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Jewelweed:

Yes, your MCV of 99 is at the high end of the range that is usually 80-100. Different Labs vary somewhat. One of the diagnostic tools used for determination of Macrocytic Anemia (Large red blood cells) is high MCV, and the periphial blood smear. In my opinion others might look at this and say it is still Normocytic unless a blood smear is conducted which defines abnormal cell size or shape. In other words it is very border line.
Macrocytic-Normochromic Anemia is also known as Megoblastic Anemia. That is, abnormal large size cells with normal amounts of HgB which sometimes can be caused by B12 or Folate deficiency (Macrocytic) or iron deficiency (Normochromic). Pernicious Anemia also falls in this category.

I am a little confused. Your B12 and Folate levels are high but then you imply that you are taking B12 and Folate supplements. If you are taking these supplements how long have you been taking them and in what dose? Could this not explain your high levels?

If you have NOT been taking supplements and your B12 levels have been high for some period of time here are some possible causes:
1) Liver Problems
2) Hepatitis
3)Polycythemia Vera
4) Myelocytic leukemia

While your B12 numbers are High they are not that high!

Hope this helps:

Vanbill
Hi vanbill,

Thanks for your comment.

The MCV has been increasing over the past 10 years or so, from 93 to 95 to 96 over a period of several years and then up to 99 within a month of the last blood draw. So even if not officially macrocytic (based on some reference ranges) yet, the RBC size is definitely trending that way.

Yes, I've been supplementing with B12 and folate for over a year, which would explain the high blood levels of them. So given that I am supplementing, I am not deficient in those nutrients, yet the RBCs are getting larger. That is what does not make sense to me.

An update that I did not post before is that I have low ferritin (14), despite supplementing with iron for over a year as well. Serum values of iron, TIBC, % saturation, and transferrin are all normal (very near the mid range) though, so I don't understand why ferritin is low.

The quest continues.

And I do greatly appreciate your input. Yours was the probably the most knowledgeable response I've seen from a message board. :-)





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