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CBC

My CBC shows low RBC 3.81, low HCT 36.0%, high MCH 32.3

My manual diff shows low segs 39%, high lymph 48%, low BANDS 1%

My doctor didn't mention any of this, but sent me home with the copy of lab work. He did however ask me questions I found odd, like have you noticed any swollen lymph nodes or had any fevers. He did make me a follow up in 4 months to repeat blood work. I remember that in Sept. I had a cervical fusion and before the doctor took me back he explained that my blood levels were so low, they would have to give me blood if I bled out any.

After getting home and looking at the results, I am feeling some concern. I've looked at what could cause these results and haven't had any of the bacterial or viral infections listed as possible causes like, the flu and the chickenpox, tuberculosis, mumps, rubella, varicella, whooping cough, brucellosis, and herpes simplex. I am pretty sure if any of these were the reason for the high lymph levels I would have known that I had them. Should I be concerned?
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1756321_tn?1377771734
Low RBC, haemoglobin and haematocrit levels are indicators of anaemia. Three common types of anaemia are due to deficiencies of iron, vitamin B12, and folate.

Causes of elevated MCH include vitamin B12 deficiency, folate deficiency, ineffective production in the bone marrow, recent blood loss with replacement by newer (and larger) reticulocytic cells from the bone marrow.

Neutrophils can be segmented (segs, polys, or PMNs) or banded (bands) which are newly developed, immature neutrophils.  Acquired causes of low neutrophils include bone marrow infiltration with malignancy, aplastic anaemia, vitamin B12 deficiency, folate deficiency, chemotherapy, radiotherapy, felty's syndrome, hypersplenism, drugs (eg: phenytoin, chloramphenicol), autoimmune neutropenia, infections (eg: viral, typhoid).  

Causes of increased lymphocytes include infection (acute viral, chronic infections, parasites, brucella), relative neutropenia (hyperthyroidism, anterior pituitary hypofunction, adrenal cortical hypofunction), stress, radiation, lead poisoning, food intolerances (metabolic rejectivity syndrome).

An increase in new neutrophils (bands) indicates that an infection is present and the body is mounting a defense. As your bands are low, infection isn't likely.
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Avatar_f_tn
my doctor said nothing to me about any of this. He asked me if I have any swollen lymph nodes. I haven't noticed any. He then gave me my lab results to take home, which he usually doesn't, and scheduled me for a repeat of blood work in 4 months. Im thinking maybe I should see a hematologist. Should I wait 4 months or try to get an appt sooner or with a hematologist?
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1756321_tn?1377771734
What symptoms do you have? I would recommend testing vitamin B12 and folate and a full iron panel (not just iron serum) to start with. Just to note, vitamin B12 serum reference range is extremely low in almost all countries so deficiency symptoms are well documented to occur in low normal ranges. Europe and Japan have risen the lowest acceptable range to around the 550pg/mL mark which is a vast difference to 200pg/mL which is found on most labs! Optimal numbers are in the upper end of the range for all vitamin and minerals.
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Avatar_f_tn
I saw another doctor this morning and asked her to explain the results to me. She said there was nothing alarming and I shouldn't be concerned except for my cholesterol, it was 244.  She said I shouldn't wait 4 months to recheck the CBC, but to do it in 4 weeks instead. So I am scheduled for blood work in 4 weeks.  

As far a symptoms, I have Hashimoto's and Hypermobility Syndrome with Osteoarthritis and Degenerative Disc Disease, so I am often exhausted from that and have several pain issues. I get short of breath easy, but have PVC's and a mitral valve leak from the hypermobility that could cause that. I have problems with urinating blood a few times a year, but I have cyst on both kidneys. The urologist said he can't find why I'm urinating blood except for maybe the cysts bleeding or from vessels bursting from the hypermobility. Its been a while since I have urinated blood though, so I don't feel that would cause the RBC and WBC to be off.

So I do have symptoms, but they are explained by my other medical issues. So Dr. isn't really concerned with my symptoms.  I am praying that blood work is back to normal in 4 weeks and all of this is just a fluke.
I did go buy me some multi vitamins for 50+, I'm 39, but they were the highest in Vit B12 and Folic Acid. I started taking those last night. I guess now its just wait and see.
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