From the Guidelines
A mildly elevated MCV is a significant finding that warrants further investigation to determine the underlying cause, as it can be an indicator of potentially serious conditions such as vitamin B12 or folate deficiency, liver disease, or myelodysplastic syndromes. This finding indicates that red blood cells are larger than normal, a condition called macrocytosis. According to the study by 1, macrocytosis is most commonly caused by megaloblastic anemia, which is often due to vitamin B12 or folate deficiency.
To evaluate this finding, additional blood tests should be performed, including:
- A complete blood count with peripheral smear
- Vitamin B12 and folate levels
- Liver function tests
- Thyroid function tests As suggested by 1, a more extensive workup may include serum concentrations of vitamin B12, folic acid, haptoglobin, and other tests to rule out underlying conditions.
If you have a mildly elevated MCV, you should avoid alcohol consumption while undergoing evaluation, as alcohol can exacerbate macrocytosis. Treatment depends on the underlying cause - for example, vitamin supplementation for deficiencies, medication adjustments if drug-induced, or addressing alcohol use if relevant. The importance of investigating even mildly elevated MCV lies in early detection of potentially serious conditions, as macrocytosis can precede anemia or indicate underlying systemic disorders that require timely intervention, as noted in 1.