Pernicious Anaemia Society
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Interpreting blood results

Hello all, I'm new here and it was only after receiving blood results that led me here.

I'm hoping you can give me some help interpreting these. I had recent blood tests for ferritin as I feel awfully tired, those results came back abnormal

Serum ferritin 10.8ng/ ml. Reference range 20 -130

Drs have followed this up with a FBC which came back as follows,

Full blood count

Haemoglobin concentration 146 g/L [115.0 - 148.0]

Total white blood count 9.6 10*9/L [4.5 - 13.0]

Platelet count - observation 267 10*9/L [140.0 - 400.0]

Red blood cell count 4.89 10*12/L [3.83 - 4.98]

Mean cell volume 83.0 fL [84.0 - 99.0]

Outside reference range

Haematocrit 0.405 [0.36 - 0.46]

Mean cell haemoglobin level 29.9 pg [27.5 - 32.5]

Mean cell haemoglobin concentration 360 g/L [309.0 - 348.0]

Outside reference range

Neutrophil count 5.70 10*9/L [2.0 - 7.5]

Lymphocyte count 2.64 10*9/L [0.8 - 4.0]

Monocyte count - observation 0.91 10*9/L [0.2 - 0.8]

Outside reference range

Eosinophil count - observation 0.24 10*9/L [0.04 - 0.4]

Basophil count 0.06 10*9/L [0.0 - 0.2]

Obviously most of this means nothing to me other than some of the results are out of reference range. Dr has advised to start iron replacement for 3months and repeat the bloods. Although it appears my MCHC is massively out of range, is this the norm.

Any help anyone could give would be greatly appreciated.

Many thanks for taking the time read.

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Hello Samina I'm new here myself and found people give good answers. Only result I can help with is the ferritin as I suffer from that depletion, it certainly makes you feel unwell. To feel better the result should over 50 at least.

You definitely need the iron replacement and if you can get the liquid one which I have, Sytron ...it really is better than tablets. Also one thing I know about iron supplements is do not take it before or after a cup of tea, preferably take on empty stomach and leave a while before taking other meds. Hopefully someone will come along to help you with your other results. X

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samina - although this forum has anaemia in the title it is actually about a particular vitamin deficiency - B12 - that causes a particular type of anaemia- macrocytic anaemia.

Your red blood cells are a bit on the small side - microcytic anaemia - which is typical of an iron deficiency - and consistent with the low ferritin. Ferritin is a protein that binds to iron enabling it to be used by cells. Small red blood cells are less efficient at carrying oxygen to your cells so will leave you feeling quite ill.

MCHC is a ratio between mcv (which is below) and mch (which is also a bit on the low side) - which is why it is coming out so high

Has your doctor done anything about investigating why you are iron deficient - eg what is your diet like? If your diet is good then it could show that you are developing an absorption problem. Any gut issues?

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Hi there,

Each one of our red blood cells has several iron molecules attached to it. The iron picks up oxygen in the lungs and as the red blood cells move thru our body the oxygen is released and carbon dioxide is picked up and taken to the lungs to be released when we breathe out. When low in iron, this lack of oxygen attachment, leads to fatigue and breathlessness.

Additiin even though your wbc are in range you could have an infection.

I had h pylori, a chronic infection with a wbc count between 7.7 and 9.7 over the years. H pylori reduces stomach acid which causes iron not to be absorbed well.

I only got tested for h pylori to rule it out as i did not have either of the major symptoms of stomach pain or heartburn, yet i was positive.

You might get tested because taking iron when you have h pylori (i did this, 3X 65 mg elemental iron, for 8 days at one point) might make you feel weirdly unwell.

Best of luck and good health.

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Thank you all for the replies, my gp hasn't done any investigating, just gave me iron tablets and sent me on my way with instructions to repeat bloods after 3 months.

This is the 2nd time in as many years that my iron has been low, although I'm a 27 year old female so perhaps my gp has put it down to my cycles, which are actually few and far between.

I am also vid d deficient, with a level of 25 before a 7 week course of vit d. I now take that monthly. I also take 40mg of citalopram daily and have suffered with psoriasis for the last 6 years. This probably has no or some significance but I feel a nuisance pestering the drs when there are many people suffering bigger problems than my own.

Thank you all so much again, all your help and advice is a great comfort.

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Hi,

Do you have blood results for b12 and folate?

I'm asking because I've read that there can be an association between psoriasis and pernicious anaemia.

Low iron can lead to small red blood cells (microcytosis) and low B12/low folate can lead to enlarged red blood cells (macrocytosis) so I wondered if effects of low iron on red blood cells could be masking effects of low B12/low folate.

Are you in UK? I'm asking because medical guidelines for treating vitamin and mineral deficiencies can vary from country to country.

B12 Deficiency Symptoms

pernicious-anaemia-society....

b12deficiency.info/signs-an...

Risk Factors for B12 Deficiency and PA (Pernicious Anaemia)

pernicious-anaemia-society....

b12deficiency.info/what-are...

b12deficiency.info/who-is-a...

B12 books I found useful

"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper

Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with UK b12 guidelines.

"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)

Very comprehensive with lots of case studies.

Coeliac disease

In UK, NICE (National Institute for Health and Clinical Excellence) guidelines for Coeliac disease recommend that any patients with unexplained iron, B12 or folate deficiency should be tested for Coeliac disease

nice.org.uk/guidance/ng20/c...

coeliac.org.uk/coeliac-dise...

Full Blood Count and Blood film

labtestsonline.org.uk/tests...

patient.info/doctor/periphe...

I am not medically trained.

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I'm on ferrous fumerate 210mg.

I've been on citalopram for 3 years now. Although I'm really short of breath, even do simple things like getting up the stairs and doing the shopping and have had X-rays, inhalers and spirometery for that, which all were normal so no problems with my lungs. I've never had b12 or folate tested so perhaps I should ask for it? I am in the UK

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