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What Causes Low MCH And MCV With A High RDW?

Posted on Fri, 25 Sep 2015

Question: what are the causes of low mch and mcv with a high rdw could having helicobacter pylori cause it my hemaglob is 12.1 I'm feeling so extremely tired to the point I'm out of breath it feels what could be going on

Answered by Dr. Anil Parth Desai (46 minutes later)

Brief Answer:
Hi can you please upload the complete blood report.

Detailed Answer:
Hello mam,
I did review your concern.
Classically low MCH and MCV with a high RDW would mean possibility of iron deficiency anemia if the hemoglobin is low and early iron deficiency state if hemoglobin is low normal or normal.
However, sometimes we also see high RDW in certain hemoglobinopathy carrier states.
Can you send me your complete blood report with rbc count, platelets and white cell count and MCHC also so that I can reply with a more detailed way to go about further.
Awaiting your reply with reports mam.
Wish you all the best,
Let me know if you have any more questions or concerns.
Sincerely
Dr Parth Desai

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Anil Parth Desai (1 hour later)

this blood work was done on Aug 19 2015 my wbc was 7.6 range is 3.5 -10.3 rbc 4.71 ref range is 3.80-5.24 hemoglobin 12.1 ref range 11.8-15.8 hemocrat 36.3 ref range 34.6- 46.2 mcv 77.0 ref range 82.3-96.7 mch 25.6 ref range 27.6-33.2 mchc 33.3 ref range 32.5-35.4 rdw 15.8 ref range 12.4 -15.2 platelet count 262 ref range 140-440 mpv 8.1 ref range 6.6-10.2 then they did a coagulation inr 1.2 ref range 0.9-1.1 then a aptt 34 with a 2 above the 4 ref range 25-37 seconds those are the results

Answered by Dr. Anil Parth Desai (17 minutes later)

Brief Answer:
Hello, hemoglobin level is normal so your problems are unlikely due to it.

Detailed Answer:
hi thank you for your reply query mam.
Your recent blood work seems normal and it is highly unlikely that hemoglobin is causing your tiredness and short of breath.
I would recommend consulting your physician for ruling out other causes of tiredness and shortness of breath.
Commonly I would recommend a thyroid function test, liver function test, basic metabolic panel, chest xray and ECG which will help us in knowing the potential cause of your problem.

Slightly high rdw with low mcv and mch can be due to early iron deficiency but since your hemoglobin is within range it is not the cause of your problems. you can take Ferrous sulphate 325 mg elemental iron pills BD for a month and increase the iron stores to bring the mcv and mch and rdw to normal levels.

I hope this helps
Let me know if you have any more questions or concerns mam.
Wish you all the best.
Sincerely,
Dr Parth Desai.

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Anil Parth Desai (31 minutes later)

yes I do have other questions and I have had a cmp and thyroid test done and have not been told that there abnormal could this be anything serious that's causing the low mch and mcv and high rdw like really serious cancer losing blood etc I can type in the lab reports from the cmp and thyroid I'm just really worried why they are abnormal

Answered by Dr. Anil Parth Desai (1 hour later)

Brief Answer:
Hi there is unlikely to be anything serious for losing blood.

Detailed Answer:
Hi I did review your reply query mam.
At your age I would not consider anything serious as first possibility for iron deficiency. It can be more likely due to menstrual blood loss, low intake in diet or H.pylori related peptic ulcer but very unlikely due to cancer or anything.

If you thyroid and bmp are normal then a chest xray and ECG can be done for shortness of breath to look for other causes, but cancer would be unlikely at your age.

So all in all, i would advice you not to worry too much about anything serious and recommend the above mentioned tests for further investigations.
I hope this helps
Let me know if you have any more concerns mam
Wish you all the best.
Sincerely,
Dr Parth Desai

Above answer was peer-reviewed by : Dr. Sonia Raina

Follow up: Dr. Anil Parth Desai (24 minutes later)

ok Yeah I am 26 and as far as menstruation I didn't have a period till the last week of August because I had a miscarriage but I think my mcv was low before I got pregnant and had the miscarriage I know I did found out I had helicobacter pylori XXXXXXX of 2013 and I have not been tested for it in in over a year and I wasen't able to take the biaxin the antibiotics and they never did give me anything else to treat it

Answered by Dr. Anil Parth Desai (54 minutes later)

Brief Answer:
Hi I would recommend the following-

Detailed Answer:
Hello mam I am sorry to hear about miscarriage
yes so i believe if you take antibiotics in 2013 for H pylori mostly it would have been eradicated from your body.
I would recommend ferrous sulfate tablets for 1 month to normalize your iron stores and then repeat the complete blood count again to see if the values are normalized.
As far as shortness of breath and tiredness are concerned I would recommend a ECG and chest xray as first things to do.
I hope this helps mam.
Wish you all the best.
Sincerely
Dr Parth Desai.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Anil Parth Desai (6 hours later)

ok thank you so this sounds like iron instead of anything bad

Answered by Dr. Anil Parth Desai (3 hours later)

Brief Answer:
Hello Yes with high rdw it seems more likely to be iron deficiency

Detailed Answer:
hello mam,
thank you for your feedback. Yes it seems likely due to iron deficiency rather than anything bad. But I would recommend the other investigations I mentioned before and also complete blood count 1 month after taking ferrous sulfate or any other iron combination.
I hope this helps mam.
wish you all the best.
Sincerely
Dr Parth Desai.

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj