Iron deficiency anemia...need to learn about this.

[elias7]

27. If she had a biopsy or a polyp removed,

that would be the most common source of bleeding post colonoscopy. The dramatic symptoms - severe shortness of breath - does in part suggest acute/sub-acute blood loss, as slower blood loss over say 6-18 months would give a person time to adapt physiologically.

If she had GI losses post colonoscopy, she would have noticed reddened stools, somewhere between bright red and dark maroon. For the hospital to test for various forms of anemia, however, would suggest that the cause of anemia was not clear.

The BNP is a typically an adjunctive measure of heart failure, used in conjunction with the chest X-ray to determine if someone’s shortness of breath is caused by cardiac decompensation. Sounds like the value was normal, so not sure it was rechecked. Low hemoglobin can stress the system since she has markedly decreased oxygen carrying capacity, causing heart attack (MI) or congestive heart failure (CHF), but this usually happens in the setting of pre-existing heart disease.

Ferritin stores are very low, suggesting the process has been going on for more than just a few weeks though. If there is no reason for iron malabsorption - precious upper GI surgery/resection, chronic GI inflammatory condition - you’re looking at finding the reason for insidious blood loss.

Often, anemia is multi-factorial, so for example, it is incumbent on your docs to determine if the anemia is a combination of iron deficiency and anemia of chronic disease (acd), and find the reason for this.

What are your docs thinking is the cause of her iron deficiency?