Low blood count

(usually meaning ANAEMIA)

Online Medical Services

By Dr Helen Webberley
MBChB MRCGP MFSRH | GMC no. 3657058

Please note that this service does not aim to replace advice given to you by your own doctor, it is meant to supplement your health knowledge and awareness. It is not ever to be used in the case of a medical emergency.
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About Anaemia

The causes of anaemia are plentiful and complex but symptoms tend to the same whatever the underlying cause is. These are as follows;

  • tiredness
  • lethargy and no energy
  • shortness of breath particularly on exercising
  • no ‘get up and go’
  • sometimes loss of appetite and weight loss
  • palor (particularly the mucus membranes such as the conjunctiva, but also the nails may appear very pale too)
Iron deficiency anaemia This is the commonest cause of anaemia and is due to lack of iron which is essential for making red blood cells. Iron deficiency anaemia occurs when there isn’t enough iron getting into the blood stream from the gut (this is usually because not enough is being eaten) or may arise as a result of blood loss (usually from the gut and may be unnoticeable, or in menstruating women) Red blood cells are circulating cells that contain no nucleus but are packed with haemoglobin and are responsible for transporting oxygen to all of our tissues from the lungs. It is the red blood cells that give us our pink colour and makes us look healthy! Iron is an essential component of haemoglobin and without it not enough haemoglobin is manufactured and the red cells look pale and small under the microscope (hypochromic and microcytic). Red meat, green vegetables and dairy products are rich sources of iron, so diets which are lacking in these can cause anaemia. The iron is modified (reduced) by gastric acid when it hits the stomach, which makes it more easily absorbed into the blood stream, this absorption occurs in the first bit of the small intestine (duodenum and jejunum). Phytates and tannates (present in tea and coffee) may slow down this absorption and vitamin C speeds it up, so citrus fruits are good for preventing iron deficiency. Any pathology affecting the small intestine (such as coeliac disease and Crohn’s disease) may interfere with this absorption too. Once the iron hits the blood stream, it binds to a special protein called transferrin and is transported to the bone marrow to make red blood cells. Extra iron is stored in very large molecules in the liver, called ferritin and your doctor may well ask for this blood test as it is a good indicator of iron stores.

Blood loss Menstruating women have lower normal blood counts than men because of the cyclical blood loss. However blood can also be lost in other ways and into the gut is the most common, although the urinary tract may be another source of blood loss. This blood loss is usually unnoticed (microscopic) but can cause significant anaemia and may be associated with serious pathology. Loss of blood into the gut forms the basis of the NHS screening programme (FOBT) for bowel cancer, when healthy patients have to provide a specimen of faeces to be tested for microscopic amounts of blood. This is available to the older population (usually over 60 – 75) The following are the commonest causes of microscopic blood loss into the gut;

  • Gastric inflammation
  • Peptic ulcer
  • Inflammatory bowel disease such as Crohn’s disease or ulcerative colitis
  • Large bowel polyps
  • Bowel cancer

Written by Dr M J Webberley, Consultant Gastroenterologist, August 2015

HRT Video

FAQ

What is the menopause?
When the ovaries shut down at the end of the reproductive life, they stop producing eggs and they also stop producing the female hormones. This lack of oestrogen and progesterone can cause problems.
Symptoms of the menopause.
  • hot flushes
  • night sweats
  • vaginal dryness
  • loss of libido (sex drive)
  • stress incontinence (leaking urine when you cough or sneeze)
  • bone thinning – which can lead to osteoporosis and fractures
Ways of Taking HRT
  • cream – applied to the vaginal area
  • tablets – which can be taken by mouth
  • a patch that you stick on your skin
  • an implant – under local anaesthetic, small pellets of oestrogen are inserted under the skin of your tummy, buttock or thigh
  • oestrogen gel – which is applied to the skin and absorbed
Who Should Have HRT?
  • All women under 50 who have gone through the menopause should be encouraged to use HRT.
  • In women under 60 suffering with the symptoms of the menopause, the benefits of HRT usually outweigh the risks.
  • The upper age limit should be based on symptoms and not set at an arbitrary level. If the symptoms persist then again the benefits usually outweigh the risks.
Who Can't Take HRT?
You may not be able to take HRT if you have:

  • a history of breast cancer, ovarian cancer or womb cancer
  • a history of blood clots
  • a history of heart disease or stroke
  • untreated high blood pressure – your blood pressure will need to be controlled before you can start HRT
  • liver disease
  • abnormal bleeding down below that has not been investigated
Potential Side Effects of HRT
  • fluid retention
  • bloating
  • breast tenderness or swelling
  • headaches
  • indigestion
  • depression
How Can I Get HRT?
Sometimes GPs can be scared to prescribe HRT. If you would like to discuss whether HRT would be suitable for you then contact Dr Webberley and discuss your case in person.

Medication

Medicine Name

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Medicine Name

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Medicine Name

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Blood Tests

Blood Test Name

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Blood Test Name

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Blood Test Name

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