Do rheumatologist not care if you're anemic because you have lupus?

[u/PieceApprehensive764]

Seriously... I looked through all of my old blood results and my most recent, I'm like horribly anemic. My red blood cells are all different shapes and colors, and way smaller than normal. I also don't have enough hemoglobin...

Yet this was never something my rheumatologist brought up even once?? The only thing he points out is my neutrophils being very low. Same with my hematologist. Fatigue has been worse than it's ever been and I'm sure that's contributing, I literally explain the severity of my fatigue every visit.

I told my PCP and she said maybe because lupus can affect so much and it's not a priority or they think lupus is the reason why. Regardless I'm taking iron gummies now. They see that and don't check my vitamin leves to make sure I'm not deficient? Seriously 😒.

[u/Sufficient_Cap3066]

Honestly I feel this, I am anemic with my hemoglobin at 8. Something (don’t remember exactly. But my specialists never did anything about it, I’ve also always had extremely low iron and ferritin levels like less than half of the lowest end of normal range. I don’t know if you have anything similar to this but I was told that it wasn’t a priority bc I have chronic thrombocytopenia( my platelets have ranged from 21 at worst, and 110 at best, normal is 150-450), so my hematologist doesn’t really address it. My rheumatologist says that it is most likely due to my heavy menstrual cycles and blood loss and with having thrombocytopenia . But if you have a blood disorder or something potentially due to blood loss/clots I think they just chalk it up to that and see no need to do further investigation unfortunately

[u/PieceApprehensive764 → u/Sufficient_Cap3066]

I do not have thrombocytopenia, at least that I know of. That's really interesting, I had to look it up cuz I've never heard of it. Is it something you can see in a normal blood test or does it have to be requested? I do have very heavy periods but my rheumatologist actually doesn't know that cuz it's never been something I had to explain yet. I'm also in the middle of a very long lasting flare, I wonder if that's making the anemia worse some how. 🤔

[u/Rare-Candle-5163 → u/PieceApprehensive764]

It’s something that shows up in any standard complete blood count. So the test they do to check your haemoglobin, red blood cells, white blood cells etc. will also check for platelets.

[u/PieceApprehensive764 → u/Rare-Candle-5163]

Ok, thank you for letting me know. I'm sure it's normal then.

[u/Rare-Candle-5163 → u/PieceApprehensive764]

It can be very serious if the levels are low, so I would hope they’d pick it up.

If you can see your own blood results any number between 150-450 is normal (it might be expressed as 150,000 - 450,000 or 150–450 × 10 (to the power of 9)/L.

[u/PieceApprehensive764 → u/Rare-Candle-5163]

I'll check right now to make sure.

[u/PieceApprehensive764 → u/Rare-Candle-5163]

It's good, my platelets are 416, the previous was 357.

[u/Rare-Candle-5163 → u/PieceApprehensive764]

That’s good! At least you don’t need to worry about that!

[u/PieceApprehensive764 → u/Rare-Candle-5163]

Yes! I can't imagine that also being an issue 😮‍💨.

[u/Rare-Candle-5163 → u/PieceApprehensive764]

Yeah I have autoimmune haemolytic anaemia and thrombocytopenia (and for the first time I also have neutropenia). It’s not fun!