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  • Am I Anemia or not really?

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    Old 06-09-2007, 06:59 AM   #1
    efang
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    Am I Anemia or not really?

    I am a 56 years old man and recently I did a blood test on February 4/2007 , the results showI have some items are out of range but not too much.

    RED Blood Cell Count 3.90L (reference range 4.2-5.8)

    Hemoglobin 12.1L (reference range 13.2-17.1)

    Hematocrit 34.4L (reference range 38.5-50.0)

    Platelet count 124L (reference range 140-400)

    Bun/creatinine ratio 22.5H (reference range 6-22)

    Bilirubin, total 1.6H (reference range 0.2-1.2)

    Ferritin 175 ( Reference Range 20-380)

    B12 386 ( Reference Range 200-1100)

    MCV 88 ( Reference Range 80-100)

    Iron 128 ( Reference Range 45-170)
    -------------------------------------------------------------------------------------------------------
    I did a new blood test on May 29/07 ,The result,

    RED Blood Cell Count 4.48L

    Reticulocyte count, absolute 22400L ( Reference range 25000-90000)

    Hemoglobin 14.1L

    Hematocrit 40.8L

    Platelet count 183L

    Bun/creatinine ratio 16.3H

    Bilirubin, total 1.5H

    Now I have only two items are out of range, but I have no Reticulocyte count, absolute figure on 2/4/07, so I canít compare with that.
    I checked my passed blood tests , my bilirubin, total has been keeping at 1.2-
    1,5 for about 7-8 years, but I have no any symptom.
    My primary doctor asked me to do a EGD ( upper endoscope and colonoscopy ) to make sure I have no internal bleeding. I did but the result are normal. I donít want to see him right now because (1) he asked me to eat B12 for a period of time, I like to see the result. (2) he said maybe he will let me to do bone marrow test later, I heard this kind of test is painful , so I donít want to do it now, I donít have any symptom now.I help I can get some advices here.




    Thanks!

    Last edited by efang; 06-09-2007 at 03:21 PM.

     
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    Old 06-09-2007, 12:25 PM   #2
    ChristineVA
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    Re: Am I Anemia or not really?

    Yes, you are anemic but it is not an iron deficiency so probably not due to a blood loss (thank goodness!!).

    Your B12 is in the normal range for the lab but way below what is recommended (best if over 600 I believe).

    Looks like you have a B12 deficiency.

     
    Old 06-10-2007, 12:33 PM   #3
    sparkles916
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    Re: Am I Anemia or not really?

    According to common standards used to assess anemia (primary one, hemogrlobin) you were clearly anemic on February. since your iron (ferritin) is not low, it would not point to iron deficiency anemia. As I and others discussed in an earlier post, it is possilbe that the anemia is b12-related.....although it is commonly characterized by macrocytosis. The macroscytosis is reflected in the lab called MCV. However, you are not above range for the MCV.

    It certainly can't hurt you to take B12 supplementation as your Dr recommended, since any excess is excrete by the body and there is really no toxicity until maybe over 10,000 mcg per day. Most people are not taking that level.

    However, your results of May show that you are no longer anemic, again by the common standards.

    It could be that the b12 was effective. I would need to know how much you were taking and for how long.

    However, as I mentioned in a post to you on your other thread, the reticulocyte count is below range, and that points to low production of immature red blood cells by your marrow. It is used to monitor responsiveness to the treatment of anemia. The count should rise as the anemia treatment is successful. The low production can be caused by b12 deficiceny, but there are other causes as well.

    Now, what we are uncertain about is if the reticulocyte count has increased since Feb. But, there apparently, was not test performed at that time.

    So, all we can rely on is that the count is now below range, and definately warrants further investigation, esp. since your other blood counts are now no longer below range and no longer show anemia accord to hemoglobin etc.

    You may need a hematologist to look at this. There are many ways to interpret anemia from labs. I am only familiar with the standard ways connected with common, classical forms of anemia.

    Finally, the bilirubin (as I said in my other post) strenghtens my belief that you need further investigation and more would be revealed with other tests.

    One good test you could ask for is a peripheral blood smear, where the cells are examined by a technician, not just be a mechanized means. It is not a big deal, just not commonly done as a first string of tests. The examiner will look at morphology (shape), count and other things. It could shed a lot of light on your situation.

     
    Old 06-10-2007, 07:02 PM   #4
    efang
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    Re: Am I Anemia or not really?

    Quote:
    It could be that the b12 was effective. I would need to know how much you were taking and for how long.

    You may need a hematologist to look at this. There are many ways to interpret anemia from labs. I am only familiar with the standard ways connected with common, classical forms of anemia.

    One good test you could ask for is a peripheral blood smear, where the cells are examined by a technician, not just be a mechanized means. It is not a big deal, just not commonly done as a first string of tests. The examiner will look at morphology (shape), count and other things. It could shed a lot of light on your situation.
    sparkles916

    I have been taking B12 1000 MCG/ daily for about one and half month. Besides, my primary doctor gives to me a B12 injection (once a month, I already took two times) , if you think this amount is not enough, I can concern taking more as long as there is really no toxicity.
    I may ask my primary doctor to let me do peripheral blood smear when I do next time blood test and to see a Hematologist. But I think I need to wait about two and half months to do next blood test because usually my insurance only allows patient to do this kind of test no less than three months unless doctor suggests .

    Thank you for giving to me so many good advices here and in my other posts.

    Last edited by efang; 06-11-2007 at 07:25 AM.

     
    Old 06-11-2007, 03:12 PM   #5
    lizzy76
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    Re: Am I Anemia or not really?

    I don't know if it's just me but I always thought the range for hemoglobin was 12-16, maybe a little higher for men, although each lab has different ranges that they use. Your hgb was just a little out of range in your first test (every lab has different ranges) but in your second test it doesn't look like it's out of range at all if you're using the same lab reference as the first test... you showed the lab reference as being 13.2-17.1. and your hgb level in the second test was 14.1 so that is definitely in range. Your hematocrit also looks good at 40.8 with the lab reference in the first test saying the range is 38.5-50. Your hct in the first test was low so that does indicate slight anemia but going by your second labs it doesn't appear that you're anemic at all.

    Your MCV (this number is used as a good indicator for anemia) is also at a good number within range and your ferriten is at a good number as well so things look good! I guess I'm not exactly sure why your doctor is pursuing anemia... Your red blood cell numbers and others related to tests for anemia (hemoglobin, hematocrit, etc) are all in range on the second test. They were only slightly out of range in the first test and that could indicate several things - not getting enough iron in your diet, etc. If it were more out of range that would definitely indicate more testing. I guess I could see further testing done for the others numbers as I admittedly do not know much about what it means when they are out of range.

    Good luck with everything ~

     
    Old 08-24-2007, 06:30 AM   #6
    efang
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    Re: Am I Anemia or not really?

    I just want to know my second time blood test shows that Reticulocyte count, absolote and Bilirubin, total are still out of range. I checked my passed blood tests , my bilirubin, total has been keeping at 1.2-1,5 for about 7-8 years, but I have no any symptom and liver problem, no any doctor asked me to do further investigation for this item .If I need to re-test in three months or I can wait to six months?

     
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