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Pre-employment physical shows abnormal CBC counts. Why is it ?

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Oncologist
Practicing since : 2002
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I took a pre-employment physical and my CBC counts were a bit abnormal, so they want me to get a underlying reason why my CBC counts are off. They want me to get a medical release saying what is causing my abnormal counts and I can go to work overseas without any limitation. Ive always had low iron and recently started taking iron supplements and it has improved. Since I took the initial CBC test, Ive taken my iron everyday and within a weeks time by New CBC is better. I am going to post both CBC test, to try and get a dignosis.

First CBC
RBC 5.70 H
WBC 6.10 NORMAL
RBC 5.70 HIGH
HEMOGLOBIN 12.9 NORMAL
HTC 44.8 HIGH
MCV 78.6 NORMAL
MCH 22.6 LOW
MCHC 28.7 LOW
RDW 18.0 HIGH
SEE TEXT * MODERATE ANISOCYTOSIS MODERATE HYPOCHROMASIA OVALOCYTES OBSERVED MODERATE POIKILOCYTOSIS
All other levels are normal

2nd CBC
RBC 5.50 Normal
WBC 6.10 NORMAL
HEMOGLOBIN 13.0 NORMAL
HTC 37.8 Normal
MCV 68.7 Low
MCH 23.6 LOW
MCHC 34.4 Normal
RDW 16.7 HIGH
Eosinophils .5 Low was normal a week ago
ABS Eosinophils 0.0 Low was normal a week ago
Posted Sat, 30 Jun 2012 in Blood Disorders
 
 
Answered by Dr. Robert Galamaga 4 hours later
Hello and thank you for submitting your question.

Your question is a very good one and I will work on providing you with some useful information and recommendations.

First of all I want to reassure you that I am not very concerned about the findings in your complete blood count.

You had some changes in your initial laboratory test which did suggest a possible degree of iron deficiency. it appears that with iron supplementation the numbers have improved. It would be important for you to consider why you might be deficient in iron. There are several possible causes.

One obvious cause of iron deficiency would be a lack of dietary iron intake. This is more common in people who adhere to a vegetarian diet. Another possible cause would be gastrointestinal bleeding. Usually in that case your hemoglobin would be low in addition to having a low MCV.

Right now there are absolutely no concerns that I have when I see your complete blood count. There is no suggestion of any disease process and there is no reason why the results of this test should inhibit your ability to continue employment or to obtain any type of insurance.

I thank you again for submitting your question. If there are specific details you would like to discuss I would be happy to review those with you as well. If you have additional questions please let me know.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by
 
Follow-up: Pre-employment physical shows abnormal CBC counts. Why is it ? 1 hour later
Is there anyway I can obtain your services to write me a letter outlining the following to obtain medical clearance for my tentative job offer in Afghanistan? I really need this job, and I am new to my current area and I do not have a personal physician. The deadline for this release is Jun 14,my time is running out. I have attached the letter Ive received from the them and the job description I would be performing.

This is the information below the letter must contain:

Possibly abnormal Complete Blood Count (CBC) results requires:
1) Evaluation by personal physician; and,
2) Release from personal physician documenting the following:
A) Diagnosis of or underlying condition attributed to the possibly abnormal
results;
B) Stability of condition, specifically to include the last 90-days;
C) Ability to safely deploy to and work in Afghanistan, as a Help Desk
Administrator (attached). [The attached job description must be provided to
the evaluating physician as part of his or her evaluation.]
D) Specifically address whether there are any on-going restrictions and/or
limitations; and,
E) Requires any on-going treatment and/or monitoring during the deployment
period for up to one (1) year.

Thank you in advance,

Shawan XXXXXXX
YYYY@YYYY
 
 
Answered by Dr. Robert Galamaga 22 hours later
Hello and thank you for your additional question.

Unfortunately we are not able to provide this type of service. Our service is focused mainly on exchange of information ideas and recommendations. These are not meant to replace the consultative services available by your primary care doctor or a specialist physician whom you could see in person.

I am sure your primary care physician or possibly a hematologist in your area could provide you with this type of documentation.

I thank you again for cementing a question. I hope we have been of some help for you. If you have additional concerns I would be happy to discuss them with you.

Sincerely,

Dr. Robert
Above answer was peer-reviewed by
 
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