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What causes large red blood cells?

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Posted on Fri, 12 Sep 2014
Question: I just had my pre-op for an upcoming neck fusion surgery and the Dr. at the hospital said I had large red blood cells. I don't drink alcohol, and he said it could be I was vit B-12 deficient, but I receive B-12 shots weekly from my hormone clinic, so that seems unlikely, is there something more serious he was not telling me? I also am hypothyroid.Further information, I have colitis which I take Entocort and Lotronex for. My Endrocronologist had told me a few months ago that my parathyroid was not functioning properly and to increase my Calcium and D intake and today during my pre-op, the Dr. said my kidneys were not functioning properly. I do not drink,smoke or do recreational drugs. Thank you!
doctor
Answered by Dr. Binu Parameswaran Pillai (5 hours later)
Brief Answer:
Hello

Detailed Answer:
Good day,
Noted your concern.
Your doctor would have got the clue about large rood blood cells from your CBC. It would have shown a high value of MCV ( mean corpuscular volume). This happen due to various reasons.
1. Alcohol
2.Vitamin B12 deficiency
3.Folic acid deficiency
4. Some heavy metal poisoning
5.Some particular types of anemias.

You did mention that you dont take alcohol. How low was your Vit B12 value. If it was low, that could be the reason. Even if you take Vit B12 injections, it may take a while to correct it. Colitis could be contributing to Vitamin b12 deficiency.

You may need a peripheral smear test, LDH, Serum folate levels for further evaluation.

Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Binu Parameswaran Pillai (10 hours later)
Is this anything to be concerned about getting ready to have a 2 level neck fusion surgery in 10 days? Thank you for your reply. I have been exposed to mercury in my 20's and 30's as I worked placing amalgam fillings as part of my dental job and that was before gloves were worn and we used to use a squeeze cloth to remove extra mercury.

Would your advice be to continue on with my fusion surgery?
doctor
Answered by Dr. Binu Parameswaran Pillai (3 minutes later)
Brief Answer:
Hello

Detailed Answer:
Hi,
Welcome back.
High MCV is not a contraindication for surgery and you may proceed with surgery if the haemoglobin ( Hb) level is adequate.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Binu Parameswaran Pillai (2 minutes later)
Thank you for your help, I really appreciate it!!
doctor
Answered by Dr. Binu Parameswaran Pillai (3 minutes later)
Brief Answer:
Hi

Detailed Answer:
My pleasure. I hope I answered your question. Happy to answer more if you have any more question. But if there is none, may I request you to close the discussion.
Wish you good luck with the surgery and have a smooth recovery
Regards
Binu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What causes large red blood cells?

Brief Answer: Hello Detailed Answer: Good day, Noted your concern. Your doctor would have got the clue about large rood blood cells from your CBC. It would have shown a high value of MCV ( mean corpuscular volume). This happen due to various reasons. 1. Alcohol 2.Vitamin B12 deficiency 3.Folic acid deficiency 4. Some heavy metal poisoning 5.Some particular types of anemias. You did mention that you dont take alcohol. How low was your Vit B12 value. If it was low, that could be the reason. Even if you take Vit B12 injections, it may take a while to correct it. Colitis could be contributing to Vitamin b12 deficiency. You may need a peripheral smear test, LDH, Serum folate levels for further evaluation. Regards Binu