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

### input:
I have had a high monocytes reading 13 and low hemoglobin this was a routine blood test at work . I have now seen my GP who has said I am anemic but is sending me for more tests what will they be looking for ? I have had a dull ache in my back for many months and like an itching on my skin too, I am 49 and 5ft 6 ...generally good health but lately just feel drained

### output:

Hello and welcome to Chat Doctor, A high monocyte count, low hemoglobin and low backache can be due to same disease process or separate disease entities. Raised monocyte count is seen in both non-neoplastic and neoplastic disorders. Non-neoplastic disorders include chronic infections like malaria, leishmaniasis, tuberculosis, etc. These infections are more common in tropical countries and absent in temperate countries.Non-infectious include multiple sclerosis, etc. Neoplastic diseases include leukemia. A peripheral blood examination and other relevant systemic investigations will help further. Low hemoglobin can occur due to dietary deficiency or due to decreased production of red blood cells in the bone marrow. Red cell indices - MTV, MCH, MHC, RDW need to be done to know the cause of low hemoglobin. Low backache can occur due to bad posture, skeletal muscle strain, or due to some pathology in the bones. In the presence of high monocytes and low hemoglobin, there is possibility of bone marrow involvement by leukemia. Consult a hematologist for further work up. Thanks and take care Chat Doctor. 