[Closed] Low-ish haemoglobin - should I worry.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3824146/

Sports anaemia

Lots of people have low haemoglobin for lots of reasons - so no you shouldn't worry, but yes you do probably want to get it investigated. Presumably this wasn't the first time you've tried to donate? so somethings had changed which has made you levels lower. i don't think it will be exercise.

The nurse said I need to get to my GP and I’ve been blocked from donating for 12 months. It doesn’t really seem that low and getting a GP appointment is a nightmare,

I'd give the gp surgery a ring and say that when you tried to donate blood there was a problem and they told you to book an appointment with the gp to discuss it. That should get you past the "receptionist filter". My guess is the GP will have a phone appointment with you in the first instance and then either ask you to come in and get blood taken or suggest you eat more green stuff (and vit C to help absorb it) and then book a test in a month or so.

plus there’s probably more in need right now

The GP is probably better placed to decide that. WHilst it probably isn't bad, there are some things that it could be an early sign of and you can deal with better with early intervention than waiting 12 months until the transfusion service say no again.

IANAD

Thanks @Poly last night would have been my 25th donation and never had a single concern re. haemoglobin. I donated last summer with no issues too.

You're right, it's probably a good idea to ring the surgery anyway and let them decide as frankly I have no idea! I eat a lot of greens, bread and brown rice already, but will be doubling down and getting my vit c boosted in the meantime as well! Might even have to get a cold pint of Guinness tonight too... that helps too with the iron right?

last night would have been my 25th donation and never had a single concern re. haemoglobin

I've donated over 50 times, and been turned away for low haemoglobin 3 times. Mine's in the normal range, just typically at the bottom end of it. Don't worry too much about it but do have a word with your GP - as mentioned above, if this is the first time it's happened it's worth flagging in case there's a new underlying cause.

Thanks @johnners that's reassuring to know. Will get in touch with the GP on Monday

Swap you.

I've way too much haemoglobin...

When you donate blood they are ultra cautious regarding your health before you donate. It makes sense really as the recipient could be in a very poor state medically.

I've had a few periods where I could not donate due to ongoing investigations for joint problems. I donated yesterday and they made me use my right arm as I had a steroid injection in my left shoulder over a month ago (I usually donate with left arm).

I’ve way too much haemoglobin

Easy on the EPO for a bit

That's happened to me twice. As I understand it there are 3 basic reasons for low haemoglobin; not enough iron in your diet, or, you have the iron but aren't producing haemoglobin from it, or you're losing blood somewhere. So GP gave me iron tablets to see if that fixed it. First time, my haemoglobin recovered, and by the end of the 12 months everything was normal and I went back to donations but spaced them out a bit more. Second time, they also wanted to check I didn't have internal bleeding (digestive system) so I had various tests and examinations that didn't find anything, by which time I was mostly back to normal.

While they didn't find a reason, I've shared my hypothesis with the GP and he agrees it's likely. Before both episodes, I had lower back issues and took ibuprofen, or in the second one, naproxen, for a couple of months. I think this gave me stomach bleeding, which had healed by the time it was examined (8 months later). So I'm back to donations, and since they were asking for as many as possible I've upped the frequency and there's been no problem. I also have omeprazole, in case I need to take NSAIDs again, to mitigate the risk of bleeding - I should have had it the first time but didn't know about it and wasn't offered it.

Last visit would have been #43 for me, but i was turned away for low haemoglobin. Second time for me, it happened for the first time just after the very first lockdown started. Try again in 3 months was the advice for me, but i was at least above the level where they recommend seeing a GP. As above, I'd second the suggestions to ring to and explain.

Had happened to me before and resulted in a tracoscopy (is that the word for a camera down your throat) and a colonoscopy. There was a final test they wanted to do but I think I forgot about the appointment and I never heard again - this was 20 years ago.

Anyway, they didn't take it lightly as it could be a sign of internal bleeding but it did seem overkill to me without other symptoms. Sports anaemia is new to me, I'm going to read up as I think I suffer from fatigue more than usual, which could be that

I had full blown anaemia diagnosis in September. Taking iron was like putting the lights back on. I would get it checked out as it’s been amazing suddenly not feeling fatigued. I’d really not realised how bad it had become until I got better.

Yes indeed, more iron is needed.

So down the local butchers and its steak for dinner all this week, or liver and onions if you prefer.

.

I'd a piece of fillet and 3 fried eggs for breakfast the other day.

Speak to your GP please.

A medical professional has recommended that you do so and you should listen to them rather than some guys on the internet.

Have never heard of sports anaemia, but the only time I was turned away for low haemoglobin was 24hrs after completing a century road ride.

Thanks all, have requested a call with my GP. Rode 40+ miles on the South Downs yesterday, made sure I ate a lot of iron rich food before and afterwards!!

Iron deficency anaemia eat red meat,iron tablets, and get some blood tests from surgery then camera up and down both ends,x rays, c t scan, more tests, more iron tablets.

Thats what happened to me, and now im semi ok.

Iron deficiency anemia eat red meat,iron tablets, and get some blood tests from surgery then camera up and down both ends

I'd try the red meat (and liver) first. Option B(Or is that A 😯 ) doesn't sound too pleasant.

