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

### input:
I have had low hemoglobin since last June in Oct 2011 my rheumotolist suggested I go see a GI doctor because my hemoglobin had dropped to 8.9 and it was appearing on the blood work thayt I was having internal bleeding . I had an endoscope and colotosopy. They were normal. I then has a capusle endoscope that was normal. I had blood work done in Feb. my hemoglobin had dropped to 7.9 still indicating internal blleding. On May 12th I went to the Er with rapid heartbeat , vomiting , and shortness of breath, My hemaglobin had dropped to 7.1 and rock bottom iron. I was admitted and given blood transfusions and iron. The doctors have now ordered a constant CT can of my adoman. I have been going to the hemotologist and getting feronine infusions weekly. My iron is still low and my hemoglobin has dropped from 10.3 in the hospital(after transfusions) to 8.3. They did do another endoscope in the hospital and that was fine. My family doctor, the GI and Hemotologist all seem to think i am having some type of GI bleed. What could it be.

### output:

Hello and thanks for the query. This is an excellent question.  It does appear that you have a significant anemia.  I am not sure that your doctors can conclude that you have actual bleeding going on.  It is possible that your body is somehow destroying the red blood cells.  This can sometimes happen through an autoimmune process.  I am, sure you're hematologist has considered this.  He may have requested some special laboratory studies to rule this out. It is important that you continue to receive your iron supplementation.  As long as the other blood cells in your body, including platelets and white blood cells are within normal limits.  It is most likely, your bone marrow is functioning normally and that some type of processes going on whether it is some type of bleeding that has yet to be discovered or whether your body is actively breaking red blood cells apart somehow through this immune process. Thanks again for sending your question.  I can appreciate, that you're dealing with a very stressful and frustrating situation.  Please let me know if you have any additional specific concerns.