeing my doctor for these problems. Why shouldn't I just improve my diet and take iron pills?

A: By all means, do as your husband tells you and see your doctor.

In the first place, many disorders can cause a feeling of weakness and chronic fatigue. Secondly, there are numerous causes of anemia. Even if your symptoms are caused by iron deficiency anemia, as you suspect, it is most important to determine the cause of the iron deficiency. Although an extremely poor diet can be to blame, other causes include poor absorption of iron from the intestine following surgical removal of the stomach or part of the intestine. By far, the most common explanation for iron deficiency is blood loss.

During childbearing years, many women are deficient in iron because of menstrual bleeding, and treatment with iron supplements cures the problem. Although you would probably improve symptoms by taking iron pills, you might miss a serious underlying disease. Development of iron deficiency anemia in a postmenopausal woman, or a man of any age, requires a medical evaluation of the gastrointestinal tract. The culprits can be gastritis, peptic ulcer, diverticulosis, cancer of the stomach, colon, or rectum, colonic polyps and hemorrhoids.

Sudden and massive bleeding from the intestine may be evident from the presence of bright red blood in the stools or from the passage of black, tarry stools. More often, the stools appear normal because they contain only small amounts of blood from slow, chronic bleeding.

Your doctor will first do a complete blood count to learn whether you are really anemic and to look for small, poorly stained red blood cells that are the hallmark of iron deficiency.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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