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What Causes Macrocytosis?

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Posted on Wed, 24 Sep 2014
Question: I am a 65 year old male in good health. I don't smoke, don't take drugs (I even minimize prescriptions), am not overweight and don't eat "fast foods". Each day, though, I have a couple of drinks before dinner (1.2-1.4 oz. alcohol content). On 8/22/14, I went in for an annual physical and found there were two flags on my CBC: MCV 100.9 & RBC 4.65. My doctor tested for vitamin B12 and the level came back 1090. TSH was 2.08. Folate was not tested, but was 18.13 on 11/17/2010. My doctor has told me that either alcohol consumption or myelodysplasia can cause macrocytosis. She wants me to cut down to 2 drinks a week for a month to eliminate alcohol as a factor, then check on myelodysplasia. I don't mind doing this, but everything I have read indicates moderate alcohol use is not a factor. Since myelodysplasia seems more serious, wouldn't it be better to stop wasting time on alcohol and concentrate on other, possibly more serious, conditions?
Thanks for your help.
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Answered by Dr. Hardik Sanghvi (37 minutes later)
Brief Answer:
We should rule out the alcohol first.

Detailed Answer:
Hi, dear.
I have gone through your question. I can understand your concern.
You have macrocytic rbcs and almost no any other medical symptoms. Now macrocytosis is most commonly due to vitamin B12 deficiency or folate deficiency which you don't have. So we should search for other cause. Alcohol is one of the factor because you are taking it on regular basis. Myelodyplasia is a rare disorder. As you don't have any symptoms and your reports are normal with only two flags, you have very rate chance of having myelodyplasia. So don't worry regarding myelodyplasia. Just take care of your alcohol. please send me your reports so that I can say surely whether you should go for further investigation for myelodyplasia or not. Presently its not needed. Please send me your all reports.
Hope I have answered your question, if you have doubt then I will be happy to answer.

Thanks for using health care magic.
Wish you a very good health.
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Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Hardik Sanghvi

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Practicing since :2008

Answered : 7043 Questions

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What Causes Macrocytosis?

Brief Answer: We should rule out the alcohol first. Detailed Answer: Hi, dear. I have gone through your question. I can understand your concern. You have macrocytic rbcs and almost no any other medical symptoms. Now macrocytosis is most commonly due to vitamin B12 deficiency or folate deficiency which you don't have. So we should search for other cause. Alcohol is one of the factor because you are taking it on regular basis. Myelodyplasia is a rare disorder. As you don't have any symptoms and your reports are normal with only two flags, you have very rate chance of having myelodyplasia. So don't worry regarding myelodyplasia. Just take care of your alcohol. please send me your reports so that I can say surely whether you should go for further investigation for myelodyplasia or not. Presently its not needed. Please send me your all reports. Hope I have answered your question, if you have doubt then I will be happy to answer. Thanks for using health care magic. Wish you a very good health.