I have had an abnormal MCV result after having routine blood tests and have had many abnormal MCV and MCH results in the past. Years ago I asked my GP what it meant I think he said it just meant I had a lot of blood… he didn’t think it was anything to be concerned about.
I haven’t had contact with anyone at the surgery this time and accessed my results through patient access. The comment said “No action. Reviewed by Clinician”
I looked up MCV and it led me to this forum - I’m wondering if I could have pernicious anaemia or are my results nothing to worry about? Here are all my test results over the last nine years starting with most recent:
MCV:
100.2fl (79-98) 2022
96.6 (79-98) 2021
102.7 (79-98) 2019
98.6 (78-100) 2018
97.8 (78-100) 2018
98.8 (78-100) 2017
98.3 (78-100) 2016
100 (78-100) 2015
96 (78-100) 2013
MCH:
32.1pg (27-33) 2022
31.7 (27-33) 2021
33.4 (27-33) 2019
31.7 (27-32) 2018
32.2 (27-32) 2018
32 (27-32) 2017
31.9 (27-32) 2016
32.9 (27-32) 2015
32.4 (27-32) 2013
I have one record of serum vit B12 taken last year 456ng/L (160-925) and serum folate 4.2 ug/L (2.9-50)
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Artemis2
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I don’t know if any of this is relevant, I had low vitamin D nine years ago 23 nmol/L. My GP was very concerned about that and prescribed high dose vitamin D. I’m sensitive to a lot of chemicals
Links to forum threads where I left detailed replies with lots of B12 deficiency info eg causes and symptoms, UK B12 documents, B12 books, B12 websites and B12 articles and a few hints on dealing with unhelpful GPs.
Some links may have details that could be upsetting.
Some of the info will be specific to UK.
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If you're in UK......
1) Always get access to or copies of all blood test results.
If GP surgery says everything is normal, no action then check results for yourself.
2) Get hold of the local B12 deficiency guidelines for your area and compare them with BNF, BSH and NICE CKS links below.
If you click on "project documents" then on "consultation comments and responses" it gives a good insight into current issues around diagnosis and treatment (over 40 pages)
See Cautions section in above link which says that folic acid should never be given on its own for PA (Pernicious Anaemia) or other megaloblastic anaemias caused by Vit B12 deficiency as this may lead to SACD, subacute combined degeneration of the spinal cord.
Local B12 deficiency guidelines
CCGs (Clinical Commissioning Groups) in England were replaced by ICBs (Integrated Care Boards on July 1st 2022. It's likely that ICBs will take on the clinical guidelines of the CCGs they replaced.
Some local guidelines have been posted on forum so try a search of forum posts using terms "local guidelines" or try an internet search using "name of ICB/CCG/Health Board B12 deficiency guidelines" or submit a FOI (Freedom of Information) request to ICB/Health board asking for a link to or a copy of local B12 deficiency guidelines.
Read blog post below if you want to know why I urge UK forum members to find out what's in their local B12 deficiency guidelines.
If you have symptoms consistent with B12 deficiency, UK guidance suggests you should be treated even if serum (total) B12 results are within normal range.
Symptoms of B12 Deficiency (folate deficiency also mentioned)
Thanks Sleepybunny, I’m not exactly sure what PA is or if my blood test results are unusual - I did read something about being cautious as you mentioned above so I’m not taking any vitamins (apart from D). I’m feeling shattered (could be menopause) but will have a look through the links when I get a bit of energy. Thanks for your help
PA is an autoimmune disorder that attacks the mechanisms that are used to absorb B12 leading to a B12 deficiency, one symptom of which is a type of anaemia in which red blood cells are larger and rounder than normal.
In general the results above seem to be mostly in range. If you had macrocytosis caused by B12 deficiency I'd expect the figures to be getting worse - though reality is that they seem to be pretty steady at the top end of the range. The ranges are 'normal' ranges in the statistical sense that they are capturing where 95% of people will be when they are okay but there will always be a few outliers.
I'm not a medic.
