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Blood test done. Need help in understanding the report

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General Surgeon
Practicing since : 2008
Answered : 5767 Questions
Good afternoon My blood work came back and I need help determining if I have to worry about anything.

All of my counts (white blood cells (5.4), red blood cells (4.56) are within normal ranges as well as my hemoglobin, platelet count, absolute neutrophils, etc. There were 5 that came back with out of range levels I will list them. I am 34 years old, smoke about a pack a day if not more at times, and drink socially about every weekend also I eat only about once a day sometimes twice a day this past year. I do work out and feel pretty good, I rarely get sick. I'm 5ft 6 inches and weigh 134 pounds.

Hematocrit 45.9
MCV 100.7
MCH 33.2
RDW 15.1
Absolute Monocytes 140

I did notice after googling each one of those counts separately that it can mean a shortage B12 and folate and one said dehydration. Well considering I don't eat much especially recently from the stress of waiting for the test and I tend to drink pepsi or water if maybe I should take a B12 supplement. Please help I'm freaking out.
Posted Sat, 27 Apr 2013 in X-ray, Lab tests and Scans
Answered by Dr. Grzegorz Stanko 30 minutes later

Thank you for the query.

There is nothing you should worry about. As you have mentioned your hemoglobin level is in ref. ranges. This means you do not suffer from anemia.
B12 deficiency can be a reason of anemia (in such case hemoglobin level is low and MCV is high). But you do not have anemia so your B12 level is sufficient.
Your hematocrit level is in ref. range as well (37-47% for woman) so no reason to worry as well. Hemtacrit level simply tells what percent of blood is hematocrit and can be decreased while there is too much liquids intake. It becomes increased with dehydration.
MCV is a factor describing volume of the red blood cell. It is increased at your case indeed. However to indicate B12 (or folic acid) deficiency it must be higher than 110 fl. So this I would say is only slightly above the norm (nothing to worry at all).
MCH is similar to MCV and both rise together.
RDW tells about diversity of the with of red blood cells. Does not indicate anything significant. It can rise with infection. And so are monocytes. So most likely you have or have had some minor infection (bacterial or viral). You may even not notice it.

In my opinion there is nothing to worry about. To make sure I suggest you to repeat this blood work in a week or two.

Hope this will help. Feel free to ask further questions.
Above answer was peer-reviewed by
Follow-up: Blood test done. Need help in understanding the report 2 days later
You mentioned it meant I may of had or have a minor bacterial or viral infection based on my blood count. If my urinalysis showed a bacterial level slightly outside the norm would that cause that ? Also everyone around me appears to have a cold I sneezed a few times but don't feel sick at all. I should mention that my ob has always told me my bacterial level is slightly outside range.

Thank you for your help, it is truly appreciated.
Answered by Dr. Grzegorz Stanko 2 hours later

Yes, it can be a cold or bacteria in urine. In such case I suggest you to treat this antibiotic (like Ciprofloxacine 500 mg twice a day) and have blood work repeated after that time.

Hope this will help.
Above answer was peer-reviewed by
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