Welcome to today’s Coag Coach teaching case with Dr. Toyosi Onwuemene, hematologist and coagulation specialist. In this case, we discuss a 49-year-old man with recurrent iron deficiency despite IV iron replacement and normal upper and lower endoscopies. The key question: If we can’t find a bleeding source, what are we missing? Dr. Onwuemene walks through the critical reasoning process for evaluating unexplained iron deficiency in men, including: Why bleeding is still the most likely cause even after negative scopes The role of therapeutic anticoagulation in recurrent iron loss When to pursue additional GI tract imaging How to balance ongoing anticoagulation with the risk of hidden bleeding Why identifying and addressing the source of blood loss is so important for long-term management 👉 If you’re a clinician, this case will sharpen your approach to recurrent iron deficiency and anticoagulation challenges. 🔔 Subscribe to the channel for more hematology teaching cases, tips, and clinical pearls to help you deliver better care for your patients. Tags/Keywords: iron deficiency anemia, recurrent iron deficiency, hidden GI bleeding, hematology teaching case, anticoagulation and bleeding, IV iron replacement, unexplained anemia, hematologist education, Coag Coach, GI tract bleeding, iron deficiency workup, medical education hematology

Iron deficiency in men is never normal. As a hematologist, I see cases where iron deficiency anemia in men is missed or dismissed. But it’s one of the earliest warning signs of gastrointestinal bleeding or even hidden GI cancer. In this video, I share three key takeaways about iron deficiency in men — and how you can save time with a hematology partner while improving patient outcomes. I’m Dr. Toyosi Onwuemene, a hematologist who supports GI practices and other providers with fast, expert input on blood disorders. For less than the cost of a screening colonoscopy, you can have a hematologist “phone-a-friend” on call to discuss your toughest hematology cases. Learn more or contact me at: https://www.coagcoach.com

Interpreting the lupus anticoagulant panel can be hard. It becomes easier when you recognize that it is one big mixing study. Hematologist, Dr. Toyosi Onwuemene, helps us with the interpretation.

Mixing studies help us distinguish coagulation factor deficiencies from inhibitors. But how do we interpret the results? Hematologist, Dr. Toyosi Onwuemene, walks us through the interpretation.

So the activated partial thromboplastin time (aPTT) is normal; but the prothrombin time (PT) is prolonged. How do you work it up? Hematologist, Dr. Toyosi Onwuemene, reviews the evaluation.

What do you do when both the prothrombin time (PT) and activated partial thromboplastin time (aPTT) are prolonged? For starters, you think about what information the prolonged aPTT and the PTT give you about the coagulation cascade (Are you feeling anxious yet?). Hematologist, Dr. Toyosi Onwuemene, walks you through the evaluation.

When the activated partial thromboplastin time (aPTT) is prolonged; but the prothrombin time is normal, that narrows down the possibilities to a deficiency or inhibitor of the intrinsic pathway. In this video, hematologist, Dr. Onwuemene walks us through the evaluation.

Anemia is so common that we don’t respect it. We guess at the reason for anemia and hope for the best. In this video, hematologist, Dr. Toyosi Onwuemene, discusses three essential tests for anemia that you should order every time.

The presence of microcytosis may indicate iron deficiency vs. hemoglobinopathy. But before all the tests are back, can you distinguish between the two? Hematologist, Dr. Toyosi Onwuemene, shows us a way to make a quick educated guess.