I would suggest that you discuss any concerns with your GP but given the history it looks like the results are normal for you - but that might indicate another on-going condition but that would generally show up in other abnormalities in a blood count.
I'm a scientist, not a medic, so these comments are driven by my knowledge of how the tests are performed etc, not any clinical significance of the results.
First of all, your results are stable; they're not 'going anywhere'. That's over a period of ten years. In the words of Lance Corporal Jones [Dad's Army] "Don't panic!" and this time he'd be right.
I note that the reference ranges quoted changed in 2019. This suggests to me that the labs probably got new equipment around that time, and revised their ranges. [Good practice.]
Your results are hovering round the upper limit they quote for the range. This range is almost certainly a 95% range [Mean +/- 2 Standard Deviations] for the 'normal population' and this means that 1 in 20 [the other 5%] can still be normal whilst being outside the reference range. 99.7% of the population fall within +/- 3 SD. So there's no evidence that your results are actually abnormal.
Further things that can cause problems are if the samples are collected in the GP surgery and sent in to the lab by transport. That can cause some minor issues for results, as red cells don't like hanging around in blood test tubes.
A further possibility is that some folks are quite susceptible to minor macrocytosis associated with regular alcohol intake. It doesn't take much either. There are a few things like that, but the changes are generally minor. Don't panic; keep calm and carry on!
Thanks FlipperTD. I’m guessing that group members have seen a lot of results and can see that mine are unremarkable which is what I was hoping for. Mostly I’m very curious about why I’m at the upper limit (and sometimes over it ) I hardly ever drink alcohol to the point I find it difficult to give my weekly units when asked as I can go weeks without drinking. My other blood test results are generally in the middle of the range apart from MVC and MCH.
You've hit the nail on the head. You're stable, your results aren't going anywhere. You're just 'an outlier' and I doubt you've ever been anything else. Some folks are taller than others, some are [no, better stop!] 'Normal' variation. If your Hb started moving, or your MCV did, then that migh be the time to wonder what's going on. From the sound of it, for you, nothing's going on.
Your MCV, MCHC can be normal but you can still have b12 deficiency / PA. The literature says 20% of people will present first with neurological symptoms without any anemia. Complicating matters further, you can have perfectly fine serum levels and still have signs of deficiency - the so-called functional b12 deficiency. Additional testing can be useful eg active B12, homocysteine, MMA, folate, intrinsic factor and gastric parietal cell antibodies. But none of these are foolproof either. So symptoms are important too.
Anyway the lab has marked MCV as above range. Do read Sleepybunny's posts and if I were you I'd consider further testing. Private testing is possible in some countries.
I walked around shattered for a long time before it was obviously b12 related but I didn't know better at the time and doctors were useless. It's taken me years to recover as a result. It's good you're investigating the possibilities!
"I have one record of serum vit B12 taken last year 456ng/L (160-925) and serum folate 4.2 ug/L (2.9-50)"
Do you have results for ferritin (or other iron tests)?
B12 deficiency and folate deficiency can lead to enlarged red blood cells (macrocytosis).
Iron deficiency can lead to smaller red blood cells (microcytosis).
A person who has both B12 deficiency (and/or folate deficiency) and iron deficiency may appear to have results on Full Blood Count (FBC) that suggest normal size red blood cells because the effects of the iron deficiency mask the effects of the B12 deficiency (and/or folate deficiency).
If your symptoms are consistent with B12 deficiency then UK guidelines suggest treatment even if serum (total) B12 is within normal range.
I had dementia and spinal symptoms with a serum (total) b12 result that was about 500ng/L.
With a normal range serum B12 result, if you have symptoms consistent with B12 deficiency it may be worth looking into Functional B12 deficiency.
Functional B12 deficiency is where there is plenty of B12 in the blood but it's not getting to where it's needed in the cells so the person develops deficiency symptoms.
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MCV 100 - Other problems. What is the cause?
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Any ideas of expectations of reticulate test after beginning b12 injections please? 
Border High RDW, Low MCV, High TIBC...what could it be?
Does this mean it isn't b12?
