MCV 100 - Other problems. What is the cause?

I have an autoimmune skin disease called vitiligo, I also have a number of other symptoms some include:

acne outbreaks

depression

anxiety

mood problems

slight ridging of nails

premature grey hairs

vitiligo as said

restless less at times

slight balance problems at times

and more....

I’ve had a few private blood tests and they have revealed a normal thyroid, higher cortisol levels, vitamin d insufficient (not deficient) and MCV 100 slightly high. I've put it down to a vitamin b deficiency (MCV) and started supplementing earlier this year but my active b12 was ok reading, still there are many other vitamin b's like folic acid, I also drink heavily at the weekend which can make b deficient.

Other things I want to test for are zinc and copper levels as these can effect skin.

Should I re-test the MCV to see if the 3 month of vit b supplement has worked and lowered it?

What about the copper and zinc test?

Any other ideas? I know vitiligo can cause imbalances and imbalances can also cause vitiligo, so I would like to know where the cheapest place is to get cheap but tests that test for lots of stuff.

11 Replies

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  • Well, it is heavy going, but this paper has quite a lot of information about elevated MCV, and the full paper is readily available:

    ncbi.nlm.nih.gov/pmc/articl...

  • Hi,

    Vitiligo, high MCV,ridged nails, premature grey hair, depression, balance problems can be a sign of PA(Pernicious Anaemia) or B12 deficiency.

    Perhaps you could look at the PAS website for more info on symptoms.

    pernicious-anaemia-society.org

    Other useful sites

    b12d.org

    b12deficiency.info

    It is possible to have severe deficiency with normal blood results.

    Have you had an IF (Intrinsic Factor) test?

  • Thanks for your reply.

    I've not had a IF test. I did have an Active B12 test done privatley a while ago, result was normal (although was probably supplementing back then, stopped a few days before as advised.) But could be folic acid too?

  • my understanding is that you need to stop all supplementation for at least 4 months prior to an active b12 test

  • I've gone ahead and ordered the IF test as you suggested:

    camnutri.com/anaemia-p-34.h...

    It says it tests for both of the antibodies. So I guess this will allow me to know if it's that or not.

    I've also ordered another full blood count to see if the MCV has lowered or not.

    This should make things easier to understand.

  • Hi,

    I had the test for IF Antibody,

    Result was 2.7

    Range: 0-10

    Result: within range.

    I guess it isn't that then?

    Also, I had my MCV re-checked and it is now 98 dropped nearly 2 to within normal range.

    I still have most of the symptoms but I guess it will take a lot longer than 3 month before i feel totally back to normal? I still need to cut down my weekly alcohol bindge too as I think that is making me feel a bit unwell now.

  • Hi,

    I had the test for IF Antibody,

    Result was 2.7

    Range: 0-10

    Result: within range.

    I guess it isn't that then?

    Also, I had my MCV re-checked and it is now 98 dropped nearly 2 to within normal range.

    I still have most of the symptoms but I guess it will take a lot longer than 3 month before i feel totally back to normal? I still need to cut down my weekly alcohol bindge too as I think that is making me feel a bit unwell now.

  • Definitely stopped the alcohol binges! The IF nti body test is bnotoriously unreliable so you can not realy conclude much, only that you are IF neg at this time see:

    bcshguidelines.com/document...

    "(a) Anti-intrinsic factor antibody

    The finding of a low total serum cobalamin level may be further evaluated by testing for anti-intrinsic factor antibody (IFAB). If positive, the test has a high positive predictive value (95%) for the presence of pernicious anaemia (Toh, et al 1997), with a concurrent low false positive rate (1-2%) i.e. a high specificity. It identifies those patients with a need for lifelong cobalamin replacement therapy. IFAB is positive in 40-60% of cases(Ungar 1967) i.e. low sensitivity, and the finding of a negative intrinsic factor antibody assay does not therefore rule out pernicious anaemia (hereafter referred to as AbNegPA). In addition, the positivity rate increases with age(Davidson 1989) and in certain racial groups [Latino-Americans and African-Americans; (Carmel 1992)].

