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  • Reticulocyte count and other lab results

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    Old 03-18-2008, 09:03 AM   #1
    steph74
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    Reticulocyte count and other lab results

    Hi Everyone,

    This has been a crazy few months. I did get a final dx of celiac, which has been causing the anemia (plus low vitamin d, b12, etc.). The iron supplements, and hopefully the gluten free diet that I've been faithful to for two months, are helping. I'm getting toward a normal range for hemoglobin--ferritin has gone up from 1 to 15!

    So here's my question, though. My reticulocyte index is NOT going up. It's been anywhere from 0.3 to 0.5, but when adjusted for the level of anemia, it's much lower (0.5 is the low end of the normal range). Any sense of why this would be? RBC's are looking healthier over all, fewer odd shapes and better size and color. My PCP is not too worried about the retic count because RBCs are improving. Should I be worried?

    Also, I had a strange bout with appendicitis (it lasted for two weeks, three trips to the ER, two hospital admissions...). As you might guess, I had a number of CBCs in this period, some as little as 12 hours apart. The numbers ranged pretty significantly! One evening I was "low" at 11.5 (though still higher than I had been at 9) the next morning I was "normal" at 12.4...! My dr. had mentioned that serum iron levels swing a lot, but so can other values, so remember to look at the overall trend, and not one particular reading.

    (I had to laugh though... My gyn's office called all worried about my ferritin level--this was the first of my blood that they'd seen--"it's low, you're only 15!" I was like, "that's great! I was 1 for many months!" But she did give me an rx for Repliva, a once/day iron supplement, with C, B12, folic acid all built in! Many fewer pills to take. Now just that, calcium, D, and the antibiotics to clear up the infection I got after surgery...!)

    Stephanie

     
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    Old 03-18-2008, 05:16 PM   #2
    FLFLOWERGIRL
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    Re: Reticulocyte count and other lab results

    Quote:
    Originally Posted by steph74 View Post
    Hi Everyone,

    So here's my question, though. My reticulocyte index is NOT going up. It's been anywhere from 0.3 to 0.5, but when adjusted for the level of anemia, it's much lower (0.5 is the low end of the normal range).

    I don't know much about this other than it is to respond rather quickly I thought after beginning supplements, am I right? I know that when I was tested 4 months after beginning iron supplements mine went to the highest end of the range at 2.8. You lost me when you said adjusting for anemia, I have no clue. It's probably something to due with such low iron values, I would not worry at this point.

    One evening I was "low" at 11.5 (though still higher than I had been at 9) the next morning I was "normal" at 12.4...!

    I think that one of these values is a mistake, I have never had a Hgb change that drastically and be correct. When I was in the ER they mishandled my blood (the vial was dropped on the floor) and I was no longer anemic, that day! LOL

    Sorry you had to have SX on top of everything else to deal with. Good luck to you! FLFLOWERGIRL

    Stephanie

     
    Old 03-19-2008, 10:21 AM   #3
    steph74
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    Re: Reticulocyte count and other lab results

    Over the course of the two weeks, I had about 8 CBCs--none were the same. They all jumped around between the 11's and 12's. Could be lab differences, but presumably the lab at the hospital (2 visits were the same hospital--the third time I got taken by ambulance from work, so I wound up at a different hospital) was consistent.

    The "adjusting for the anemia" part is that there is an assumption that when you're anemic, the reticulocyte count should be higher than normal. So although 0.5 is the lowest end of normal, you have to multiply that by a fraction (I think it's the hematocrit over ~ 35, so if your hemat. is 25, you multiply the retic index by 0.71 (=25/35). So the adjusted index is 0.36, too low. (I may not have the denominator correct, it's different for men and women.) So my retic index & count have never been normal. I'm wondering if I need to see a hemotologist or just not worry about it.

     
    Old 03-20-2008, 08:15 AM   #4
    FLFLOWERGIRL
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    Re: Reticulocyte count and other lab results

    I see, that's why my count would have been at the high end of the range when taken. Interesting what we learn. FLFLOWERGIRL

     
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