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Pernicious Anaemia Society
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Blood Test results

Hi, my mom ended up In The hospital with a blood count of 4.9, in January. She has been anemic off and on for all of her life (since she was 5). She had just about every test done in the ER at Cedars - along w 4 blood transfusions. Her blood count stayed steady for again for months and then began to drop. Her RBC is always low. I've attached her cumulative blood results. What are we missing? Is the doctor testing for the right things? Any help is greatly appreciated...

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Does your mum supplement folate?

High RDW indicates that there is a problem with folate and / or B12. Serum B12 looks well into range but serum B12 isn't a gold standard test and will miss 25% who aren't B12 deficient so symptoms are important.


it is also possible that there may be something genetic going on - particularly if your mother doesn't supplement folate/folic acid.

You could also look at getting MMA and homocysteine levels checked to help clarify if B12 is a factor.


Hi, there is folate in the B12 and iron supplements she takes...perhaps not enough? Her MMA was 130 on a prior test. The doctor wants to do a bone marrow, but my mom is hesitant. Thanks for your reply :)


so that explains the folate result.

Did you have the range for MMA - don't remember off the top of my head what the normal range is and was she using the supplements before the test was taken.


Should she be taking more folate or does she have a build up of too much? The MMA range on her testing results is 0-378 and it's actually MMA serum. She doesn't have severe symptoms - hence the 4.9 blood count - which possibly could have been from baby aspirin? She lost the blood slowly, over 3 months. Actually and sadly, in September her blood count was 10 and the doctor didn't tell her...she should have done something then. She went to the ER in January. I'm going down the rabbit hole researching leukemia and heart failure and liver cirrhosis... thanks again for all of your input. Very grateful.


folate isn't stored in the body.

no problem in itself with folate being just above top of the range - I was just clarifying if it was high without supplementation.

if MMA is in the normal range then B12 is unlikely to be the issue.

Think the best think you could do would be to try and get your mother to go for the bone-marrow test.

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