    The incidence of pernicious anaemia in the UK population is estimated (extrapolated from NHANES surveys in United States) to lie between 1-5/100,000 per annum i.e. a rare disease. Reflex testing of all low cobalamin samples in a routine diagnostic laboratory is therefore expensive with a low detection rate. A history of other autoimmune disease e.g. hypothyroidism, and family history(Banka, et al 2011) increases the pre-test probability of pernicious anaemia.

    High titre intrinsic factor antibody may interfere with assays of cobalamin, leading to a false normal serum cobalamin. Testing for intrinsic factor antibody is therefore advised in patients with strong clinical features of deficiency such as megaloblastic anaemia or sub-acute combined degeneration of the cord despite a normal serum cobalamin level. In these cases pre-treatment serum should be stored for investigation with an alternative assay (HoloTC or MMA) to confirm the presence of a severe deficiency.

    Intrinsic factor antibody assays, based on automated chemiluminescence cobalamin binding, are vulnerable to give false positive intrinsic factor antibody results if the patient has had a recent cobalamin injection. Manufacturer product literature warns that these assays are only suitable for samples with a specified upper limit of serum cobalamin levels, and laboratories must comply with this advice. Results of assays using these methods should not be reported if the serum cobalamin is greater than 295 pmol/L (400ng/L) based on UK NEQAS survey data. True immunoassays for intrinsic factor antibody based on porcine or recombinant intrinsic factor binding can be used for post treatment samples."

    As you have vitiligo, then that ia an autoimmune condition, more are more common, as in if you have one you could get/ have more, although it does not mean you will have more.

    See:

    patient.co.uk/doctor/pernic...

    Associated diseases[2]

    People with pernicious anaemia are at increased risk of developing gastric cancer, and there is an association with other autoimmune diseases (including primary myxoedema, thyrotoxicosis, Hashimoto's disease, Addison's disease, and vitiligo).

    •Vitiligo

    •Primary hypothyroidism

    •Hashimoto's disease

    •Addison's disease

    •Hypoparathyroidism

    •Diabetes mellitus

    And:

    patient.co.uk/doctor/vitili...

    "Vitiligo is an acquired condition where there is patchy loss of melanin from the epidermis, causing areas of pale skin. There may also be loss of melanin in hair follicles. It is usually seen as an autoimmune disease and is associated with other such diseases."

    "General measures[4]

    •Protect against sun exposure as white patches can only burn and cannot tan. Advise about wearing protective clothing, avoiding the sun at peak sun times, and use of high-factor sunscreen.

    •Minimise skin injury as there is an increased likelihood of new white patches in areas of injured skin.

    •Monitor for other autoimmune conditions in adults with NSV.[3]

    •Blood test for thyroid function and thyroid autoantibodies.

    •Monitor thyroid function annually.

    •Look for symptoms of diabetes, pernicious anaemia, Addison's disease and thyroid disease.

    •Advise patients to report symptoms of the above conditions.

    •Assess impact on quality of life and presence of psychosocial problems."

    I would be good to have thyroid antibodies tested if MCV rises again.

    But definitely stay off the alcohol, see what that does would be good.

    Kind regards,

    Marre

  • Thanks for your detailed reply.

    As for the Thyroid antibody test, I had this done last year, it all came back on within range.

    I am aware about other auto immune conditions linked with vitiligo especially as my mother has one too.

    I’m guessing drinking hard at weekend for last 5 years straight is what caused MCV to go high and cause a number of symptoms (possibly) however, now it appears to be slowly lowering, imp hoping to see noticeable changes within next 4 month such as no gray hairs, no brittle ridges, feeling more alert and alive etc.

  • i don't want to ruin your weekends but drinking heavily with a suspected B12 deficit is not a good thing to do. Alcohol just wipes you of masses of B12. If you have an absorption problem it will require you putting it back artificially, food won't be enough. This is first time I've seen the initials MCV so i'm away to do some more study!

  • Look up labtestsonline for info on all blood tests.

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