My mean corpuscular volume is 85 fL and my hemoglobin is persistently 15.5–16.5 g/dL (once 17 g/dL); what does this indicate and what further evaluation should I pursue?

Your MCV of 85 fL with Hemoglobin 15.5–17 g/dL is Normal and Requires No Further Evaluation

Your mean corpuscular volume of 85 fL falls within the normal range (80-100 fL), and your hemoglobin levels of 15.5–17 g/dL are normal to high-normal for an adult, indicating you do not have anemia and require no further workup at this time. 1, 2

Understanding Your Results

MCV Interpretation

• Normal MCV range is 80-100 fL, and your value of 85 fL is solidly within this range 1, 2
• MCV below 80 fL would indicate microcytic anemia (typically iron deficiency or thalassemia), while MCV above 100 fL would suggest macrocytic anemia (vitamin B12/folate deficiency or other causes) 1
• Your MCV indicates normal red blood cell size 1

Hemoglobin Assessment

• Normal hemoglobin for men is ≥13 g/dL and for women is ≥12 g/dL 1
• Your hemoglobin of 15.5–17 g/dL is well above the anemia threshold for either sex 1
• The occasional reading of 17 g/dL remains within normal limits and does not indicate polycythemia or other pathology 1

Why No Further Testing is Needed

Absence of Anemia

• Anemia is defined as hemoglobin <13 g/dL for men and <12 g/dL for women 1
• Since you do not have anemia, the extensive workup for microcytic, normocytic, or macrocytic conditions is not indicated 1
• MCV-guided classification is primarily useful when anemia is present to help determine its cause 3

Normal Red Cell Production

• Your normal MCV with normal-to-high hemoglobin indicates adequate iron stores, normal hemoglobin synthesis, and appropriate bone marrow function 1
• There is no evidence of iron deficiency (which would cause MCV <80 fL), thalassemia trait (which would cause MCV <80 fL with normal/elevated red cell count), or vitamin deficiencies (which would cause MCV >100 fL) 1, 4

Critical Pitfall to Avoid

Do not pursue unnecessary testing based on a normal MCV value in the absence of anemia. The diagnostic algorithms for MCV abnormalities apply only when anemia is present 1, 5. Testing ferritin, iron studies, vitamin B12, folate, or performing gastrointestinal evaluation would not be indicated with your current laboratory values 5.

When to Reassess

• Routine monitoring is appropriate only if you develop symptoms of anemia (fatigue, pallor, dyspnea on exertion) or if your hemoglobin drops below the anemia threshold on future testing 1
• If hemoglobin falls below 13 g/dL (men) or 12 g/dL (women) on repeat testing, then MCV-guided evaluation would become relevant 1, 5