MCV And RDW Indicate B12 Deficiency Which Explains Anxiety. Are My Blood Results Okay?

Posted on Fri, 29 Jun 2012

Question: Blood test resultsHello Doctor would it be possible for you to take a look at my blood test results and provide some feedback? My doctor did not explain why some things were low or high. I did some research and my mcv and rdw indicate I may have a b12 deficiency which could explain my anxiety? I dont know im not a doctor. If I were to type out the results could you tell me if anything is wrong?

Answered by Dr. CS Narayan (45 minutes later)

Hello and thanks for your query.

I shall make an effort to provide you with good professional recommendations specific to your questions.

Megaloblastic anemia occurs due to symptoms like fatigue, palpitations, dyspnoea etc. Long term effects include neurological symptoms like tingling, walking difficulties, mood and memory changes. Anxiety as such could be the result of depression that ensues. But, a 2003 study The Hordaland Homocysteine Study - does not see any relation of Vitamin B12 levels and anxiety. Data is also meager on this. Whereas, depression and b12 is more studied.

A blood test results, may be interpreted theoretically by me too. You could send me for this reason. But, I have to tell you - that it is the clinical findings that needs correlation with tests that give the final diagnosis.

Let me know if I have missed out any other concern in your question.

Yet again, I duly appreciate your query to me, I do hope that you have found something useful to help you and I shall be glad to answer any further apprehensions.

Sincerely,

Dr Sujeet N Charugulla,
MBBS, MD.
Consultant Physician.

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. CS Narayan (11 hours later)

Thank you doctor I understand. I am 5'8 and 200 pounds with a recent blood pressure of 140/90. HAEMOGLOBIN - 15.1 g/dl PCV - 0.46 L/L RBC - 5.6 10^12/L MCV - 82 fL MCH - 27 pg MCHC - 33 g/dl RDW - 15.3 % PLATELETS 435 10^9/L WBC 9.1 10^9/L NEU ABS - 6.3 LYM ABS - 2.4 MONO ABS - 0.3 EOS ABS - 0.0 BASO ABS - 0.1 NEU% - 69 % LYM% - 26 % MONO% - 4 % EOS% - 0 % BASO% - 1 % ESR - 2 MM/HR eGFR - >60, eGFR >59 mL/min/1.73 meters squared: NORMAL GFR OR MILD DECREASE IN GFR SODIUM - 142 mM/L POTASSIUM - 4.1 mM/L CHLORIDE - 102 mM/L BICARBONATE - 27 mM/L BUN - 4.1 mM/L CREATININE - 105 uM/L CPK - 303 U/L TROPONIN I - NEGATIVE TROPONIN I (QUANT) -

Follow up: Dr. CS Narayan (0 minute later)

I am also 28 years old

Answered by Dr. CS Narayan (1 hour later)

Thanks for the response.

Let me go one by one -

BMI = 30.4 - obese category.
BP = 140/90 - Needs 2 more abnormal levels to start antihypertensive treatment.
Hb = 15.1 g/dl - Normal for age.
PCV - 0.46 L/L - Normal for age.
RBC - 5.6 10^12/L - Upper normal range.
MCV - 82 fL - Normal in the range of 80-99.
MCH - 27 pg - Normal
MCHC - 33 g/dl - Normal
RDW - 15.3 % - Slightly above Upper normal. (red blood cells are more variable in volume)
PLATELETS 435 10^9/L - Slightly above upper normal range of 400 10^9/L (at risk category)
WBC 9.1 10^9/L - Normal
NEU ABS - 6.3 - Normal
LYM ABS - 2.4 - Normal
MONO ABS - 0.3 - Slightly below lower normal range of 0.45
BASO ABS - 0.1 - Normal
EOS ABS - 0.0 - Normal
NEU% - 69 % LYM% - 26 % MONO% - 4 % EOS% - 0 % BASO% - 1 % - All well except the value of Monocytes as explained above.
ESR - 2 MM/HR - Normal.
eGFR - >60, eGFR >59 mL/min/1.73 meters squared: NORMAL GFR OR MILD DECREASE IN GFR - Needs clinical correlation to explain.
SODIUM - 142 mM/L - Normal
POTASSIUM - 4.1 mM/L - Normal
CHLORIDE - 102 mM/L - Normal
BICARBONATE - 27 mM/L - Normal
BUN - 4.1 mM/L - (Blood Urea Nitrogen) - Normal. (Kidney function grossly good.)
CREATININE - 105 uM/L - Normal.
CPK - 303 U/L - Normal. (Cardiac isoenzyme test.)
TROPONIN I - NEGATIVE TROPONIN I (QUANT) - (Cardiac specific isoenzyme test) Good and normal.

So, to summarize MCV is absolutely fine. RDW will stand alone not be enough to diagnose Vit B12 deficiency. You might have to test serum levels if you need ruling out this condition.

Sincerely,
Dr Charugulla

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

Follow up: Dr. CS Narayan (3 hours later)

Thank you doctor for explaining. Just to clarify is there anything I should be testing for or at risk for based on the results?

Answered by Dr. CS Narayan (20 hours later)

Thanks for the reply.

Red cell Distribution Width (RDW) usually is normal and MCV is raised in anxiety is attended to.

I am sure you will do well with the right approach to treatment.

Hope I have answered your query. Please close this discussion if all your queries have been answered.

Wish you good health.

Best wishes,

Sincerely,

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Above answer was peer-reviewed by : Dr. Prasad