Hello there - I was diagnosed with sub clinical hypothyroid 16 months ago. My vitamin b12 was borderline and I also have the TPO antibodies. My Serum T4 level is 10.4 pool/L and has stayed pretty much the same. My Serum TSH level has gone down from 10.2 mU/L to 8.2 and the last test was 3:62.
However my MCH has gone from 32.9, to 33.8 and the last 34.3 pg. The GP says this is normal but it is outside the normal range where the normal range is 27 - 33.
I have looked this up and have found that raised MCH can be related to hypothyroid - if so should I arrange to have a complete thyroid panel completed? Or any other suggestions will be helpful,
Thank you
Written by
KarlNorge
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B12 tests aren't very sensitive so borderline can easily be deficient .... and given the variation from individual to individual could well be deficient for you.
Basic yearly blood work generally includes a CBC, or a complete blood count. This gives a breakdown of red blood cells (their sizes and distributions), white blood cells and their subtypes, and platelets, and can offer clues to certain aspects of overall health.
One of the measurements pertaining to red blood cells is the MCV (Mean Corpuscular Volume). This is a measurement of the size of the red blood cell. When it’s too high, this is called macrocytosis (large red blood cells). When coupled with lower than normal hemoglobin levels, this becomes macrocytic anemia.
You can have macrocytosis without macrocytic anemia, though. Often, elevated MCV without anemia occurs along with high MCH (Mean Corpuscular Hemoglobin) and high MCHC (Mean Corpuscular Hemoglobin Concentration)—these mean that, while the overall hemoglobin concentration may be the same, there’s more stuffed into individual red blood cells than usual, because they’re bigger.
Causes of Macrocytosis
Most often, both macrocytosis and macrocytic anemia occur due to deficiency in Vitamin B12 or folate. Pernicious anemia is an autoimmune destruction of the cells that make Intrinsic Factor, necessary to absorb B12. Therefore, macrocytic anemia follows.
But if you’ve already tried supplementing B12 and folate, and macrocytosis persists, one likely cause is hypothyroidism. According to this paper, macrocytosis is found in up to 55% of hypothyroid patients, although all types of anemia can be associated with hypothyroidism. This is because thyroid hormone is necessary to stimulate the production of red blood cells. (Note that this doesn’t mean you have to actually be outside the lab reference range! If you have the symptoms of hypothyroidism and your levels are suboptimal, this can still be the cause.)
Not sure if this will help , but I have stared investigating diet related deficiencies with my dogs as 4 had abnormal blood blood work ( high MCHC and low MCV) and low thyroid function - we found abnormal iron status in them and also copper deficiency ; just waiting for ferritin results - but they all improved on iron tablets ( and copper and zinc )
The latest diagnoses dog was not put on Levo despite slightly over the range antibodies as I want to see if his thyroid function improves and his TgAA come come once the nutritional deficiencies are resolved ! Haven’t tested his thyroid again but he is improving !
One of my dog is hashi and we couldn’t stabilise her thyroid function even with meds ( tried different doses ) as she was not converting - again suspect iron deficiency was to blame
I had the dogs’ B12 and folate heckled and those were really good on all of them - so it wasn’t the B12 as that’s what I suspected initially
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