iron levels are at 18, very low.?

Hello and welcome to e health forum.

The normal iron levels in a female is ‎26-170 µg/dL.

In your case, this is found to be 18, which is very low, indicating iron deficiency anemia.

The cause of anemia in a middle aged female, could be either due to lack of iron in the diet or due to loss of excess blood during menstrual periods.

Presence of a low vitamin B 12 levels, would indicate dietary low intake or intestinal malabsorption.

To know the exact cause of the anemia, you may consult with your treating doctor, who can assess your condition with tests including a complete hemogram, ultrasound of the abdomen , stool tests or others as needed.

Treatment with iron and B12 supplementation, should be initiated as soon as the diagnosis is confirmed.

The description of "losing blood" in a elderly male is most probably due to gastro intestinal tract bleeding resulting in anemia.

The cause of this could be ulcers, intestinal inflamamation, gastric or duodenal ulcers, polyps, or neoplasia.

Your brother in law, would benefit by consulting his primary physician, who can get a stool test for blood and complete hemogram, a peripheral blood smear, and iron studies, to confirm the cause of bleeding and the type of anemia.

In addition , a upper GI endoscopy and / or a colonoscopy should be done to rule out any intestinal bleeding sources. Hence a consultation with a gastroenterologist should also be sought.

Treatment would depend on the exact cause of the loss of blood, and can be decided based on the results of the above tests.