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Blood test showed slightly elevated RDW and normal MCV. Feeling tired, headache and difficulty to sleep. Concerned

Sep 2012
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General & Family Physician
Practicing since : 2008
Answered : 1416 Questions

I had my blood test done a few weeks ago and i have a slightly elevated RDW (15.9) and normal MCV. I exercise every day ( i used to play tennis 4-5 times a week) but lately i feel very tired and quite unable to keep up the pace. I also have terrible headaches and difficulty in sleeping. Since i got my results i have been taking Milgamma N (two pills /day) and started to feel much better. I am not sure if it is only B12/B9 anemia or it can be Iron related as well. I would like to know your opinion. These headaches/loss of balance usually become a huge problem while and after jogging. I have also heard that jogging a lot can make you loose iron through the feet..., maybe this can be an explanation....?Thank you!
I weigh 87 kg and i am 1.86, my blood pressure is good and i have no other health condition.
Posted Fri, 23 Nov 2012 in Blood Disorders
Answered by Dr. Das Arindam 3 hours later
Thank you for asking a question.
Firstly, an increased level of RDW should be interpreted with the whole report. RDW itself is not a very specific indicator of any particular disease.
RDW means red cell distribution width. An increased level of RDW indicates that the red blood cells of the examined blood are of different size and shape. It is also known as anisopoikilocytosis. It indicates iron deficiency anaemia, megaloblastic anaemia, thalassemia, abnormal hemoglobin variants,anaemia of chronic disease,etc.
Now, from your history, all the other parameters like Hb, MCV,PCV,MCH,MCHC all are supposed to be normal. So, it can be definitely said that you do not have any abnormality related to RDW level. Because in that case the other parameters should also be increased or decreased.
If you have had megaloblastic anaemia, the MCV level should have been increased above 100 fl. A decreased Hemoglobin level should also be present. So, you do not have megaloblastic anaemia due to deficiency of vitamin B6 and B12.
You do not have iron deficiency. Because in that case the hemoglobin and MCV level must be lower than normal.
As you took the multivitamin agents, you may feel good and more energy due to the vitamin and micro nutrients. But it is not the real picture.
Your headache may be due to refraction error of eyes. For this you have to check it. The headache may be due to migraine. For this, you should consult with a neurologist for further investigation and management. It may also be due to decreased sleep, for which you can take any mild sedative.

Summary - This isolated, slight increase of RDW does not denote any abnormality. For your headache, you should consider the abovementioned conditions and consult with respective doctors.

Hope this information suffices. Let me know if you have any more question.

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