Help with blood test results

[Page123]

Hi, I'm new to this site but hoping that you can all help with my recent blood results. I've been feeling unwell for a while now and was sent for a full blood count blood test, which came back abnormal. My MCV result was 104.4 and my MCH was 34.9. I've googled both of these and it suggests I'm lacking in B12, with anemia. Does anyone else have similar readings that can offer advice? I have a follow up appointment with my doctor in a week, so anticipating what I'm going to be told. Thanks

[Gambit62 Administrator]

Do you have the full blood test results - including the ranges and units - which can vary depending on kit and exact methods of measurement so important to give results in these context.

What other results were there?

The results do sound as if they are at the top end of ranges that are usually quoted so indicative of macrocytosis - a condition in which red blood cells are larger and rounder than they should be - making them less efficient at transferring oxygen around the body.

This is a classic symptom of B12 and/or folate deficiency - suggesting that the next step would be to check on levels of these two vitamins in the blood - but possible that these results are already in the test that you have done - but B12 may not be flagged up as outside normal range as the B12 serum test isn't a definitive guide.

If you have the full set of results suggest that you post them in full - reference ranges are given in brackets

[Page123 in reply to Gambit62]

Thank you so much for the reply, the full blood results are as follows:

MCV 104.4 fl (80 - 100)

MCH 34.9 pg (27 - 32)

I can't see anything so that references b12 on the result so not sure if that was tested.

[Gambit62 Administrator in reply to Page123]

okay - but would have expected there to be quite a long list of tests - not just MCV and MCH

B12 and folate aren't generally done as part of a full blood count so may not be there

[Page123 in reply to Gambit62]

He are the rest of the results:

Heamoglobin concentration 133g/l (115.0-165)

Platelet count observation 226 10*9/l (140-400)

Total white blood count 8.2 10*9/l (3.6-11)

Neutrophil count 5.49 10*9/l (1.8-7.5)

Lymphocyte count 1.94 10*9/l (1.8-7.5)

Monocytes count - observation 0.65 10*9/l 0.2-0.8)

Eosinophil count observation 0.10 10*9/l (0.1-0.4)

Basophil count 0.04 10*9/l (0.2-0.1)

Red blood cell count 3.82 10*12/l (3.8-5.8)

Haematocrit 0.399 1/1 (0.37-0.47)

Thanks

[Gambit62 Administrator]

Haemocrit and red blood cell count are both towards the low end of the range - combined with raised MCH and MCV but normal haemoglobin levels it does indicate that you probably do have macrocytosis.

Suggest you ask GP to follow up with testing for B12 and folate ...

put together a list of symptoms

pernicious-anaemia-society....

and also arm yourself with some of the documents from BCSH and UKNEQAS on diagnosis and treatment of B12 deficiency - so you are in a strong position to make sure your GP is aware that diagnosing B12 deficiency isn't just a matter of looking at the result but also means looking at symptoms etc.

pernicious-anaemia-society....

healthunlocked.com/pasoc/po...

Please continue to keep us updated.

[Page123 in reply to Gambit62]

Thank you so much for the help, it's finally good to get a reason for why I've been feeling so unwell, thought I was going mad !!!

[Page123 in reply to Gambit62]

Dear Gambit62, I had a follow up appointment with my Doctor today and she said that my results were fine and that there was nothing to worry about. I'm now confused as still feeling un-well but with no way forward. She is however putting me forward for some more testing regarding my IBS so not sure if this help. Any suggestions would be gratefully received.

[Gambit62 Administrator in reply to Page123]

did you get a copy of the blood test results for your own records so you know exactly what has and hasn't been tested? you should be able to request from the practice without needing a GP appointment - there might be a small admin charge and the receptionists may be obstructive but all they can really do is require proof that you are who you say you are.

Other than that I'd suggest that you see what testing is proposed in relation to the IBS.

Think you are probably having to deal with one of the vaste majority of GPs who is totally unaware of what B12 deficiency really is and how it manifests.

On the other hand the symptoms overlap with so many other possibilities that it is good to get other things ruled out ... but sorry that you have to continue to feel so ill in the meantime.

