@shoch1957 I hear you. It's kind of like what came first, the chicken or the egg! MDS causes anemia which in turn causes these symptoms. The clinician probably identifies divisions in anemia: mild, moderate, severe where specific symptoms are "expected." Also, dysplastic cells are not good at carrying oxygen which leads to some of your symptoms. I would tell the Dr that those are your symptoms and that you don't appreciate the fact he/she is not acknowledging them. Otherwise, are you satisfied with your care?