I was turned away the day after a 20 mile run, nowt wrong with me at all, but all the training had upped my plasma volume so the haemoglobin density dropped.

Now I'm an arthritic plodder I never have the droptest fail on me, but oh my word I feel the lack of those red blood cells the week or two after donating, these days! Unless I was doing speed training I used not to notice all that much....

Probably, if you feel fine fine fine, it's just training induced high plasma volume, but IANAD and so that opinion is worth about 7 1/2p...

@Clover - what iron tablets / supplements do you take?

I've just ordered some Vitabiotics Iron + Vit B12 and C.

I need to take these regularly to see if they can make a difference. My usual pattern is:

- string a couple of rides / runs together in a fortnight, feel run down, tired, fatigued, possible cold, mouth ulcers.

This is where I'm at just now.

I've never regularly and consistently taken iron, more a case of taking one tablet, not feeling any difference, forgetting to take any more. I will take these regularly and see if it helps (if it does I'll be annoyed with myself for being so lax over the years).

Definitely get the doc to do a blood test to double check the level.

I tried to give blood in Dec (male, 42nd donation, never any issues) and had a reading of 118! Nurse said it could be the hand sanitiser in the donation centre messing with the finger tests as they had a few similar that week.

Blood test at docs came back 2 weeks later at 156, so it was a false reading at the donation centre.

@eskimonumber1 - that's interesting to know, have a phone consultation with my GP on Friday - which they said may not be on the actual phone it might just be via SMS instead - who knows when I could have an actual blood test!

@project - yeah I might stick to the red meat, lots of greens and wholemeal bread first. Hoping I don't need the cameras at both ends!!

@stripeysocks that's what I think/hope it might be, but will leave that for the GP to determine.

I had this exact same issue somewhere around my 25th blood donation too.

I went to see my GP
He/She reffered me to hospital for 'oscopy's of both types plus other blood tests
I also swallowed a camera in a small capsule and that recorded images all the way through and out!
No internal bleeding was observed so they decided I had some kind of issue with absorbing Iron from my food
I know take a 'Ferrous Sulphate' tablet everyday (200mg dose)

I feel fine and I have no issues with Iron or Heamaglobin :o)

First and most important things:
To answer your question, no you shouldn't worry.
As other people say, see your GP anyway.

But my experience might be relevant to you, given how strangely close it is.
I'm also on around 25-30 donations.
I've had slightly low haemoglobin once or twice before when they've told me I can't donate, but not low enough to see the doctor. At least one of these was a day or two after all day, possibly multi-day, can't remember, ride, and I've definitely been told that's likely to be a factor. These days I'm careful not to book a donation in the week after a big ride.

About a year ago I had low haemoglobin, which I think was exactly 123g/l too. Told to go see the doctor and come back in a year (!) to allow iron levels to recover. I managed to get a doctor's appointment the following morning, and so had my blood tested about 18 hours after the non-donation. That came back with 136g/l, so slightly low, and only just above the lower threshold for donating.

I asked the doctor if haemoglobin really fluctuates that quickly, or whether it was more likely that one of the tests was inaccurate, and he suggested the donation test was quite likely not very accurate.

I suspect diet is a large factor for me. I eat a largely, though not exclusively, vegetarian diet. I'm quick to correct anyone who suggests iron deficiency is inevitable if you don't eat lots of red meat - there are plenty of other sources of iron - but it's true that the iron in meat is more readily absorbed, so you do have to be a bit more careful if getting most of your iron from non-meat sources, and it might be useful to think about these things anyway:
- vitamin C is really good for helping you absorb the available iron from vegetables/pulse (it's one thing consuming things with iron in them, but your body doesn't necessarily absorb it if the conditions aren't right) so eating/drinking something with vitamin C in it at the same time helps (glass of orange juice with your spinach)
- tannins inhibit absorption of iron, so having a cup of tea or a glass of wine somewhat negates eating something with iron in it

I've tried to be more careful with my diet, and I'm not worried about having unhealthily low iron, but I do want to keep giving blood, so have started taking iron supplements. My girlfriend did some research, and apparently Spatone is by far the best, on the basis that it's the most easily absorbed. It's iron rich water that comes in little sachets. It's a bit like bottled water, but with more plastic waste and even more hideously expensive, but supposedly very effective. Better absorbed on an empty stomach so I have one in a glass of OJ (see above) first thing in the morning, then hold out as long as possible before I have a cup of tea/breakfast.

Hoping I don’t need the cameras at both ends!!

The drugs were fun. Like 8 pints of stella in one hit without the hangover. What happens in the meantime, fortunately I can't remember.

My wife was so anaemic that when she went to the doctor (about 8 weeks after childbirth) the doctor was surprised she actually walked in. Doc gave her some 200mg iron pills but they didn't work until she started taking them with 5,000mg mega-dose vitamin C pills from the supermarket.

I also had a mate at uni for whom pills didn't work, so he started drinking stout which got his levels up.

