Low Hemoglobin

[Lori1851]

Hi Friends,
Was just lookin over Dustin's lab report. His hemoglobin is 8.3. At what point will he need a transfusion? Its been like a year since he had any. I just cant remember at what point they do it.

Lori/ Indiana

[Ohio Buckeye]

Many of us get epo or another form of shot to raise the blood count.
I've had to have blood transfusions in the hospital when a procedure(s)
caused blood loss tho.

[KT0930]

I believe I was below 6.0 when I got a transfusion, but I had not been to a doctor in awhile, so I don't know what the treshold is.

[stauffenberg]

Usually the threshold for transfusion is 80 (on the scale where 140 is normal for males and 120 is normal for females).  If you ever intend to seek a transplant, however, it is good to have as few transfusions as possible, since each one increases your antibodies to potential donor kidneys.  At a hemoglobin value of around 80 you should still be able to build the blood up to a tolerable level by EPO without having to resort to a transfusion, but quick intervention is necessary.

[Lori1851]

Thanks for the input. I know Dustin does get Epo during dialysis  wondering why it tends to go low.
Lori/Indiana

[Slywalker]

My hemoglobin was always low even with the epo shots.  Mine used to hang around 8.0.  I never had a transfusion though.  It was never discussed.  I probably didn't get low enough for it to come up.

Take care

Sandyb

[kitkatz]

My docs say if I am at 9 for over two to three months then transfusion time.

[dmahlalek]

My Dr. waits until I hit 8.0.  EPO has brought my hemo to 12.7.

[highlite36]

I think the general number to look for is 7.  I know whenever I reached that number, I got a transfusion.  Actually, for a while there, I was getting transfused every two months or so.  It was bad enough that I was sent to hematologist and had a bone marrow biopsy to check for cancer because my body just wasn't responding to anything....  Kinda scary....

[jbeany]

Bone marrow biopsy - gee, aren't those fun?     My hemoglobin was at 6 when they started me on Procrit.  No one ever mentioned a transfusion at any point in time.

[stauffenberg]

It is dismaying to see the hemoglobin values reported by renal patients.  Anemia requiring treatment begins for women at anything below 120, and for men at any value below 140.  If your body remains in an anemic state for any length of time, a whole range of serious damage occurs, from generalized deoxygenation of the tissues to pathological enlargement of the heart muscle.  Just because hemoglobin cannot be safely restored to normal levels with EPO, nephrologists tend to act as if the anemia they cannot cure is harmless, but that is siimply not true.

[willieandwinnie]

Lori1851, EPO doses are a balancing act. They give EPO until the hemoglobin gets to 12.0 or 13.00, then they stop it until it gets low again. With the clinics it's all about money and medicare won't pay if the hemoglobin is what they consider high for a dialysis patient. Been there, done that. We found that feeding Len liver (YUKKKKKKKKK) a couple of time a month actually raised his hemoglobin and iron. Take care and I hope you can get these straighten out.

[donnia]

Mine was at 7.9 and my doctor said if I wasn't waiting for a transplant, he would have ordered a transfusion.  Instead, they raised my Epo from 10,000 to 20,000.  My hemoglobin is up to 9.0.... hopefully it will keep going up.

[livecam]

Interesting..when I started my hemoglobin was quite low and two units of blood were given during dialysis on successive days.  The plan then was for a transplant but the whole blood was given anyway.  I never had any issues with antibodies as a result and tranplant plans moved forward.

[stauffenberg]

There has been a lot of debate in the medical community about the new, lower levels of hemoglobin at which the government is willing to pay for EPO to correct the problem.  The experimental data on which it was decided to lower the hemoglobin level which the government would regard as tolerable for anemic patients was based on an exercise test in which people with an HbB of 130 and people with an HbG of 100 were asked to WALK FOR 10 MINUTES, and both groups were found equally capable of doing this in the same amount of time!  But this is idiotic, since anyone not yet at death's door can walk for ten minutes at a normal speed.  The test was thoroughly inadequate to measure the actual energy level required to get a person through the day, and of course those designing the test knew that, but then, the whole point of the test was just to find an excuse, however flimsy, too keep taxes low on rich people by cutting EPO payments no matter how much suffering in the sick population was necessary to achieve that.

[Lori1851]

Thanks for teh info friends

[Ang]

iron  infusion  and  red  meat should  help somewhat

[kitkatz]

My hemoglobin is up to 13, no wonder I feel better. Up from 10.

[willieandwinnie]

Glad to hear that kitkatz.

[KR Cincy]

My neph (a young guy) even recommended that we cook using cast iron skillets to increase the iron I get...I found that to be, um, a little antiquated...but we do it (along with iron infusions once a month, a GentleFE tablet once a day, and red meat when possible.)

[stauffenberg]

Of course iron is necessary for EPO to help increase the number of red blood cells your body can make, but since iron can be given intravenously or orally in perfectly adequate amounts, iron levels are not the problem.  The real problem is that EPO cannot safely be given in sufficient quantities to raise hemoglobin to normal levels, so that is the bottleneck in the system which keeps renal patients exhausted, no matter how much iron or B12 they get.