Why the cause matters
Iron deficiency is common, especially with heavy periods, pregnancy, poor diet or gastrointestinal blood loss. But anaemia can also come from vitamin B12 or folate deficiency, haemolysis, thalassaemia, sickle cell disease, chronic kidney disease, inflammation, medication, or a bone marrow disorder.
Taking iron without confirming the cause can mask a gastrointestinal cancer or other source of bleeding. In thalassaemia, unnecessary iron can be harmful. The evaluation therefore looks for the mechanism, not just the haemoglobin number.
Related: Haematology → · Dr. Sachita Baniya profile → · All conditions →
What the assessment covers
The consultation reviews diet, menstrual history, pregnancy, bleeding, jaundice, dark urine, family history, medicines, alcohol, kidney disease and chronic illness. A full blood count with reticulocyte count and blood film is the starting point.
Further tests may include iron studies, vitamin B12 and folate, haemolysis markers, liver and kidney tests, stool occult blood, coeliac screening, haemoglobin electrophoresis, and referral for endoscopy or colonoscopy when blood loss is suspected. Bone marrow examination is reserved for selected cases.
- Full blood count, reticulocyte count and blood film
- Iron studies, B12, folate and haemolysis screen
- Kidney, liver, thyroid and coeliac testing where indicated
- Evaluation for gastrointestinal blood loss
- Haemoglobin electrophoresis for suspected thalassaemia
Treatment
Treatment depends on the cause. Iron replacement may be oral or intravenous where indicated. B12 and folate are replaced when deficient. Haemolytic anaemia, thalassaemia and marrow disorders need specific management. Transfusion is used for symptomatic or severe anaemia, not as a substitute for finding the cause.
Pregnancy, heavy menstrual bleeding and chronic kidney disease need coordinated care with obstetrics, gynaecology or nephrology. Genetic counselling is important for thalassaemia and sickle cell disease.
Access and booking
Dr. Baniya consults at Kathmandu Neurology Clinic & Cognitive Center, Durbar Marg, and also practises at Kathmandu Cancer Center (KCC) Nepal, Civil Service Hospital, Kathmandu, and Advanced Care Hospital. Appointments are arranged at the Durbar Marg clinic or through the respective hospital or cancer centre. Bring all blood counts, marrow, flow cytometry and molecular reports.