Frequent Bruising Concerns
I’m a 29-year-old female, standing at 5 feet 7 inches and weighing 140 pounds. Lately, I've been experiencing excessive bruising; just brushing against an object can result in noticeable marks, even when there's no pain involved. Initially, I attributed this issue to iron deficiency anemia (IDA), despite diligently taking two iron supplements daily along with vitamin C for the past two years. My hemoglobin levels had been consistently dropping, reaching 95 g/L, and my ferritin was alarmingly low at 2 ug/L. Following this, my hematologist opted for intravenous iron treatment in 2023, administering two doses of 1000mg ferric derisomaltose. Thankfully, my hemoglobin has risen to 124 g/L and my ferritin levels are now 441 ug/L, which has also alleviated my shortness of breath during conversations. I underwent both an esophagogastroduodenoscopy and a colonoscopy since my hematologist suspected a potential gastrointestinal bleed. Fortunately, both procedures showed normal results without any detectable issues. However, over the weekend, while playing beach volleyball casually with friends — unstructured play without intense movement for about ten minutes — I noticed severe bruising an hour later. My skill level was adequate, having played during my high school years, yet I ended up with significant bruises and pain in my wrists. This has raised concerns, especially since none of the others experienced similar bruising — it feels disproportionate to the activity. My platelet count and mean platelet volume (MPV) are both well within normal limits. There is a slightly elevated C-reactive protein (CRP) level, but I also deal with chronic neck pain stemming from TMJ disorders. It’s worth noting that my history of easy bruising is relatively recent, developing over the past eight years. If I can, I will share an image in the comments for reference.
Answers (1)
6/15/2025, 10:10:39 PM
OpenHealth AI
It’s understandable to be concerned about frequent bruising, especially since you noticed significant bruising following a casual activity. While you've made significant progress in managing your iron deficiency anemia, the easy bruising can arise from various factors, including underlying conditions or lifestyle elements.
Explanation
Frequent bruising can occur for several reasons:
- Platelet Function: While your platelet count is normal, the efficiency of platelets in forming clots can be affected by conditions not evident in standard tests.
- Vascular Fragility: Sometimes blood vessels can be more fragile, leading to bruising from minor impacts.
- Medication: If you’re taking any medications, even over-the-counter supplements, some can increase bleeding tendencies or affect platelet function.
- In recent history, you mentioned this bruising has developed over the last eight years, which might indicate a gradual change rather than an immediate serious condition.
It’s crucial to understand that significant bruising with pain may also suggest soft tissue injury or strain that could be occurring even with minimal movement, especially if there are underlying muscle or joint issues from your chronic neck pain.
Next Steps
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Monitor Symptoms: Keep a diary of when bruising occurs and any accompanying symptoms. Note if you see patterns related to specific activities or injuries.
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Protect Yourself: Consider using protective gear if you're engaging in activities that may increase bruising, like volleyball, particularly around your wrists or other common bruise spots.
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Avoid Blood Thinners: If you take any supplements (such as fish oil or herbal remedies) that may thin the blood, consider halting them and observing any differences in bruising frequency.
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Hydration and Nutrition: Ensure you're well-hydrated and consuming a balanced diet rich in vitamins, particularly Vitamin C and K, which play roles in blood vessel health and healing.
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Follow Up: With recent procedures yielding normal results, discuss with your hematologist or primary care provider any new symptoms or concerns about bruising. They might consider further testing, such as checking for clotting disorders or vascular issues.
These steps can help you manage and potentially reduce further bruising incidents. It’s essential to stay vigilant and proactive about your health while discussing any ongoing concerns with your healthcare team.
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