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  • Anyone with normal MCV & RDW but low ferritin?

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    Old 05-21-2010, 11:41 AM   #1
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    Question Anyone with normal MCV & RDW but low ferritin?


    I have had low ferritin for several years but my doctors have not been concerned. I found out I was anemic back in April 2008 but my MCV and RDW were in the normal range:

    RBC: 3.40 (low)
    Hgb: 10.5 (low)
    Hct: 30.0 (low)
    MCV: 88.2 (normal)
    RDW: 13.1 (normal)
    Ferritin: 6

    My doctor called this "normocytic anemia" but attributed it to the low ferritin. After a few months of low dose iron supplements, by anemia had improved but my iron levels were still low:

    RBC: 3.86 (low normal)
    Hgb: 11.7 (low normal)
    Hct: 34.2 (slightly low)
    Total Iron: 39 (slightly low)
    TIBC: 361 (normal)
    Transf Sat: 11 (low)
    Ferritin: 10

    After another two months, the anemia had resolved and I was told to stop taking the iron:

    RBC: 4.16
    Hgb: 13.0
    Hct: 38.47
    Total Iron: 115
    TIBC: 333
    Tranf Sat: 35
    Ferritin: 13

    I'm wondering if I should have kept taking the iron because some recent bloodwork shows the anemia may be returning. I don't know my iron levels, but MCV & RDW are still normal:

    RBC: 3.75 (slightly low)
    Hgb: 12.2 (low normal)
    Hct: 35.1 (low normal)
    MCV: 93.6 (normal)
    RDW: 12.7 (normal)

    I was under the impression that iron deficiency produced "microcytic anemia" not "normocytic anemia". In iron deficiency anemia, I believe MCV is usually low and RDW is usually high. I'm not sure if my latest b/w categorizes me as anemic, but it's definitely normocytic and has always been normocytic even when I was truly anemic.

    My question is, does anyone else here have normocytic anemia? Can low iron/low ferritin cause normocytic anemia? Perhaps my anemia wasn't severe enough to the point where MCV and RDW were altered?

    Angela, 44
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    Old 05-21-2010, 06:08 PM   #2
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    Re: Anyone with normal MCV & RDW but low ferritin?

    I would say keep taking iron tablets and a daily multivitamin.

    You need not only to replace the iron in your blood, but also the iron stores in your body.

    Sundown Perfect Iron is a well tolerated iron supplement, and is quite cheap (about $5 for a 3 month supply < edited > )
    Also, a daily multivitamin, such as Centrum (or the generic store brand), would be a good idea, just to make sure your body is getting everything it needs -you should probably take this every day for ever, as a cheap insurance policy Of course, make sure your doctor knows what you are taking!

    Normolytic anaemia can have several causes,

    a decreased production of normal-sized red blood cells for some reason, such as an autoimmune condition (could your chrons be the cause? ask your doctor)

    an increased destruction or loss of red blood cells (e.g., hemolysis, blood loss - have you had a fecal blood test?);

    a B2 (riboflavin) deficiency
    a B6 (pyridoxine) deficiency - Amultivitamin should cover these possabilities.

    It might be time to ask for a referal to a hemotologist

    or a mixture of conditions producing microcytic and macrocytic anemia.[

    Last edited by hb-mod; 05-22-2010 at 01:44 AM. Reason: Please don't post disallowed websites, per Posting Policy. Thanks!

    Old 05-23-2010, 04:42 PM   #3
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    Re: Anyone with normal MCV & RDW but low ferritin?

    Also, you may have a B12 or folic acid deficiency as well. A B12 or folic acid deficiency makes your MCV higher, while the iron deficiency pushes it lower. So if you have both conditions, you may have a normalish MCV. But at 13, your ferritin is still low. You should continue iron supplementation until your ferritin is at least 50. Some people shoot for 100.

    But 13 is still too low to stop supplementing.

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