Is My Blood Test Normal? MCV and Anemia Concerns

Q: Is My Blood Test Normal? MCV and Anemia Concerns

Hello： In response to your questions. <br><br>1. <br>Anemia is a common clinical symptom, typically referring to a decrease in the number of red blood cells, hemoglobin levels, or hematocrit. <br>MCV stands for mean corpuscular volume, which indicates the average volume of red bl

Could you please provide more details about the report in question?

Hello Doctor: A few days ago, my health check report came out.
One item was highlighted in red, M.C.V 97.7, and the comments below indicated possible microcytic anemia, iron deficiency anemia, or thalassemia, suggesting that I should seek further diagnosis and treatment.
Should I get tested again? In high school, I experienced brief dizziness and a temporary loss of vision for 2-3 seconds when standing up from a squat or sitting position, but it has improved significantly since I started college.

Xiao Zhu, 10~19 year old female. Ask Date: 2006/10/27

Dr. Xiao Yongxun reply Internal Medicine

Hello: In response to your questions.

1.
Anemia is a common clinical symptom, typically referring to a decrease in the number of red blood cells, hemoglobin levels, or hematocrit.
MCV stands for mean corpuscular volume, which indicates the average volume of red blood cells, measured in femtoliters (fl).
Normal MCV values range from 80 to 94 fl, hemoglobin levels from 13 to 16 gm/dl, and red blood cell counts from 450 to 550 x 10^4/mm3.
2.
Clinically, anemia is classified based on MCV values into macrocytic anemia, normocytic anemia, and microcytic anemia.
Your MCV of 97.7 suggests a tendency towards macrocytic red blood cells; however, it can only be classified as macrocytic anemia if there is definitive evidence of anemia.
Common causes of macrocytic red blood cells include vitamin B12 or folate deficiency, as well as potential drug-induced causes or other factors.
On the other hand, causes of microcytic anemia include iron deficiency anemia, thalassemia, lead poisoning, chronic disease, among others, which need to be clarified individually.
3.
The phenomenon you experienced "during high school" has improved significantly.
There are many potential causes, including orthostatic hypotension, anemia, or specific diseases.
4.
In summary, given that your red blood cells are larger and you have experienced dizziness in the past, it is advisable to discuss this with your primary care physician before making any decisions.
If necessary, further examinations may still be required.

Reply Date: 2006/10/27

More Info

Based on your blood test results, it appears that your Mean Corpuscular Volume (MCV) is reported as 97.7 fL, which is slightly elevated compared to the normal reference range (typically 80-94 fL). The report mentions "疑小球性貧血" (suspected microcytic anemia), "缺鐵性貧血" (iron deficiency anemia), and "地中海貧血" (thalassemia), suggesting that there may be a concern regarding your red blood cell characteristics and overall hemoglobin levels.

Understanding MCV and Its Implications
MCV is a measure of the average volume of a red blood cell. It helps classify anemia into different types. Generally, a low MCV indicates microcytic anemia, which is often associated with iron deficiency or thalassemia, while a high MCV indicates macrocytic anemia, which can be due to vitamin B12 or folate deficiency, among other causes.

In your case, an MCV of 97.7 fL suggests macrocytic anemia, which is not consistent with the microcytic anemia mentioned in your report. This discrepancy may warrant further investigation.

Symptoms and Historical Context
You mentioned experiencing brief episodes of dizziness and visual disturbances in high school, which improved during college. These symptoms could be related to anemia, particularly if your hemoglobin levels were low at that time. Anemia can lead to insufficient oxygen delivery to tissues, causing symptoms like fatigue, dizziness, and shortness of breath. However, since your symptoms have improved, it may indicate that your condition has stabilized or that you have adapted to any underlying issues.

Next Steps
1. Follow-Up Testing: Given the concerns raised in your report, it would be prudent to undergo further testing. This could include:
- A complete blood count (CBC) to assess hemoglobin levels, red blood cell count, and other indices.

- Iron studies (serum iron, ferritin, total iron-binding capacity) to evaluate for iron deficiency.

- Vitamin B12 and folate levels to rule out macrocytic anemia due to nutritional deficiencies.

- Hemoglobin electrophoresis if thalassemia is suspected.

2. Consultation with a Specialist: It may be beneficial to consult a hematologist, who specializes in blood disorders. They can provide a more comprehensive evaluation and interpretation of your results, as well as recommend appropriate treatment options if necessary.

3. Monitoring Symptoms: Keep track of any new or recurring symptoms, such as fatigue, dizziness, or changes in your vision. If you experience significant symptoms, seek medical attention promptly.

Conclusion
While your MCV is elevated, which suggests a potential issue, it does not automatically indicate that you have anemia. The context of your overall health, symptoms, and additional lab results will be crucial in determining the next steps. It is essential to follow up with your healthcare provider for further evaluation and to address any concerns you may have about your health. Regular monitoring and proactive management can help ensure that any underlying issues are addressed effectively.

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