Is Your Fatigue From Anemia But No One Is Finding It?
Fatigue is one of the more common complaints that brings people to see their Primary Care Provider and even accounts for a loss of productive work days. As most people know, fatigue can stem from so many different sources including food allergies, insomnia, thyroid problems, Lyme Disease, chronic pain, adrenal dysfunction and so much more. Another very common cause of fatigue is anemia, typically defined as a deficiency of the oxygen carrying components of the blood, either the red blood cells themselves or the amount of hemoglobin within the red blood cell. Anemia itself has a multitude of possible sources and is beyond the scope of this article, however, important to note is that the presence of anemia can be foundational to other unresolved health issues. That’s why it is so important to discover if anemia is present as well as to understand how its presence can be hidden on a routine blood test if you are dehydrated at the time of your blood draw.
As a Physical Therapist, I am suspicious of anemia when someone is trying to follow through with a prescribed rehab program but can’t due to fatigue, light headedness, disproportional shortness of breath, extended heart rate recovery time, or even increased breath rate, heart rate, weakness or pallor at rest.
Additionally, as a Nutritionist, I am on alert when someone is on an anemia prone diet like vegan or vegetarian or when I see food diaries that are low in leafy greens, veggies, and legumes. I am highly suspicious of anemia when someone shows evidence of a malabsorption condition such as Gluten Intolerance. I ask about stool color and consistency and look for paleness in the lower eyelids, nail beds and palmer creases. Just as Xray, MRI and surgical reports provide me with all of the orthopedic data I need when treating someone as a Physical Therapist, knowing the results from blood work, glucose studies and GI workups that a physician has ordered also round out the patient’s total picture when I am working with someone on Nutritional Therapy.
Your Primary care Provider will test for anemia usually by ordering a standard blood panel called a Complete Blood Count (CBC). It is looking for the anemia markers I first mentioned about red blood cells and hemoglobin. Red blood cells are a solid particle in the blood and are quantified in relation to the liquid portion of the blood sample. If you happen to be dehydrated (lacking adequate fluid) at the time of your blood draw, then the proportion of solid particles (cells) to the liquid portion of your blood will be skewed and it will look like you have more red blood cells than you actually do. Your blood values can look normal and if you really are anemic, it may have been missed! That’s why it is imperative that you hydrate sufficiently the day before your blood draw and even drink a glass of water upon waking the morning of your blood test.
On your last blood draw for your annual physical were you told to be adequately hydrated? These are simple instructions that could make the difference of finding a possible cause of your chronic fatigue or not!