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I Am Trying To Find The Source Of Sudden Episodes
Question: I am trying to find the source of sudden episodes of fatigue. Can you review the attached blood work results and provide an opinion. (1) Of particular interest is CBC red values and A1C red value. (2) More generally, your impressions of the report as a whole would be appreciated as well. (3) Finally, any additional tests or next steps to discuss with my doctor would be helpful.
I appreciate your help.
I appreciate your help.
Brief Answer:
Consider iron deficiency
Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. Fatigue can be a challenging symptoms to figure out, as many different causes can lead to it, and often the cause is difficult to know for sure. However, based on your blood test results, we can say a few things. First, there is low MCH and MCHC, as well as a mildly low white blood cell count, specifically the neutrophils. Ferritin is also borderline low.
Checking for autoimmune diseases is reasonable with a low white blood cell count like that, but the negative ANA probably rules that out; your other inflammatory markers are also normal. With the ferritin being on the lower end of normal (even with the other iron tests being normal), along with the low MCH and MCHC (which can be signs of iron deficiency), as well as the MCV being on the lower end of normal, I think at least treating with iron to see if that helps with these blood counts and your symptoms would be reasonable.
Other than this, there could be certain viral infections that could lower the white blood cell count like this, including HIV, Epstein-Barr virus, cytomegalovirus, and other viruses, so I would consider checking for these (especially if these blood findings persist).
As for your Hemoglobin A1c, you are just barely considered in the "pre-diabetes" stage, which means your blood sugars on average are a little elevated. No treatment is needed at this stage, but if you can change your diet to less sugars, low weight if you are overweight at all, and exercise, this may help prevent or delay having diabetes.
Otherwise your labs looked good and I didn't see anything remarkable.
I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.
Consider iron deficiency
Detailed Answer:
Hello, I'm Dr. Branch, thanks for using Ask a Doctor. Fatigue can be a challenging symptoms to figure out, as many different causes can lead to it, and often the cause is difficult to know for sure. However, based on your blood test results, we can say a few things. First, there is low MCH and MCHC, as well as a mildly low white blood cell count, specifically the neutrophils. Ferritin is also borderline low.
Checking for autoimmune diseases is reasonable with a low white blood cell count like that, but the negative ANA probably rules that out; your other inflammatory markers are also normal. With the ferritin being on the lower end of normal (even with the other iron tests being normal), along with the low MCH and MCHC (which can be signs of iron deficiency), as well as the MCV being on the lower end of normal, I think at least treating with iron to see if that helps with these blood counts and your symptoms would be reasonable.
Other than this, there could be certain viral infections that could lower the white blood cell count like this, including HIV, Epstein-Barr virus, cytomegalovirus, and other viruses, so I would consider checking for these (especially if these blood findings persist).
As for your Hemoglobin A1c, you are just barely considered in the "pre-diabetes" stage, which means your blood sugars on average are a little elevated. No treatment is needed at this stage, but if you can change your diet to less sugars, low weight if you are overweight at all, and exercise, this may help prevent or delay having diabetes.
Otherwise your labs looked good and I didn't see anything remarkable.
I hope that helps, please let me know if you have any questions about any of that, and I would be glad to discuss it with you further.
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Above answer was peer-reviewed by :
Dr. Nagamani Ng
Answered by
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