Thanks @northwind that's reassuring and really useful. I'm thinking a lot more about my diet now, as I do a lot of riding (burning about 5/6k calories a week) and generally use that as an excuse to eat whatever I like, whereas I think I should be a bit more careful now. Although I quite like the Guinness diet @molgrips mate used, I'm not sure the GP would support it!!

@jimmy people would pay a lot of money for the 8 pints of Stella effect and no hangover 🙂 assume you weren't walking like John Wayne afterwards...?

Slightly off topic I know, but what is people's experience of how donation affects their power when riding?

Before I used Zwift I found that the day after a donation I felt like I was missing the "top end" power but otherwise no effects - and that only seemed to last a couple of days. But now I race on Zwift, and see the power data, it looks like I drop about 10% FTP for a week or so then take about 3-5 weeks to fully recover.

Do others see the same? Anything we can do to minimise the impact?

Iron tablets will make your pooh turn black and hard to releaase may give you stomach ache and wind,but youll not fall asleep all the time, and theyre cheap to buy from any chemist or you can get Ferroglobin over the counter like drinking oily thick gear box oil even if it is only by spoon and not bottle.

Your finger nails have white spots in the nail if youre anaemic said my gp, and youll have very cold hands nose and feet, and ive got all them.

Yeah, my approach to diet is largely the same: I expend lots of calories, so I can put lots back in... but apparently you have to put the right things in too... who knew?

Lack of stout is certainly not a problem in my case! Pretty certain the Guinness thing was just a marketing ploy, but you can't be too careful 😉

Never had a problem with tiredness post-donation, and I'm often economical with the truth when they ask if I'm doing anything strenuous afterwards, but I don't do anything as scientific as measure my power.

Iron tablets will make your pooh turn black

That's your body not absorbing the iron is it not? Which is either because a) tablets aren't a great way to get supplementary iron, or b) there's some problem stopping you absorbing iron which needs dealt with.

Your finger nails have white spots in the nail if youre anaemic said my gp, and youll have very cold hands nose and feet, and ive got all them.

I thought white flecks in your nails was calcium deficiency? But I'm not a (medical) doctor. The other symptoms are also caused by something known as "winter".

Iron tablets will make your pooh turn black and hard to releaase

High doses can, lower might not.

Although I quite like the Guinness diet @molgrips mate used, I’m not sure the GP would support it!!

It's a serious and well documented suggestion. If you are drinking a few beers a week then choosing stout is a good idea, if you like it. It was his GP that suggested it. Along similar lines you can put a tsp of Marmite in any sauces/stews/spag bol etc that you make. It's a great way to add a bit of savoury umami (especially in vegetarian food) and is really good for you. And doesn't really taste of Marmite, even I can't tell and I'm a hater.

A pint of Guinness has 0.3 mg of iron, which even for men is only 3% of your RDA. I think your mate's GP might be a bit old-fashioned.

I don't think Marmite has iron in it. A quick Google suggests it does in other countries, but not the UK, so I guess they must add it, but not here?

It is great in a chilli though, you're right.

That’s your body not absorbing the iron is it not? Which is either because a) tablets aren’t a great way to get supplementary iron, or b) there’s some problem stopping you absorbing iron which needs dealt with.

I understood it to be a relatively quick way to restore your iron levels and/or get some data on the problem; you're prescribed more than you'd normally absorb, to see what happens.

I understand one can diy spatone by boiling a lump of **unpainted** cast iron (+) in water with a bit of lemon juice added.

(+) Remember those screw on dumbbell weights you bought a while back with the idea of doing home strength training...

I understand one can diy spatone by boiling a lump of **unpainted** cast iron (+) in water with a bit of lemon juice added.

Along similar lines you can put a tsp of Marmite in any sauces/stews/spag bol etc that you make.

He has low iron levels, he doesn’t want depression and an eating disorder as well

I understand one can diy spatone by boiling a lump of **unpainted** cast iron (+) in water with a bit of lemon juice added.

It's plausible, similar concept to the lucky iron fish distributed in third world countries to boost women's health. The acids in the food leach out just enough iron into the food to give people a boost. Same can apply to cast iron cookware, potentially.

https://www.bbc.co.uk/news/health-32749629

@thenorthwind ah, well, still won't hurt if you like it 🙂

Some interesting stuff here. I have low-ish haemoglobin (138 in a blood test a few days ago) but a consistently low red blood cell count throughout all my medical records. It's always varied between 4.1-4.3 (normal should be 4.5-5.5). I've never been the quickest up hills on the bike so this might partly explain why?!

My GP also "prescribed" drinking Guiness by the way.

Some great advice here, thanks all, will see what the GP says - hoping for a prescription of Guinness! I love Marmite too and just read that a single 5g serving provides 15% of the recommended dietary intake, so I'm going to fully embrace this!!

Despite being in my forties I'm probably the fittest I have ever been despite my 'I've done an epic ride so I can eat cake and drink beer' diet. I always eat a decent amount of iron-rich veg and red meat, but will be thinking a bit more carefully about the rest of my nutrition moving forwards.

An update - had a call with my GP, who was excellent and arranged a blood test within 2 days. Results came back within 24 hours, my blood count was entirely normal at 144 with normal B12. So must have been an inaccurate test with at my donation session! 🙂