h2g2 The Hitchhiker's Guide to the Galaxy: Earth Edition

I was diagnosed with iron deficiency anaemia about a month ago, so I thought I'd have a look at what h2g2 has to say about it.

Apart from having other common symptoms, I feel *absolutely exhausted* from the moment I wake up in the morning. I hardly think this, "you might notice that you tire more than you normally would", comes anywhere near to covering the effects the illness has on me.

[My latest blood test shows iron level of 44 (normal range 65-175) - not a particularly low level according to my doctor. The iron supplement I've been taking for the last three weeks has yet to have any noticeable effect, although I understand it might take a couple of months to kick in.]

OOoh it's while since I wrote this entry I was a 3rd year medical student then, and I've now been a doctor for 7 years. It's still mostly accurate, though if I was writing it again I'd probably add a bit more.

Looks like it's time for an update.

I find the level of fatigue varies a lot from person to person, i've seen people with very very lot levels of iron say they feel 'just a bit tired, but pretty much ok', and people with mild anemia feel exhausted.

I think it needs a re-word. Let's come up with something and ask the curators to update it.

Have you had any other tests to confirm why you're iron deficient? Have you been tested to see if you're loosing blood from elsewhere in your body for instance. Out of interest do you know your heamogoblin level (normal is 14)?

Hi Z!

Many thanks for your interest . Sorry I've not been able to get back to you sooner.

My latest blood analysis is dated 1st June, and I have it right in front of me.

Normal levels for heamogoblin are shown as 13-17 (no idea why they should differ from the figure you gave), and my reading was 12.9.

There are also a number of other readings that are either under or over normal levels - I have no idea of the significance of any of them.

I haven't had any other tests (yet), but my doctor knows me well and has taken me off the daily 400mg lithium carbonate as it's the likely cause.

If I'm losing blood, I'm certainly not aware of it (if you know what I mean ). I do have a hiatus hernia and tend to be a bit stomachachy, but apart from the stomach protector I take (to counterbalance the Adiro I believe), I'm not taking anything for it at the moment.

I take 10mg Enalapril twice daily to keep my usually slightly high blood pressure well within normal levels. I have noticed that my resting pulse rate, which is still quite low (I'm 62), has recently risen from between the usual range of 45 to 63 at most, to 70.

I hardly drink any alcohol at all, and I've reduced my intake of nicotine to 6 or 7 roll-ups a day.

The foul taste I had at the beginning of this episode has diminished quite a bit.

Erm... that's probably much more information than you want - don't worry, I don't expect you to offer a diagnosis...although I would take heed of any suggestions you might make...



Ps Headaches, sometimes quite severe, come and go.

Hi.

Sorry for the confusion re the normal level of Haemogloblin, in the population of healthy people the Hb levels form a normal distribution with a mean and median of about 14 (depending on how you measure it..). But half the population will have an Hb above 14 and half below. So if you say 'normal is 14' that means that nearly everyone is abnormal, either to high or to low.

So actually you need a normal range, two figures between which 95% of normal people's values will lie - (13-17 in the case of this test), but you have to remember that 2.5% of healthy people will have an hb below the lower value, and another 2.5% will have one above the healthy value.

Ok, - so getting to why you are tired. Clearly your doctor knows you well, and has access to your full medical history, so they've got much more of a chance of getting to the bottom of it than I have! I can't safely give any sort of medical advice or diagnosis online, and it sounds like you're under the care of a doctor who is doing all the right sort of things. (So if things don't get better go back to them..).

In my experience it's really unusual to get symptoms from an Hb just so close to the normal range, I suspect that there's a little more going on than just the iron deficiency, and I guess that your doctor thinks the same thing - as s/he's already stopped another drug that they think might be responsible.

The link between Hb level and tiredness doesn't seem to be a linear one though - some people with a very low Hb feel fine and some people whose Hb is only slightly low are really affected.

Many thanks for troubling to respond.

I have no idea how long the change of diet (ie more iron-rich foods) and the iron supplement will take to make a noticeable effect - I guess, after two or three weeks with little improvement, I'm just being impatient.

I'll be seeing the doc again next week, and I'm sure he will (at least) order another blood test.

It might be an idea if you are to tweak the Entry to make some mention of the likely recovery time - if that's possible.

Call it coincidence if you must, but just two days after our chat I'm beginning to feel a whole lot better.

My father-in-law, a master at giving appropriate (and often hilarious) nicknames, dubbed me 'The English Patient' - not patient enough, I guess.