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Chronic Diarrhea, Lymphocytic Colitis, Smoker. History Of Elevated MCV. Could High MCV Be Due To Diarrhea?

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Posted on Sun, 17 Jun 2012
Question: Trying not to worry! I'm 52 y/o, 5'4", 104 lbs. I've had an elevated MCV in the past and recent blood workup last week shows it has increased to 106. I am NOT a drinker, at all. My doc just called and mentioned possibility of bone marrow biopsy. However, I have chronic diarrhea (10 to 20 stools a day) from lymphocytic colitis. Is it possible that malnutirion/dehydration from my chronic diarrhea could cause the increase in MCV? Because of the diarrhea, I tend not to eat all day and really don't drink many fluids (I do eat evening meal). I should add that I am a smoker and tend to take acetaminophen nearly daily. Thanks for your time!
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Follow up: Dr. Swapnendu Sekhar Ghosh (17 minutes later)
My labs that were "flagged" include:
MCV 106.4
MCH 36.1
Chloride 108
Alk phos 127

Too embarassed to add earlier that I take up to 15 Fioricet daily for nearly a decade, and have horrible withdrawal if I try to go off.
doctor
Answered by Dr. Swapnendu Sekhar Ghosh (8 hours later)
Hi,
Thanks for posting your query.

Please do not be worried.
There are few common causes of raised MCV like Vitamin B12 or folic acid deficiency. The cause of these in your case may be the persistent diarrhea. Hypothyroidism is another condition that can cause an increased MCV. Please consult your physician who can perform a complete evaluation and prescribe appropriate therapy.
I would also suggest that you speak to your physician about your dependence on Fioricet.

I hope I have answered your query. Please accept my answer if you have no further queries.

Regards.

Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Swapnendu Sekhar Ghosh (11 hours later)
Just received my B12 and folate results. B12 was 464 and folic acid was >24.0. I saw an oncologist about 3 years ago when MCV was 103. He laughed & said he couldn't believe my doc sent me in for such a mild elevation. He sent me home & didn't even charge for the visit. The MCV now, as stated before, is now 106. Is it possible to just simply run high MCVs as my own personal "norm"? Is it really necessary to see oncology again? AND is bone marrow biopsy warranted with no other abnormal blood chems?

I'm really trying NOT to freak out about this but well... I am! Thanks SO much for your help!
doctor
Answered by Dr. Swapnendu Sekhar Ghosh (4 hours later)
Hi,

Thanks for writing back.

Yes, such high range of the MCV could be a norm to one without any specific reason.I would not recommend you a visit to oncologist.

I suggest you to go for like Megaloblastic anaemia and Myloproliferative disease can be ruled out by the same.

Wish you good health.
Note: For further follow up on digestive issues share your reports here and Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Swapnendu Sekhar Ghosh

General Surgeon

Practicing since :1974

Answered : 1750 Questions

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Chronic Diarrhea, Lymphocytic Colitis, Smoker. History Of Elevated MCV. Could High MCV Be Due To Diarrhea?

My labs that were "flagged" include:
MCV 106.4
MCH 36.1
Chloride 108
Alk phos 127

Too embarassed to add earlier that I take up to 15 Fioricet daily for nearly a decade, and have horrible withdrawal if I try to go off.