From the Guidelines
Your lab results indicate macrocytic anemia, which is likely caused by vitamin B12 or folate deficiency, and I strongly recommend following up with your healthcare provider for further evaluation and potential treatment with vitamin supplementation. Your red blood cell count (RBC) and hematocrit are slightly below normal, while your mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) are elevated, which is consistent with macrocytic anemia 1. This pattern typically indicates that you have fewer red blood cells than normal, but each cell is larger and contains more hemoglobin than usual. Some possible causes of macrocytic anemia include:
- Vitamin B12 or folate deficiency
- Liver disease
- Alcohol use
- Certain medications
- Other conditions I recommend that your healthcare provider checks your vitamin B12 and folate levels, liver function, and thyroid function to determine the specific cause of your macrocytic anemia 1. In the meantime, ensure you're eating a balanced diet rich in B vitamins (found in meat, eggs, dairy, leafy greens) and avoid excessive alcohol consumption if applicable. Don't make any changes to your medications without consulting your doctor first. Further evaluation may include additional blood tests, such as reticulocyte count, serum ferritin, transferrin saturation, and CRP, to rule out other conditions like iron deficiency anemia or anemia of chronic disease 1.
From the Research
Blood Test Results
- WBC: 5.3 K/uL (within normal range of 4.5 - 11.5 K/uL)
- RBC: 3.68 M/uL (low, normal range: 4.10 - 5.10 M/uL)
- Hemoglobin: 12.5 g/dL (within normal range of 12.0 - 16.0 g/dL)
- Hematocrit: 36.7 % (low, normal range: 37.0 - 47.0 %)
- MCV: 100 fL (high, normal range: 80 - 99 fL)
- MCH: 34.0 pg (high, normal range: 27.0 - 31.0 pg)
Possible Causes of Abnormal Results
- The high MCV value indicates macrocytosis, which can be caused by megaloblastic or nonmegaloblastic anemia 2
- Nonmegaloblastic macrocytic anemia can be caused by various diseases such as myelodysplastic syndrome (MDS), liver dysfunction, alcoholism, hypothyroidism, certain drugs, and inherited disorders of DNA synthesis 2
- The low RBC and hematocrit values indicate anemia, which can be caused by various factors, including iron deficiency, vitamin deficiency, or chronic disease 3, 4
Further Evaluation
- Laboratory testing plays a significant role in the diagnosis of anemia, and various hematologic parameters and biochemical tests can be used to identify the underlying cause 3
- A complete blood count with red cell indices, reticulocyte count, and testing for specific causes of anemia can help determine the etiology of the patient's anemia 4