Question
Should I worry about borderline anaemia?
28 February 2008. Related: All topics, Living with HIV long-term, Side effects.
Since starting treatment (on Sustiva and Truvada), I have always been borderline anaemic. This now seems to be getting progressively worse (but still is still asymptomatic).
Except for haemoglobin (HGB) at 10.4, ALL my numbers are comfortably within reference ranges – which, as I understand it, just about rules out any iron, B12 or other common dietary deficiencies – so I really don’t understand what is going on.
My doctor always comments on it, but can’t explain it and seems happy to wait until it becomes a problem. Personally I’d like to stop it ever becoming a problem, IF I can.
I don’t smoke, I hardly ever touch alcohol, I don’t use recreational drugs, I am active and I generally regard myself as being free of any obvious symptoms or side-effects.
Any ideas what could be going on? .. and should I even be worried about it if it isn’t causing problems?
Answer
Hi – thanks for your question which I asked one of our medical advisors to comment on. This is his reply:
“Your Hb is only slightly below the normal range. Anaemia is well recognised to occur in individuals with chronic illness. However it is important to exclude potentially treatable causes. Baseline investigations usually include tests for iron deficiency, B12 + folate, sickle and thalassaemia, thyroid function.
It is important to ensure that you are not on any drugs associated with anaemia and that you are not losing blood from your intestine or having heavy periods (if you are female). It is not uncommon for all these tests to be normal and for the doctor to decide that if you are otherwise well that no further invesitagtion is warranted.
Let your doctor know that you are concerned that h/she keeps commenting on it and it worries you that you have an abnormal blood test and ask them to provide you with more information and assurance that no further tests are indicated.
Because anaemia is common and usually of no clinical consequence the doctor
may be relaxed about the result and not be aware that you are worried. Hope this helps.”
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