I'm assuming that you aren't vegan or someone who eats very little meat/fish/dairy/egg - if you are then I'd suggest trying to supplement B12 to get you up to 100% RDA - may be a little more - if you have an absorption problem it isn't going to make any difference but if you don't then it would demonstrate that any deficiency was dietary and then you would know how to avoid it in the future

[Page123 in reply to Gambit62]

Thanks for the advice, I have a copy of the full blood results (posted earlier), the GP said that they were up for her interpretation even though the results said they were abnormal, but she said looking at them with the other results they were fine and the scale on which showed they were abnormal was just a measure!!! This doesn't help me, I got up today feeling very lightheaded, shakes, disorientated but still had to get myself together and go to work, feeling exhausted. Luckily my boss is very understanding and has b12 deficiency herself so understands. I've been out and bought iron and b12 supplements and am starting to make green veg and fruit smoothies hoping that I can get on top on these ill feelings. Do other doctors normally skip over these result, or is it a uk GP issue? Many thanks

[Gambit62 Administrator in reply to Page123]

basically the tests were only a full blood count - no vitamin or mineral screening.

She is ruling out B12/Folate because there is no sign of macrocytosis but macrocytosis isn't among the first symptoms of a B12 deficiency for 30% of population so, whilst on the balance of probabilities not having macrocytosis indicates that you don't have a B12 deficiency it doesn't rule it out.

Did you go armed with a list of symptoms and the materials I suggested a couple of days ago?

Next step would probably to to write drawing her attention to relevant facts in the guidelines.

you might also want to look at the PAS website and draw your GPs attention to the microsite aimed at medics

pernicious-anaemia-society....

pernicious-anaemia-society....

you might also want to consider joining as they will be able to provide you with more direct support in relation to GP

pernicious-anaemia-society....

martynhooper.com/2016/09/23...

[clivealive Forum Support]

Hi Page123 I think it is important to try and work out for yourself why (if you are) you may be B12 deficient.

Who’s at greatest risk for B12 Deficiency?

Anyone at any age, can become B12 deficient. However, certain people are at an elevated risk. They include the following:

Vegetarians, vegans and people eating macrobiotic diets.

People aged sixty and over

People who’ve undergone any gastric and/or intestinal surgery, including bariatric surgery for weight loss purposes (Gastric bypass).

People who regularly use proton-pump- inhibitors. H2 blockers, antacids, Metformin, and related diabetes drugs, or other medications that can interfere with B12 absorption.

People who undergo surgeries or dental procedures involving nitrous oxide, or who use the drug recreationally.

People with a history of eating disorders (anorexia or bulimia).

People with a history of alcoholism.

People with a family history of pernicious anaemia.

People diagnosed with anaemia (including iron deficiency anaemia, sickle cell anaemia and thalassaemia).

People with Crohn’s disease, irritable bowel syndrome, gluten enteropathy (celiac disease), or any other disease that cause malabsorption of nutrients.

People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) Type 1 diabetes, vitiligo, lupus, Addison’s disease, ulcerative colitis, infertility, acquired agammaglobulinemia, or a family history of these disorders.

Women with a history of infertility or multiple miscarriages.

Can you see if you are "like" any of the people above and if so add it to the list of your symptoms as Gambit62 suggests to present to your doctor.

I wish you well.

[Page123 in reply to clivealive]

I have suffered with IBS for many years and some days it is really bad, so this could be one of the reasons.

[clivealive Forum Support in reply to Page123]

Now skim down the list of B12 Deficiency/P.A symptoms below and list those that apply to you and present that plus a mention of your IBS to you doctor.

1 Pernicious Anaemia - Symptoms

1.1 General Symptoms

The following general symptoms are common in those with PA:

 The Strange Tiredness

 Fog days, where you have difficulty in thinking clearly

 Weakness

 Fatigue

 Upset stomach

 Abnormally rapid heartbeat (tachycardia) and/or chest pains

 Abnormal yellow colouration of the skin (jaundice)

 Heightened sensitivity to hearing, smell, and taste

 Vision distortion, e.g. seeing stars, or double vision

 Breathlessness

 Headache

 Cankers (ulcers) in the mouth

 Sleep disorders

 Intolerance to loud sounds, flashing lights

 Intolerance to crowded malls (needing personal space)

 Tinnitus – ringing in ears

1.2 Neurological Symptoms

The neurological symptoms of vitamin B12 deficiency may include:

 Numbness and tingling of the arms and more commonly the legs

 Difficulty walking

 Loss of balance

 Hands feel gloved with loss of sensitivity

 Loss of vibration sense, having to look down to see where you are walking

 Unable to close your eyes and stand on one foot

 Night vision

 Memory loss

 Disorientation

 Dementia

 Extreme mood changes

 Short term memory loss

Some experience many of these symptoms and some none of them. It depends on how quickly the PA is treated and on how well managed it is.

1.3 Gastrointestinal Symptoms

The gastrointestinal symptoms of vitamin B12 deficiency may include:

 A sore tongue

 Appetite loss

 Diarrhoea and/or constipation

 Stomach pain