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What is the reason for abnormal blood results?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
Hi I am a 48 year old male - about 15 kg's overweight, not very fit and I sometimes suffer from mild to moderate breathlessness on effort. In July this year, during a routine medical examination, I did a full blood count and chemistry panel. My Haemaglobin was 18.2 g/dl, my red cell count was 6.09 and my haematocrit was 53.8%. I have done a previous full blood count (approx 3 years ago) when the results were 18.3 / 55.3% and 6.46. My GP was not concerned then because he attributed the results to my being a smoker (30/day). I stopped smoking completely 13 months ago. After the July results were known, my GP sent me for an abdominal ultrasound (which was normal incl no enlargement of my spleen), an effort ECG (which was normal), a chest x-ray (which was normal) and an additional test to check for the JAK-2 gene mutation (which came back negative). I re-did the bloods about a month ago - and the results came back as 18.5 / 6.1 and 52.5% - so at least the haematocrit is dropping. My GP is satisfied that I dont have any tumours, my lungs are healthy (I did a full lung function test - which came back all good). My GP Is convinced that the high haematocrit etc is still a resifdual effect from being a smoker for approx 18 years. He thinks that, because the haematocrit is slowly reducing (especially now that I have stopped smoking) - there is no need for any additional treatment or testing.Instead, he has encouraged me to lose some weight and become fitter which he is convinced will cure the problem. It seems I dont have polycythema vera. I am not dehydrated, apparantly have no erythropoetin producing tumours, I dont have any lung disorder, my heart is good, I dont live at altitude, I have never taken any steroids - but yet, my bloods remain abnormal. What could be causing the abnormal blood results? - or do some people simply have raised haemaglobin / red cell count/ haematocrit levels without actually suffering from any illness? My plasma / white blood cell counts have always been normal. My cholestrol is also normal.
Posted Tue, 24 Dec 2013 in Smoking and Alcohol Addiction
Answered by Dr. Preeti Parakh 1 hour later
Brief Answer: There is absolutely no need to worry. Detailed Answer: Hi, Welcome to Healthcare Magic! I understand that the consistently abnormal results make you feel concerned. But in my opinion, your reports are not too abnormal. According to most researchers, for men, haemoglobin more than 18.5 or haematocrit more than 52 should be investigated further. Haematocrit should be more than 60 for men to considered diagnostic of polycythemia. Even the red cell counts are considered to be normal for men if they are in the range of 4.7 to 6.1 million cells per cubic mm. Your values aren't too out of the normal range. The normal range for all tests is usually calculated as the range in which around 96% normal values lie (plus and minus two standard deviations from the mean). That means that there still will be 4% people who are normal but whose values will be outside the normal range. Your doctor has already investigated you thoroughly and tried to exclude the usual causes. It is true that smoking could have been responsible for your abnormal reports and now that you have quit, the levels are gradually falling. Your doctor is also correct in thinking that being overweight may be contributing to the slight abnormality in results as the arterial oxygen level falls at night in people who are obese. This hypoxia can lead to a slight increase in haematocrit. This has been found in quite a few studies. That is why, in my opinion, you absolutely need not worry about your test results. I would not consider them as abnormal, but as being just on or slightly outside the upper limits of normal range. If you are physically fit, these slight abnormalities need not worry you. If later you were to develop some symptoms that would indicate some illness, then more tests can be done as required. Hope this allays your concerns. Please feel free to ask if you need any clarifications. Best wishes. Dr Preeti Parakh MD Psychiatry
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