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CBC Abnormalities
Dear Dr.

I'm a 23 year-old female with previous considered as a healthy woman but I am now feeling not quite well. I have tachycardia at rest (approx. 110s-130s) and sometime chest pain radiated to my lower jaw and inner of my throat, I feel tired most of the day, having headache, joint and bone pain sometimes, extremely skin allergy on and off occurs anywhere of my whole body even the scalp. Although I have been consulted with many specialists, there's still no definite diagnosis just yet.
My GP sent me to take a CBC test 2 weeks ago and It came out like this;

Hb 10.4(L)
Hct 32.7(L)
RBC 4.68
MCV 69.9(L)
MCH 22.2(L)
MCHC 31.8(L)
RDW 18.2(H)

Abnormal RBC Morphologies are;
Hypochromia 1+
Anisocytosis 1+
Microcytosis 1+
Polychromasia Few
Ovalocyte Few
Spherocyte Few

WBC 5.64
Neutrophil 60.3
Lymphocyte 31.4
Monocyte 6.0
Eosinophil 2.1
Basophil 0.2

Platelet count 418
MPV 11.7(H)
Platelet smear Adequate

I don't have any Thalassemia conditions and no any bleeding detection. My GP gave me an Iron supplement to take 3 times daily because she thought I had an iron deficiency anemia, tho today my CBC turned out at the same rate with no any improvements.

Please help !!!!
Thank you

FYI : I have not had my period for over 6 years now (Amenorrhea) tho my all hormone levels are completely normal (said my GP)
1 Answers
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351246 tn?1379685732
Iron supplements will only help if there is iron deficiency anemia. For this further tests are required. To assess a patient’s iron status, measurements of iron, TIBC (total iron binding capacity) and measurement of ferritin are performed. Transferrin is a substance that transports iron in the plasma. If the saturation is below 20%, the amount of iron carried by transferrin is decreased. In this situation it is also expected that the absolute serum iron will be low. Normally in iron deficiency, iron is low, TIBC is high, percent saturation is low and ferritin is low.
The three main causes of low iron are—poor intake, poor absorption, and high loss. Poor intake can be compensated by diet rich in iron and iron therapy. Poor absorption is seen in conditions like Crohn's, IBS, severe acidity etc, and needs to be ruled out. High loss is seen there is a bleeding in your gastrointestinal tract, either due to esophageal varices, polyps, gastric bypass site, hemorrhoids or an ulcer. You should get your stool examined for occult or hidden blood to detect this blood loss. The renal function and liver function needs to be checked, and electrophoresis of hemoglobin done to know whether there is thalasemia trait or sickle cell anemia. You need to see if there is vitamin B12 deficiency. Once the cause is found and corrected, then the lost iron is replaced by iron therapy, either in form of pills, capsules or syrups, or as injectable preparations. Consult your PCP regarding this. You should ideally consult a hematologist for this. Take care!
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