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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does This Blood Test Report Signify?

My total RBC is 4.43, MCV 108.8 mch 32.6 mchc29.9 rdw-sd 59 rdw-cv 14.5 hamogram alert predominantly normocytic normochromic with macrocytes and ovalocytes Vit d 26.61 b12 1520ng t3 114 t4 11.3 tsh 2.99 Iron 74.2 tibc 289 %saturation 25.67 Please advise what does report mean & what is treatment My email address is YYYY@YYYY
Mon, 16 May 2016
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Dietitian & Nutritionist 's  Response
Welcome to HCM,

Well, you have some good news! Your thyroid panel looks normal and your iron level looks fine. I do see some vitamin D deficiency, not unusual but still needs repletion.



Your complete blood cell count is slightly abnormal, but to me, if I had run this test, I would be wondering about your tissue level of folate. Your Vitamin B12 is normal indicating that the macrocytic indicator is not related to a B12 deficiency but more probably a folic acid deficiency, which was not tested for. I don't see a hematocrit listed but the hemoglobin of 14.5 is in the normal range for both men and women.

The RDW-SD and the RDW-CV, both elevated with a high MCV is indicative of a folic acid deficiency with other medical possibilities.

Your red blood cells are on the low side. A normal hemoglobin for a male is 13.5-17.5 and for women 12.5-15.5. Low values of Hematocrit and Hemoglobin are indicators of anemia, but I don't see a hematocrit result.

My suggestion here, nutritionally speaking, is to run a homocysteine test which will be abnormal in folic acid deficiency but not B12 (your B12 is normal). A red blood cell folate test can also be run.

Some medical conditions may cause this profile as well, but I would check my folic acid levels first before considering a medical reason.

You may receive other answers from HCM with medical, rather than nutritional,implications.

Good luck to you! Kathryn Shattler, MS,RDN
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What Does This Blood Test Report Signify?

Welcome to HCM, Well, you have some good news! Your thyroid panel looks normal and your iron level looks fine. I do see some vitamin D deficiency, not unusual but still needs repletion. Your complete blood cell count is slightly abnormal, but to me, if I had run this test, I would be wondering about your tissue level of folate. Your Vitamin B12 is normal indicating that the macrocytic indicator is not related to a B12 deficiency but more probably a folic acid deficiency, which was not tested for. I don t see a hematocrit listed but the hemoglobin of 14.5 is in the normal range for both men and women. The RDW-SD and the RDW-CV, both elevated with a high MCV is indicative of a folic acid deficiency with other medical possibilities. Your red blood cells are on the low side. A normal hemoglobin for a male is 13.5-17.5 and for women 12.5-15.5. Low values of Hematocrit and Hemoglobin are indicators of anemia, but I don t see a hematocrit result. My suggestion here, nutritionally speaking, is to run a homocysteine test which will be abnormal in folic acid deficiency but not B12 (your B12 is normal). A red blood cell folate test can also be run. Some medical conditions may cause this profile as well, but I would check my folic acid levels first before considering a medical reason. You may receive other answers from HCM with medical, rather than nutritional,implications. Good luck to you! Kathryn Shattler, MS,RDN