low RBC and HCT, normal MCV and iron

[1lydia]

Hi everyone,
I'm a woman, 41 years of age. I've always been rather slim. No serious illnesses that I know of. Not a vegetarian or vegan. Recently I've been experiencing drowsiness, headaches and sometimes fast heartbeat. I did blood tests and here's what I got: RBC 4.11, HCT 36.7 - these are the items that according to data available on the net are below norm. HGB is also fairly low - 12.3. (I'm from a non-English-speaking country, but I hope those symbols are universal). However, iron is OK - 110. The rest of the parameters are OK. From what I read it may mean that I have anaemia related to low level of B12 vitamin and/or folic acid (megaloblastic anaemia). However, I have two doubts: 1) in megaloblastic anaemia MCV should be above 95 and I have 89; 2) I've been taking folic acid in pills for several years now (in case I get pregnant) and vitamin B-complex for something like 2 years (because I had Angular cheilitis), so it would be rather strange if I still had deficiency. I must admit, though, that I'm not very regular with vitamins - sometimes I forget about them - and that I only take one pill of B-complex a day. But usually I take them. The last time I had blood test was about 2 years ago and my levels were OK.
I wonder what the problem may be and I'm a bit anxious because I've read those deficiencies may be due to some serious health problems like parasites, fungi or even stomach cancer. I know I'm probably panicking, but still the results baffle me. I wonder what you think of them.  

[1lydia]

I'll just add that urine examination showed a lot of bacteries and doctor put my blood results down to a chronic infection of the genitourinary system. After taking the prescribed drug I got slightly better, and now after three months I feel OK, so the weakness and drowsiness might have been the combined result of the infection and lack of sunshine, although I still get headaches after sleeping too long (longer than 8 hrs). I haven't repeated the blood tests though.

[1lydia]

Thank you very much for replying. My doc says the results are not so bad. He ordered other examinations and if they turn OK he says there's no need to worry. So far I've done TSH and sugar and they're good, Monday I'm doing urine and ECG. We'll see. What got me interested in your response is the possibility of postviral fatigue syndrome. I've looked it up on the wiki and they say it can last a few moths to a few years even. I had a very strong flu in 2009 and then last fall I had throat infection which lasted about a month due to the first antibiotic not helping, so I got two series of different antibiotics altogether, which could have weakened me too. Anyway I'm optimistic it's nothing serious and I'm going to take more care of my food and physical shape, see if that helps. Thanks again!

[Dr. Kokil Mathur]

Hi!
It all depends on how you interpret the results. Your levels of RBC, hemoglobin and HCT are actually on the lower side of normal. For many women across the globe these can be considered as normal levels. To increase their levels you can take a multivitamin pill along with over the counter syrups to raise the hemoglobin levels. Chances of vitamin B12 deficiency are almost nil. However do consult your local doctor, and if in your country these are considered low levels then proper treatment will help.
Other than that drowsiness, headaches, increased heartbeat can be due to hormonal imbalance of PCOD diabetes, hypothyroidism, or due to kidney or liver problems. Another possibility is sleep disturbances (like sleep apnea, imbalance of rapid eye and non rapid eye movement sleep etc.). You may sleep your customary 7-8 hours and yet feel fatigued. You need sleep studies to rule this out. Other possibilities are chronic fatigue syndrome, depression, low Vit B12, low iron, low calcium, sodium and potassium. Hyperthyroidism too causes increased sweating and tiredness.   Postviral fatigue syndrome is another possibility. Persisting EBV infection or mono can also be the cause. A comprehensive investigation is required keeping all the points in mind.
Since I cannot examine you and know other related conditions you may be having, nor is a detailed history possible on net, I have listed the various possibilities that should be looked into. Do discuss this with your doctor and get yourself examined. Take care!