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  • Recent Blood work - need help

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    Old 04-15-2011, 07:11 PM   #1
    goleafsgo
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    Recent Blood work - need help

    Hi all,

    Last year I had some blood work done that showed very mild anemia for a few months. My doctor ran an absolute retic count which came back as 15 (ref range 25 - 80). She ran it again in the future, with the same results. Due to my red blood cells floating around low-normal, she decided it was likely just normal for me.

    Recently at my annual checkup, she reran the tests. My results are below. She told me that my reticulocytes are almost none existant. Even though my HB and HC are not that low, they are still lower than normal and my retic should be higher to make up for it. She has referred me urgently to a Hematologist and requested I am seen before June. The only symptom I have is I have been really tired the last few months and I've lost 10lbs over last two months without trying. I am a slender male as it is, so the 10lbs should of been hard to lose. I am not too worried, but just wondered if everyone thinks my GP is right is requesting a BMB. She feels it is needed, but I don't know. Any help understanding this is appreciated! Thanks!!

    Hemoglobin: 120 (range 140 - 170) LOW
    Hematocrit: 0.34 (range 0.39 - 0.49) LOW
    RBC: 3.9 (range 4.4 - 5.7) LOW
    MCV: 86 (range 80 - 97)
    MCH: 30 (range 27 - 32)
    MCHC: 349 (range 320 - 360)
    RDW: 12.7 (range 11.5 - 15.5)
    Platelets: 177 (range 150 - 400)
    MPV: 8.6 (range 7.4 - 11.3)

    WBC: 3.8 (range 4.2 - 11.0) LOW
    ABS Neutrophils: 2.24 (range 1.8 - 7.0)
    ABS Lymphocytes: 0.9 (range 1.0 - 3.0) LOW
    ABS Monocytes: 0.34 (range 0.0 - 0.80)
    ABS Eosinophils: 0.23 (range 0.0 - 0.40)
    ABS Basophils: 0.04 (range 0.0 - 0.20)
    ABS Reticulocytes: 1 (range 25 - 80) LOW

    INR: 1.2 (range 0.8 - 1.2)

    B12: 174 (Deficiency < 148, Insufficiency 148 - 220, Normal > 220) LOWISH
    Ferritin: 54 (range 20 - 200)

    Bilirubin Total: 4 (range < 23)
    Albumin: 44 (range 34 - 48)
    Alkaline Phos: 41 (range 40 - 130)
    ALT: 28 (range < 46)
    LDH: 160 (range 110 - 215)

     
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    Old 04-15-2011, 07:34 PM   #2
    JJ
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    Re: Recent Blood work - need help

    Seeing you have been having this problem for awhile, plus it doesn't seem to be getting better...yes I think she needs to find out what is going on. If it is something fairly easy to treat, catch it now.

    Best of wishes and good luck...JJ..
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    Old 04-15-2011, 09:01 PM   #3
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    Re: Recent Blood work - need help

    thanks for the response.

    My doctor thinks because my anemia is normocytic, that my B12 is not likely the cause of the anemia. She also feels since my B12 is not in the deficient category yet, it would be unlikely to cause a retic of almost 0. Do you agree? I ask because I know nothing about it. THanks.

     
    Old 04-16-2011, 06:26 AM   #4
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    Re: Recent Blood work - need help

    I'm not totally sure of this but from what I do know is usually they would check to see if your B12 is low and could possibly be treated with either taking a suppliment of even a B12 shot. From what you say that isn't the case so she is looking into other reasons why your numbers are low as there are a number of them like a cronic disease..kidney problems..rheumatoid arthritis and even thyroiditis. Obviously she has to try and figure out what you may or may not have. Sometimes even certain meds. will cause this, but I believe it is pretty rare and mostly in older folks.

    Did she give you any indication as to what she is looking for? Do a search on normocytic anemia to get an idea of what your Dr. is looking for. Hopefully your tests will come back with something easy to treat. Please keep us updated.

