Question

A 20 year old female received back her labs. She complained of fatigue, diarrhea, and abdominal pain. She has a history of acne, eczema, and occasionally notices undigested food in her stool. She did have one severe GI episode that required antibiotics and anti-inflammatory medications. She has a normal menstrual cycle. Her Hgb, Hct, and RBC counts are all low. Based upon her CBC, What type of anemia does she most likely have? What additional lab testing would you order to confirm this and what would you expect to see elevated or low? What would be your dietary and/or nutrient recommendations be based upon your previous answers? What is most likely the underlying cause of this clients anemia?

Answer 1

1. The history of Acne, eczema, undigested food in stool are associated with Irritable bowel syndrome (IBS). Also patient had episode of severe GI. People with IBS and related digestive problems often have a problem absorbing nutrients. They are not absorbing the Iron in the food too. Also low haematocrit and haemoglobin is also a typical symptom of Iron deficiency Anaemia along with IBS.

2. Complete blood count (CBC) is the primary test to rule out Anaemia. Additional tests may be ordered by the physician to diagnose Iron deficiency anaemia and the expected results are as follows,

-Low Haemoglobin (Hb) and haematocrit (Hct)

-Low mean cellular volume (MCV)

-Low ferritin

-Low serum iron (FE)

-High transferrin or total iron binding capacity (TIBC)

-Low iron saturation

The peripheral smear or blood slide may show small or oval shaped cells with pale canters.

3. It is necessary to take medicinal iron until the deficiency is corrected and body’s iron stores are replenished. In some cases, if the cause cannot be identified or corrected, patient may have to receive supplemental iron on an ongoing basis. Include the following in the food to increase the iron intake,

a. Meat-beef, pork, lamb (especially organ meat such as Liver).

b. Poultry-Chicken, turkey and duck.

c. Leafy green vegetables of the cabbage family like broccoli.

d. Legumes, including lima beans, peas, etc.

e. Iron enriched Pastas, Rice, Grains and Cereals.

4. The evidenced Intestinal disorder is the major reason for anaemia in this patient. A lack of iron in the diet and blood loss during menstruation also can be suspected.