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FAMILY DOCTOR

Q: I guess I worry too much, but the words of my doctor just didn't go far enough to reassure me. I was told I was slightly anemic, and there was nothing for me to worry about. Shouldn't there be more tests or a better diagnosis than "slight anemia"? All I was given were some new vitamins and I don't think they count as real medicine. Can you give me your thoughts on this important matter? Important to me, that is.

A: Think back. Hasn't your doctor already run a blood test or two on you, perhaps during a previous visit? Does the term "complete blood count" jog any memories? This test is often part of a routine annual physical, but forms the part of many diagnostic workups. It provides the information that can lead to the diagnosis "slight anemia."

The normal levels of hemoglobin for men are from 14 to 18, and 12 to 16 for women. When the numbers dip a bit below, it is often referred to as a slight anemia. There are some other numbers in a complete blood count that tell of the size of your red cells and the amount of hemoglobin in each one. When these numbers fall below the normal levels, your doctor has another clue to the cause of your anemia.

The most common cause is a deficiency of iron in the system. This can come from blood loss, decreased intake of iron, or the failure of your system to absorb and utilize iron correctly in the manufacture of hemoglobin. An inherited disease called thalassemia (also known as Mediterranean anemia, since it is found in people who come from the region) is the second most common form of anemia, followed by the anemia seen in chronic disease.

For iron deficiency anemia, additional tests are often unnecessary; they create additional costs, but give little useful information. However, when the diagnosis is unclear, serum iron, ferritin and transferrin values may be sought; they all tell how the iron is being used, or not used, in your system.

If simple iron deficiency is found, the addition of iron supplements to the diet can turn the situation around, and that is what I will bet you can find in your new vitamin preparation.

Dr. Allan Bruckheim welcomes questions from readers. Although he cannot respond to each one individually, he will answer those of general interest in his column. Write to Dr. Bruckheim in care of Tribune Media Services, 435 N. Michigan Avenue, Suite 1400, Chicago, IL 60611.

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