Elevated mch and mchc

[Luac]

I had posted about a change in the need to inject once I had started taking creon/artificial enzymes.

I started creon in Feb and realised that I did not need to self inject as much. It seemed a month between injections was fine. Tingling in hands was my trigger to inject.

Last week i had an episode which gradually came on - sleepiness, brain fog, some gut issues, mood change, confusion etc it was really horrible after so much time without it.

I have gone back to SI every two days and im improving but not 100% yet.

There is always trial and error with spacing the dosing but I'm disappointed to be back at square one.

By coincidence, I had a full blood count taken on the worst day of it last week - I went to the supermarket after and that was a nightmare. I couldnt find anything even if it was right in front of me, scanned things twice by accident several times etc

The results were fine according to the gp but there were elevated/abnormal MCH and MCHC results.

This has been the case for every test I've had for the mchc including one in 2013, and 3 out of 5 for the MCH including the last two. The MCH results within range have been close to the top end of the range.

My GP has never mentioned it and when I've asked he says not to worry about it.

Any thoughts about that?

[FlipperTD]

I'm a scientist, and have performed very, very many of these tests using a variety of methods.

You don't state the actual numbers, which would be helpful.

The MCHC is arguably the least useful of the figures produced in the FBC, for a variety of technical reasons. Some laboratories don't actually report the MCHC any more to avoid confusion. If the numbers in question are just outside the reference ranges, then it's worth remembering that these are usually 95% ranges, so 5% of 'normals' will fall outside the range whilst still being normal. The further away from the range, the less likely this will be.

If there is no trend in the results, then your GP is probably 100% correct. If your FBC reports the Red Cell Distribution Width, that can be interesting. If it's stable and within the reference range then there's not much happening. Keeping records of your previous results for comparison is a good thing. Good luck.

[Luac in reply to FlipperTD]

Thanks for the explanation - the highest MCH is 32.6 and MCHC is 369. There is a red cell distribution width a highest reading of 13.2. These are all well within a 5% discrepancy so I should rest my mind!

[FlipperTD in reply to Luac]

Splendid! The RDW is reassuring.

Good luck, and listen to your GP.

[Luac in reply to FlipperTD]

I think I got in a flap about it because I have all my records on the patient app and those reading appear as "abnormal", written in red. Makes it look like a warning!

[FlipperTD in reply to Luac]

Reference Ranges are built in to laboratory systems to help and guide folks, both within the laboratory, the hospital and the GP systems. The way systems handle the numbers is complicated. Given the massive numbers that are used, then it's likely that anything that flags as 'within rage' might be issued withut delay, without being seen by anyone before it hits the 'end system' of the GP practice. If it's outside the range then it will usually be seen by someone within the system who will then decide if further action is required before issue. However, the important thing to remember is that the GP ought to be trained to 'treat the patient, not the numbers'. Given that the ranges are usually 95% confidence limits, 5% of 'normals' will lie outside that 95% whilst still being 'normal'. Given the massive number of figures issued, then it's easy to see how, when the '95%' is applied to each one, then the more things you measure, the more likely you are to find one outside that 95%, whilst still remaining normal.

Some folks simply have some lower or higher numbers than other folks, but that doesn't make them abnormal. Hope this helps.