I have had low hemoglobin and rbcs from the time of my diagnosis, I've never heard of pale cells though. It depends on how low your tests are. When I was mildly anemic, my doctors didn't do any intervention. I did become severely anemic, Hemoglobin of 6.6 when my bone marrow was being too suppressed by Cytoxan and they had to lower the dose. My nephrologist told me that if your hemoglobin gets below 7.0 you need a blood transfusion. I never had one as my lowest measure of 6.6 was taken in the ER when I had an unexplained fever and they wanted to rule out infection. I was already just started on a prescribed oral iron supplement from my doctor and had just lowered my dose of Cytoxan so the ER doc wanted to wait and see if it would come up on its own. When it was that low I felt very tired, low blood pressure, muscle cramps, pounding heart rate, so you would also probably have some symptoms if it was really low. Do you have access to an online portal to see your lab results. Many hospitals and clinics are now offering this service to their patients and you can see if any labs are abnormal, what the normal range of values is, and research what the tests mean.
My rheumatologist had done a lot of tests to see why I was anemic, and they all were normal including B12, etc so they told me I had anemia related to having a chronic illness. I took the iron supplements for about a month and my hemoglobin is back in the normal range, although my red blood cells and hematocrit were still low on my last labs. Many of the medications we take for Wegeners can cause anemia as a side effect also and even something such as a medication to decrease stomach acid can cause decreased absorption of nutrients contributing to anemia.
Iron from animal sources is better absorbed by our bodies than iron from vegetable sources. Eating a food rich in vitamin C along with your meal will also help increase absorption of iron. You can google a list of foods that are good sources of iron. I also now take a multivitamin that includes iron. If you want to do that, check the label on the vitamin bottle as many adult multivitamins do not include iron, I take a children's chewable.
We must let go of the life we have planned so as to accept the one that is waiting for us.
Joseph Campbell
When sleeping women wake, mountains move.
Chinese proverb
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