### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hello. My sister is 23 years old and is suffering from very low HB that is 3.5. Two years back she had severe bleeding due to fibroids and after that she s on medication. Her bleeding has become better but her HB has fallen down a lot. I am really worried what to do. Should we go for a blood transfusion.

### output:

Dear patient. Greetings from Chat Doctor !!!  I am Chat Doctor and shall be answering your question. I can understand your reservations about blood transfusion and when it should be done. Furthermore, I will try my best to answer your question and guide you through the problem. Your sister has an HE of 3.5gm/DL. The normal HE for her is 12gm/DL. Her anemia can be multifactorial, blood loss due to fibroid, nutritional, menstrual loss. HE of 3.5gm/DL is a very low hemoglobin. The body goes into a state of high output cardiac failure and blood is not able to deliver enough oxygen to the tissues. Oxygen is a basic requirement of the cells. Hypoxia leads to accumulation of acids in the blood and the patient feels tired and breathless. Hence, I would recommend your sister be transfused with a total of 3 to 4 packed cells to get the HE till 7gm/DL. She can then be treated for the cause. She can then be given hepatitis, intravenous iron and treated for fibroid if any. Current day transfusions are safe and the risk of acquiring diseases is minimal. Hence, you shouldn't worry about that, I hope this helps you out. If you have any more questions, please do not hesitate to write back to me. Yours sincerely, ChatDoctor.