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Blood test showed enlarged RBC but folate and B12 normal. Have extreme tiredness. Suggest?

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General & Family Physician
Practicing since : 2005
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HI. In a recent blood test my red blood cells were enlarged but my folate and B12 levels normal. I am suffering from extreme lethagy and tiredness which is preventing me from working. I have obstained from alcohol for one month but the extreme tiredness remains. Do you have any suggestons? Thanks desperate
Posted Fri, 19 Jul 2013 in Medicines and Side Effects
Answered by Dr. Prasad 4 hours later

Thanks for writing here.

Macrocytosis or enlarged red blood cells is generally seen in vitamin B12 and folic acid deficiency when DNA synthesis is impaired. I am glad to know that folic acid and vitamin B12 deficiency are ruled out.

Apart from the usual vitamin deficiencies, a few other conditions are noted to cause macrocytosis. Hypothyroidism is one amongst those conditions.

Since you also report of extreme lethargy and tiredness, it may be part of depression. However as underactive thyroid state also causes lethargy and tiredness, I would suggest you to get your thyroid hormone checked.

You are encouraged to consult a hemotologist who can consider hypothyroid state and the other possible conditions. He/she can subject you to relevant investigations which can get to the root of this problem.

I hope this helps. Let me know if you need clarifications.

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