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Complete blood count test done. Tested negative for thalassemia. What does the reports suggest?

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General & Family Physician
Practicing since : 1978
Answered : 6714 Questions
I had cbc done on 6/19, my results were following HGB 11.8 (low), Hematocrit 38.4(low), MCH 25 (low),RDW-CV: 179High)..I am not sure what I can make out of this, I had blood work done on 5/22 and at that time my HGB was 13.o. Occult blood is negative. I am negative for Thalassemia. I am in great shape, with 6 pack on my abdomen, eat regular well balanced meals however in the past I have done some creatine and high protien diets...Can you please assist me in making sense out of this. I have seen GI, have a Colonoscopy and endoscopy schedule however GI called me and notified that he is pretty sure ther is no bleed as the blood level dropped by 2.0, however he will proceed with the procedure just to ensure...any ideas?
Posted Tue, 31 Jul 2012 in X-ray, Lab tests and Scans
Answered by Dr. Pavan Kumar Gupta 1 hour later
Hello and thanks for the query
These all finding are consistent with iron deficiency anemia. But what intrigues is normal level of iron.You should have had low values of serum iron.

Hemoglobin and hematocrit is decreased in

Digestive inflammation (with hidden or obvious blood loss) as might occur with parasites, colitis, hemorrhoids, etc.
Adrenal cortical hypofunction
Hereditary anemia(s)
Hemodilution (pregnancy, edema)
Blood loss (lung, gastrointestinal/hemorrhoids/ulcers/colitis, uterine/menses, in urine via kidneys, hemorrhage)
Deficiency (protein malnutrition, iron, copper, Vitamin C, Vitamin B1 (thiamine), folic acid, B12)
Chronic disease (liver, kidney, rheumatoid arthritis, Carcinoid, etc.)
Bone marrow insufficiency (infiltration with tumor or tuberculosis, toxic or drug induced Hypoplasia

The RDW is often increased in:

B12 and Pernicious anemia
Folic acid anemia
Iron deficiency anemia combined with other anemia
Hemolytic anemia
Sideroblastic anemia
Alcohol abuse
Various less common and hereditary anemias

There has to be some reason for your low HB and high RDW and all the causes listed above should be checked by your doctor.
I know it is a daunting process but your doctor has to keep on looking at different possible causes.
Best of luck.
Most welcome to ask a follow up query.
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