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MEPS Dq'd, low hemoglobin

Sundevil106150

Well-Known Member
My OR just gave me the news that MEPS dq'd me when I sent them my blood work to get a MEPS appointment. The reason according to my OR was that my hemoglobin was a 11.5 and not the average 13-16. Granted when I did the blood work I had 5 cups of coffee and nothing to eat so that may have hurt along with having BTM (Beta Thalassemia Minor, its an iron deficiency). I am going to my doctor to see what I can do. I know I can diet, take vitamins C, B16 and vitamin D, get a blood transfusion, etc (can't take too much iron due to BTM even though it helps). Anyone know how to go about this. My Kit is done and everything else is fine medically. I wrestled my whole life and into college so obviously BTM has no physical effect on me, especially since I was originally training for SEALs. The fact that MEPS would sign a waiver for someone with a heart condition, a concussion, and other medical conditions but not for being 1.5 on my hemoglobin count is ridiculous. I would greatly appreciate any help and input. I know I can get it raised but then I would have to worry about N3M; yet I'll worry about that when I cross that bridge. Thanks everyone.
 

FormerRecruitingGuru

Making Recruiting Great Again
You're not supposed to drink coffee or energy drinks at least 12 hours prior to your MEPS physical because of labs. Why your recruiter didn't brief you on that is beyond me. Anywho, just because MEPS DQ'd you doesn't mean N3M will do the same. When your OR picks up the medical forms from MEPS and submits it to N3M, you will have the opportunity to write a Letter of Activity (LOA) explaining the situation and how it hasn't impacted you in any way. I'd also recommend getting another lab done with a civilian provider and who knows you might be within the hemoglobin limit. I've seen MEPS DQ an applicant and N3M overturn it with the proper documentation.
 

Sundevil106150

Well-Known Member
I went to civilian them submitted it to MEPS to get an appointment. So I never even went to meps. So yah I am assuming that is what did it. So it was worse especially since I have Beta Thalassemia Minor. Another appointment with doctor is scheduled. I just won't be making this board. Any other suggestions Ruf?
 

TimeBomb

Noise, vibration and harshness
Sundevil,
First off, beta thalessemia is not an iron deficiency condition. It is a genetic defect in hemoglobin production. Supplemental iron will not change your hemoglobin/hematocrit unless you have a concommitant iron deficiency. Taking supplemental iron while getting blood transfusions for your condition may lead to significant problems with iron overload. Secondly, I doubt that your pre-physical fluid consumption had a major effect on your hemoglobin/hematocrit, unless the volume you drank was enormous.

Hereditary anemias are disqualifying for commissioning. Having an established diagnosis of beta thal, you will need to get a waiver for commissioning, which N3M may or may not recommend. Asymptomatic thalassemias may receive a waiver recommendation for aviation, provided your hematocrit falls into the NAMI "normal" range (40-52%, or given your diagnosis, 38-39.9%). NAMI requests the average of three blood samples drawn on three separate occassions to get an average hemoglobin/hematocrit. Might want to start that process now as it appears you're considering aviation. They'll also want to see the results of your hemoglobin electrophoresis to confirm the diagnosis and ensure you don't have anything else going on.

R/
 

Sundevil106150

Well-Known Member
mmm Ok so will it be MEPS and N3M doing the blood work then? Or my civilian doctor? Can I get commissioned and then just do the blood work again if my hemoglobin is within range. I know I can get it raised significantly from 11.5 to the 13-17 range but I don't know what else they will look for in my blood work. Also thank you for the detailed reply
 

Sundevil106150

Well-Known Member
Also would a blood transfusion dq me or no? How would you go about this? I am not giving up since it is this one little thing that is preventing being on my merry way
 

TimeBomb

Noise, vibration and harshness
Sundevil,
You will need a waiver for commissioning based on your diagnosis. I don't think that you'll be able to get commissioned without one, regardless of your hemoglobin/hematocrit at the time since you've already been identified as having beta thalassemia. Even if you don't disclose that fact at MEPS (not recommended by the way) your blood work can't hide the abnormally small red blood cells characteristic of beta thalessemia. That finding will set the evaluation machine into motion, which will reestablish what you already know.

MEPS and/or your civilian physician will be doing the blood work that you'll need. N3M has a purely administrative role reviewing the physical examinations on applicants. Based on their review, N3M may request additional information to aid them in either recommending or not recommending a waiver for commissioning. Any studies requested by N3M will be at your expense.

I personally wouldn't authorize a transfusion. I don't know if you've had transfusions in the past, but the guidelines for transfusing people are becoming increasingly stringent, so it is more difficult for physicians to order up blood transfusions solely for "low hemoglobin". There are a number of potential complications with transfusions, and a number of studies on a variety of conditions are conclusively showing that "routine" transfusions to get hemoglobin/hematocrit above an arbitrary cutoff are associated with poorer outcomes. Iron overload caused by repeated transfusions has it's own set of complications. I know the cutoff seems arbitrary to you, but it really isn't medically justified to undergo a significant medical procedure (blood transfusion) simply to hit a target.

I'd recommend honesty up front, and frequent conversations with your officer recruiter about how N3M is handling your commissioning package.

R/
 

Sundevil106150

Well-Known Member
Hey TimeBomb thanks for everything man I greatly appreciate it. Other than me having BT Minor, everything is perfect physical wise. I know I can raise my level from an 11.5 to the 13-17 range. If I have any more questions I'll be sure to go to you when you have the time. Already have an appointment with my doctor and a top blood specialist. Blood transfusion seems extreme for my case since my Hemoglobin level is only 1.5 under and not a drastic 5 or 6. Just one more question. Is this at all something that N3M can overturn. Lets just says I get a 1.5 count or just under the 13 requirement. Can they look at my history with physical activity and health and overturn MEPS?
 
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