Anaemia undiagnosed for decades, now being clueless

Hey there,

Lately, I was diagnosed with anaemia when I just took a simple blood test. By the way, I am 21, male, 190cm and 66kg. I am underweight because, since the age of 13, I have been taking medications for ADHD which lower my appetite significantly; but nothing that evolved recently. I have also been low on meat for roughly 1 year, but know I catch on eating meat regularly again.

Here we go with my blood test results from 1 month ago (the minus indicates lower than normal values)

Erythrocytes: (-) 4.30 {4.54 - 5.77} Mio./µl

Hemoglobin: (-) 12.7 {13.5 - 17.5} g/dl

Hematocrit: (-) 37 {40 - 51} %

RDW: 12.7 {< 14.8} %

Leukocytes: 5.6 {3.9 - 9.8} Tsd/µl

Thrombocytes: 284 {146 - 328} Tsd/µl

Ferritin: 44 {20 - 250} µg/l

Transferrin: 292 {200 - 360} mg/dl

Vitamin B12: 303 {187 - 883} ng/l

Vitamin D, 25-Hydroxy: (-) 29.7 {> 30; (Grey area: 20 - 29)}

Folate: 16.1 {2.3 - 17.6}

Transferrin Saturation: 21% (within lower bands)

Serum Iron: 88 (within range)

MCH, MCV, MCHC: well within range

But to be fair, two weeks before blood was taken, I took 2x80mg iron supplements per day because I was already diagnosed iron deficient in 2016, during childhood and adolescents.

I were then directed to a internist. However, I went to a private doctor to have consultation on further proceedings more quickly. She prescribed me with some Iron supplements (100mg per day). She also advised me to get some historical blood test results to have some sort of comparison. 

So I did. I managed to get blood test results dating back to as far as 2007 until 2015, with one being from 2015, one from 2012, one from 2011, two from, and one from 2007. They were from two different doctors (internist and paediatrician)

Then, surprise. All blood test results showed (even more) lowered Hematocrit, Hemoglobin and Erythrocytes levels. Besides that, lymphocytes (49.2%) were increased (but lymphocytes count absolute is 2,600), Monocytes (8.9%) were normal, eosinophil granulocytes (6.2%) were increased, neutrophil granulocytes (34.8%) were lowered.

Yet, I have never been diagnosed with anaemia, only with iron-deficiency early-on.

Let's be clear, I have always had the same lowered blood levels, but now my doctor wants to scrutinize into detail, what the cause is. She said that she could not exclude IDA at the moment, but if my next blood test results stayed the same, I would have to undergo further tests By further tests, she meant bone-marrow punction.

There are two things I don't understand:

1. Why are the same blood test results that were considered O.K. for more than 10 years are now deemed problematic? I mean, I do not feel any different, I am nowhere near prone to infections, fever or inflammation, I only catch a cold once in year, and my wounds, if any, heal in a normal time frame. There are simply no complaints on my health, as far as I can assess it.

2. If it would be something serious (think of leukaemia, etc) how can I lack any symptoms for more than 10 years, except having those lowered blood levels. I know, that there are forms of leukaemia that can develop over years (CML, CLL) but isn't this because no relevant CBC values were taken over on a regular basis?

Please help me on my diagnosis or further proceedings

Max

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