*I did some research and this is what i could find about occasional tiredness when hg levels are okay:*

Fatigue or that “sleepy, heavy” feeling can definitely persist in people with autoimmune hemolytic anemia (AIHA), even when hemoglobin is normal and the disease is in remission. It’s not rare, just under‑discussed.

What’s going on isn’t anemia itself, but lingering immune activity. In AIHA, the immune system has learned to target red blood cells. Even after successful treatment, it often remains slightly “on,” releasing low levels of inflammatory molecules (cytokines such as IL‑6 or TNF‑α). These directly affect the brain’s energy and sleep centers and can create that drained or foggy sensation without any drop in oxygen levels.

People with mixed or cold‑reactive AIHA are especially sensitive to temperature changes. When exposed to cold air and then rewarmed indoors, cold antibodies (IgM) detach from red cells and trigger a small immune reaction. That releases cytokines and can cause 30–120 minutes of fatigue or sleepiness afterward. It feels like exhaustion but is actually an immune‑circulatory response.

So, while there’s no fixed percentage published, patient reports and clinical experience suggest that many people in remission—perhaps a significant minority—still experience intermittent fatigue, especially in fall and winter or after temperature shifts. It tends to improve over time as immune activity stabilizes, but can fluctuate for months or even years after remission.

In short:
• The fatigue is real and immune‑driven, not psychological.
• It can appear in waves, often linked to temperature or minor immune triggers.
• It usually lessens as the immune system fully quiets.

Important disclaimer: This specific post-cold exposure pattern of fatigue in remission has not been quantified in large studies, but it is recognized in clinical practice and by patient reports as a real and biologically plausible phenomenon.

there is also the pred withdrawal fatigue, something i'm going thru right now as i am tapering for a few weeks, it makes u very tired and very sleepy tbh

that means we have fatigue related to AIHA even if our HG levels is around 12 or 14? i mean, like a background symptom besides the fatigue that u start to feel at hg 9 or 8? for example, in winter i get so tired after i come from outside sometimes, it makes me sleepy, even if my hg is at 12. it improves with rest and a hot shower