How I Found Out I Was Anemic As A Guy

Yes, even men can be anemic without being a vampire.

Seth Underwood
3 min readOct 26, 2023


Back in December 2022, I published on Medium a story titled “My Hemochromatosis Journey.” It detailed my discovery of the fact I’m a carrier for hemochromatosis, and I’ve recently discovered that my eldest has inherited the same gene.

But this piece isn’t about hemochromatosis. It’s about how I ended up finding out I had drug-induced anemia.

Let me elaborate on what is drug-induced anemia… also known as drug-induced immune hemolytic anemia. It’s a situation where a “medicine triggers the body’s defense (immune) system to attack its own red blood cells. This causes red blood cells to break down earlier than normal, a process called hemolysis.”

When I was looking into hemochromatosis, my PCP ran blood ironwork, which included red blood cell counts. The results showed initially slight anemia.

This was an odd result for someone who’s supposed to have too much iron absorption.

After 2022, we ran the test again as a follow-up in the spring of 2023. Things were worse, but nothing to warrant concern. Then, with my 2023 physical, the test results came back, showing a marked drop. This was followed up by another run a month later, after adjusting my diet for increased iron intake. But the blood work came back, showing a tick downwards. Now I’m off to the hematologist.

Now the problem is I’m on a blood thinner that inhibits my Factor Xa enzyme production. Unfortunately, it was never told to me when I started this drug back in 2014 after a pulmonary embolism event that I could randomly develop anemia. I must take this drug because of my genetic clotting factors to prevent serious health issues like pulmonary embolism, stroke, or heart attack.

When I asked Google’s Bard about any co-relationship between the HFE gene and Factor Xa, this was its response:

“The HFE gene and Factor Xa are both involved in blood clotting, but they work through different mechanisms. The HFE gene encodes a protein called hepcidin, which regulates iron levels in the blood. Iron is a cofactor for many enzymes, including Factor Xa, so hepcidin levels can indirectly affect Factor Xa activity. However, there is no direct interaction between hepcidin and Factor Xa.”

Now I know people today question the accuracy of the output of generative AI, but honestly, I think Bard’s response is more than likely accurate. When I try my own searches using similar terms and questions for published papers on the subject, I’m not getting anything. Either there is no research on the topic, I didn’t word my queries well, or medical doctors have settled the science. I think the latter may be the case.

Looking back on my health journey, I can’t help but emphasize the importance of considering one’s health in a broader sense, beyond the standard screenings and tests. The discovery of my carrier status for hemochromatosis was a direct result of an individual decision to undergo genetic testing with 23andMe. The results from this test led me to further investigations that eventually revealed my drug-induced anemia.

When a doctor prescribes some drug, always ask health questions like — “Could this cause anemia? Or will it trigger some autoimmune problem?” I failed to do this back in 2014, and now I have a problem which could have gone unseen and could have killed me.

And if you take blood thinners, or drugs that can cause anemia, make sure your doctor runs a standard CBC, and iron tests if the red blood cell counts are showing anemia or have been decreasing since the last test.

Let my story serve as a reminder to monitor your health. Always insist on an annual check of your iron levels and red blood cells if you take blood thinners or similar anemia causing drugs. It might unveil anomalies that could be crucial to your health journey.



Seth Underwood

54+ autistic, undiagnosed dyslexic, sufferer of chronic migraines, writer of dark science fiction, player of video games and Mike Pondsmith Fan. Race- Human.