TO: Dr Mark Lupo, Re: Just One More Question (CBCs)

[Jimlow]

Drmark, I'll make this my last question for a good while, so as not to hinder others from getting answers.  You mention pernicious anema recently. I may have been looking in the wrong direction as far as my fatigue symptom.  I'm a Hashi's patient but my Dr. wouldn't go over my CBcs much. Following are the results, I'll list only the questionable ones. March-2003: WBC "3.7"(range 4.5-11.0), March 2004: WBC "4.0"(range 4.5-11.0), HGB "14.2"(range 14.0-18.0), MCHC 32.7(range 33.0-37.0 flagged low), Hemocrite 43.1(range 42.0-52.0), MCH 27.6(range 27.0-31.0 Near Borderline low), Eos 4(range 1-3 flagged high).
After the preceeding results I had, I took liquide Geritol, then retested in 4-months. The labs only raised very slightly, for example, my HGB, went from 14.2 to 14.5 and the others also only changed by a couple of tenths (WBC 14.2).
I looked at a test my age-69 dad had recently and his HGB was 16.5, mine at age-40 was much lower (now age-42). Could this have been onset of pernicious anemia. I had been on thyroid med, nearly a year when the test was done. Would the best diagnostic test for me now, be a B-12 level and possibly another CBC? I read that pernicious anemia can lower WBC and mine was low on three diff. tests?  Thanks Much.

[Trish915]

A related discussion, hyperparathyroid? was started.

[Mark Lupo, M.D.]

Pernicious anemia (PA) happens when the body cannot absorb b-12 due to an immune system attack.  B-12 levels are the place to start.  There is a new test called MMA that may pick up b-12 def earlier than the b-12 level.  The CBC may be normal in early b-12 deficiency - first place to look in the CBC is the MCV (high in b-12 def).  WBC may be decreased as well, but there are other causes of low WBC (leukemia, HIV, bone marrow problems - are most likely you just run a little low normally).  If it gets lower, perhaps a hematologist should be consulted.

The other tests are antibodies against Intrinsic Factor and Parietal Cell.

Good luck - PA is more common in hashi pts but still rare....

[Jimlow]

Drmark, I read on some blood lab sites that a low MCHC, "always indicates hypochromia"/iron deficiency. I had not found this before. My MCHC was flagged low. I don't take the liquid iron anymore, only a vitamin with small amount, I think 8mg (always at least 6-hours apart from thyroid med). I feel it's possible I need higher dose treatment and B-12 shots. Would inadequate blood counts, also mean less adequate utilization of thyroid med?

[Catastrophia]

Becky, did you read my response to your last response to me?
( under Graves Disease ) question? If you have time tomorrow afternoonish, check out the women's health board.I'll comment to a recent question and send the comment to you.I don't know how else to communicate.We need to do some serious communicating.
Cat

[Jimlow]

Sorry I meant 4.2 on that last WBC I listed. Also, while correcting let me say my last Eos count was "5"(range 1-3), so was flagged high like the earlier "4" but I had no sinusitis symptoms during any of these times, so don't know what the allergy might be, unless Hashi's does that.
I was anemic as a child, don't know if that makes me more suceptable.

[tnt406]

HI YES I SAW YOUR LAST POST,I HAVE RESPONDED TO YOUR POST ALL READY ON THE WOMENS FORUM.I WILL ALL WAYS BE HERE FOR YOU,IF I DON'T EVER ANSWER,IT IS BECAUSE I MIGHT NOT BE ABLE TO.BUT I WILL ALL WAYS TRY MY BEST GOD WILLING.IN CHRISTIAN LOVE TO MY NEW FOUND SISTER CATS.TNT406[BECKY]