What can cause sudden onset of anemia?

I am a regular blood donor and have been for years. They test your hemoglobin prior to donating and my level has consistently been between 14.1 and 14.4. I went into donate a couple of weeks ago and it was 12.5 which isn’t terribly low as I understand it but it’s below the 13 threshold needed to donate. I went back a week later and it was 12.8. It was 14.2 two months prior when I last donated.

Next step was to go to my primary care physician and she ordered blood work. Her records showed high hemoglobin levels as well in my past blood work but the results from this one were again in the 12.5 range. She suspects abdominal bleeding and I will confer with a gastro doc next week.

I have not seen blood in my stool. I have not changed my diet or exercise level. I had a colonoscopy 18 months ago and it was clear. I don’t feel any differently than normal.

tl;dr: After a life time of high hemoglobin levels my level dropped significantly after eight weeks.

There could be a “leak” in your system somewhere. If not in the colon, then elsewhere in the gastrointestinal system. I work in a major hospital, and I know our Gastro clinic, if everything else has been ruled out, will have patients swallow a pillcam to see if there may be a leak in the small intestine. Bear in mind that you could have blood in your stool but not visible. That’s where a stool sample comes in.

Thanks very much. My nurse friend said that a stool sample is probably next. How would a leak develop?

That I don’t know offhand. Have you been swallowing glass recently?

Polyps can cause a slow bleed in your gut. Anemia can be a symptom.

There are a number of causes of an ‘acute’ anemia. As you and others have have indicated, a common and potentially serious one is loss of blood through your GI tract. Often, and especially in the absence of visible blood in the stools (whether red or black in color) where there’s been a slow leak, the anemia is due to iron deficiency. Iron deficiency is very easy to check for and, if present, would almost certainly call for upper and lower GI scopes to be performed.

Another cause of acute anemia, although less common than blood loss/iron deficiency, is hemolysis where the red blood cells are being destroyed for some reason (e.g. autoimmune, mechanical).

As you can imagine, there are many, many other causes of anemia but common things are common.

ETA: Occult blood loss is also very common in people who take blood thinners (anticoagulants like warfarin,apixaban, and rivaroxaban) and antiplatelet agents like aspirin, Plavix, etc.

I was having severe exhaustion issues two years ago and on the advice of my doctor went to the ER. When my blood test results came in they immediately gave me two units of blood and admitted me to the hospital. In addition to giving me more blood and iron they set me up for an upper and lower GI. While the colonoscopy showed no intestinal problems, it turned out I had severe stomach bleeding. This has become a recurring problem; I’ve had several blood infusions and endoscopies. My blood iron level has tested under 7 (which is when they have me come in for a blood infusion and schedule an endoscopy). When I had my last endoscopy in late May they found and cauterized more bleeders, and scheduled me for a follow-up in early August.

I am not happy.

I would ask for a vitamin B12 test and an iron test. B12 is poorly absorbed if your stomach isn’t acidic enough, and that happens with aging. I don’t know if it can happen that fast, but it doesn’t hurt to get that checked.

I’ll have to pull up my medical records and see what tests I’ve had. I’ve been borderline diabetic for years, and was also diagnosed with fatty liver disease, so I’ve had so many tests I can’t remember them all. I’m also scheduled for my six-month MRI the week before the endoscopy to verify that my liver is holding steady.

Thanks for the responses so far.

The blood work showed normal levels of D, B12 and blood sugar. My cholesterol is a bit too high but it always is.

My wife had this and they went through her GI tract with gun and camera, well camera anyway and found nothing. Finally concluded a minor seepage from a hiatal hernia. They gave her iron for a while and it eventually cleared up.

I had a problem last year. I got poison ivy and my doctor put me on a steroid medicine to clear it up. A day later I had black stools and some that looked like coffee grounds (which per Google was a side effect), and thought nothing of it. The next morning, I got out of bed and immediately fell down. Checked my blood pressure and it was down to 74/40 or something.

Got to the hospital and I was told I had internal bleeding and was lucky I didn’t die. And had lost two pints of blood.

Apparently, the blood thinners I was on interacted with the steroid, and caused the bleeding. Had the encoscopy done and colonoscopy done and it all came back okay. They said it was a fluke.

Then I was on iron pills for almost six months as I was now anemic due to the blood loss.

Fast forward a year and my blood work was fine. Then I had diarrhea and I took an Immodium AD tablet to help. A day later–shitting coffee grounds. So no more Immodium AD for me. They did my blood work and I was slightly anemic. Back on iron pills.

Seems blood thinners have bad reactions to OTC stuff :frowning:

Interesting. Are both of those things causes of anemia? I have Type 2 and fatty liver, and was chronically low in iron (thanks for that knowledge, Red Cross!) I told my doc and he was like “most women are low in iron” (cuz we bleed dontchaknow). So I started taking OTC ferrous sulfate a couple years ago and I haven’t tested low since (Red Cross again, not my doctor). Anyway my doctor doesn’t seem too worried about it. I do have regular blood tests from the doc too.

Apparently, one cause is long distance running. The blood in your feet gets pounded to nothing, killing the red blood cells.

If you just took up running as a hobby, it could be a cause.

My wife went through this and spent two years undergoing endoscopes including camera endoscope, colonoscopies, several GI docs, and nobody found any answers. It was an iron deficient anemia and she was now getting iron infusion treatments regularly. We read a lot of medical reports and she decided to cut gluten from her diet and it fixed everything. Evidently gluten is a digestive system irritant, and it’s possible for the body to become less adept at tolerating it over time, one of the many things that change as we age. We’ve experimented with it and she can handle small amounts of gluten ok, but anything more than about half a slice of bread gives her trouble.

In your case, has your diet recently changed to include more gluten? Do you feel gassy or bloated after eating a high gluten meal? If you cannot find a solution, cutting or reducing gluten is an experiment you can do for free to see if it helps.

No, as far as I know they’re not contributing to my anemia. It’s just that my medical history is so full of tests and treatments that sometimes I have to think about what’s being done to me, and why. I have been taking ferrous sulfate twice a day since the anemia kicked in. And I did have my B12 level checked when I was diagnosed, and it was normal.

My diet has changed a little since I am not going out to eat and I don’t eat at the work cafeteria anymore but I can’t imagine that the ratio of gluten has materially changed. I don’t ever feel gassy or bloated after a meal.

Before all, you need to see a doctor. I know you have done that, but it’s important.

First, your levels have changed but hardly sound like they are in the danger zone. You have seen your doctor, who ideally would check your hemoglobin, mean cell volume, ferritin level, electrolytes, complete blood count, glucose, creatinine, stool for blood and urine sample. Often, B12, TSH and other iron tests are performed. Less often, tests for celiac, Crohn’s, fava bean consumption, fish tapeworm, cancer, gynaecological or prostate problems, angiodysplasia, diverticulitis, ulcers, polyps, etc. depending on age, symptoms, history and family history.

Fairly Common: iron levels, diverticulitis, giving blood too often, excessive hydration, polyps, gynaecological problems (in women). B12 hardly ever turns out to be the cause.

Indeed, but that doesn’t stop people from prescribing B12 replacement therapy!.

It used to be a big business in Canada, maybe still is. I’ve ordered hundreds, possibly thousands of B12 levels. I can’t remember it ever being the cause - maybe once or twice at most.