    Very best of luck and wishes...JJ...
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    Old 04-16-2011, 02:36 PM   #5
    goleafsgo
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    Re: Recent Blood work - need help

    Thanks again for the response.

    My doctor has tested all my vitamin levels and only my B12 came back low, but it still isn't under the deficient line, although very close.

    My GP believes that I'd have to have a B12 clearly in the deficient stage to have a retic of almost 0. But I have had others who say even a borderline B12 can cause this issue. The other weird thing is with a retic of 0, why is my HB still at 12, I thought it would be lower. As a guy 12 is low, but not dangerous yet.

    I've had my kidney's, thyroid and other tests done, all seems ok. My GP said normally normocytic anemia is caused by some kind of bone marrow suppression and that B12 Anemia usually shows as large cells (Macrocytic I think).

    She wants the hematologist to do a BMB to rule out bone marrow suppression disorders. I have heard that most hematologists don't do what GP's say, so I'm worried it will be pushed under the rug.

    I just want to be realistic with what I'm dealing with. I don't panic, so I'm not losing sleep. I just wanted to see if you or others had experience to see if this is worthy of being investigated or not.

    Thanks a lot for helping me :-)

     
    Old 04-16-2011, 03:12 PM   #6
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    Re: Recent Blood work - need help

    Well your more then welcome, although I really couldn't put much info. that is going to help too much. Before you go to your hematologist I would get in contact with your PCP to make sure he/she writes exactly what she wants done. If this is a Dr. she is associated with, then normally they do the tests required.

    Even though your 12 is low but not dangerously low, I would want to get to the root of it myself. I'd rather be tested for whatever so I can rule anything serious going on. As I said, it might be something that can be treated easily but you won't know till the tests are done.

    I admire your way of going about this as some folks do panic especially when you say hematologist. I've had some tests done many years ago that were a bit scary but try and deal with it head on..but I'll admit, I was worried.

    Definately keep us posted. Wishing you well...JJ...
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    Last edited by JJ; 04-16-2011 at 03:13 PM.

     
    Old 04-26-2011, 12:14 PM   #7
    goleafsgo
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    Re: Recent Blood work - need help

    Hi everybody,

    I have received my latest blood work. I will be speaking to my doctor on Friday about it. I have put my lab results side by side for ease. It appears my levels are all a bit higher. I was very sick the day of the test, so that likely explains my higher WBC. My retic is still a lot lower than I would expect though. Do I still need to see a hematologist or is the improvement in the other numbers mean I don't need to? Thanks a lot!!


    ------------------------------- April 11 -------- April 20

    ABS Retic: (range 25 - 80) ---- 1 --------------- 7

    HB (range 140 - 170) ---------- 120 ------------- 128
    HCT (range 0.39 - 0.49) ------- 0.34 ------------ 0.37
    RBC (range 4.4 - 5.7) --------- 3.99 ------------ 4.27

    MCV (range 80 - 97) ----------- 87 -------------- 86
    MCH (range 27 - 32) ----------- 30 -------------- 30
    MCHC (range 320 - 360) -------- 349 ------------- 342
    RDW (range 11.5 - 15.5) ------- 12.7------------- 12.9
    Plat (range 150 - 400) -------- 185-------------- 177
    MPV (range 7.4 - 11.3) -------- 9.0-------------- 8.6

    WBC (range 4.2 - 11.0) -------- 3.8 ------------- 5.9
    ABS Neut (range 1.8 - 7.0) ---- 2.24 ------------ 4.48
    ABS Lymph (range 1.0 - 3.0) --- 0.99 ------------ 0.53
    ABS Mono (range 0.0 - 0.80) --- 0.34 ------------ 0.59
    ABS Eosin (range 0.0 - 0.40) -- 0.23 ------------ 0.24
    ABS Baso (range 0.0 - 0.20) --- 0.04 ------------ 0.06



     
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