What to do if my MCV and MCH are low after taking metformin and I'm feeling suffocated?

Given your symptoms and the lab results showing low MCV and MCH, it’s important to consider iron deficiency anemia. Low MCV usually suggests microcytic anemia, commonly due to iron deficiency rather than the B12 deficiency often associated with metformin. The feeling of suffocation is concerning, particularly if you’re experiencing shortness of breath or fatigue, which can accompany anemia. It’s crucial to address this with your healthcare provider promptly. They will likely want to evaluate your iron levels, including tests like serum ferritin, transferrin saturation, and total iron-binding capacity, to diagnose iron deficiency accurately. If iron deficiency anemia is confirmed, they might recommend dietary changes to include more iron-rich foods, like red meat, leafy greens, and fortified cereals, or oral iron supplements. It’s usually advisable to take these supplements with vitamin C to enhance absorption, but they should be taken as directed by your doctor since they can cause stomach upset or constipation. Additionally, you should avoid taking them with calcium or certain medications, as these can interfere with iron absorption. Your feeling of suffocation should not be overlooked; ensure you seek immediate medical attention if symptoms worsen, as these could be signs of cardiac or respiratory issues, which can be exacerbated by anemia. Meanwhile, continue metformin as prescribed but make sure your healthcare provider monitors your B12 status periodically to prevent deficiencies. Regular follow-ups and possibly adjusting medication might be necessary based on your comprehensive lab results and symptoms. Always consult your healthcare provider before making any changes to your medication or supplement regimen.