Lab results - looking for opinions [PLEASE READ 1ST POST]

Chris Chase4 said:Could someone who understands blood work explain why my MCH and MPV levels would be low when everything else looks fine?

Here are the basic values and the reference ranges in parentheses:

WBC 8.4 ( 3.4 - 9.7 )
RBC 4.88 ( 3.86 - 5.08 )
Hemoglobin 133 ( 119 - 157 )
Hematocrit 0.410 ( 0.356 - 0.470 )
MCV 83.5 ( 83.0 - 97.2 )
MCH 27.3 L ( 27.4 - 33.9 )
MCHC 327 ( 320 - 345 )
RDW 12.6 ( 9.0 - 15.0 )
Platelets 245 ( 158 - 424 )
MPV 6.2 L (6.8 - 10.4 )
Lymphocytes 40.7 ( 20 - 46 )
Monocytes 7.1 ( 2 - 12 )

I previously had an episode where I essentially "overdosed" on Vitamin B12 after breaking my arm—I experienced numbness in my hand and face, along with some chest pain, because I was taking B-complex vitamins daily alongside a standard diet. That mild tingling still happens occasionally, and it seems to trigger whenever I consume B12 through multivitamins or foods high in it. As for my heart, everything seems fine since I’ve already had an echocardiogram and a Holter monitor test.
I assume these numbers are negligibly low, but I'm wondering if this could be a result of that B12 spike or perhaps my daily fish oil capsules over the last two years.

Hello,

Since your hemoglobin and platelet counts are normal, the MCH and MPV values in your report aren't particularly meaningful; in fact, they are practically within the normal range. Regarding whether you overdosed on Vitamin B12, I can't say for certain, but it doesn't seem likely.

Regarding how Vitamin B12 and Omega-3 fatty acids affect MCH and MPV, here is the breakdown. In individuals without anemia (which you do not have, based on these results), the influence of B12 levels on MCH (average hemoglobin per red blood cell) is minimal. Generally, there is a positive correlation: as B12 rises, MCH rises. However, even an increase of several hundred pg/ml in B12 concentration might only bump the MCH by about 1 pg. Theoretically, if someone has very high B12 levels and no anemia, we would expect a higher MCH, not a lower one. Therefore, an MCH at the bottom edge of the scale doesn't align with high B12 concentrations.

As for the effect of B12 on MPV (mean platelet volume), an increase in B12 concentration typically leads to an increase in MPV. Again, this is the opposite of what your results show. A lower MPV suggests smaller platelets, which can sometimes be seen in various inflammatory conditions. However, that isn't significant unless there is also a concurrent abnormality in the actual platelet count, which isn't the case here.

Looking at the impact of Omega-3 fatty acids from fish oil, they don't have a significant effect on MCH, nor do they affect MPV in otherwise healthy people—though they can lower MPV in diabetics.

Based on all of this, it appears that your MCH and MPV parameters are not significantly deviating from the norm and, in your specific case, shouldn't be linked to your B12 supplements or fish oil.

Maria Fisher46 said:Dear ma'am,

Since your hemoglobin and platelet counts are normal, the MCH and MPV values in your report don't really matter—though, for what it's worth, they actually fall within the normal range anyway. I can't say for sure whether you overdid it with the Vitamin B12 supplements, but I don't think that's likely the case.

Regarding how Vitamin B12 and omega-3 fatty acids affect MCH and MPV levels, here is the breakdown. In people without anemia (which, based on these results, you don't have), the impact of B12 levels on the MCH parameter (the average hemoglobin in an erythrocyte) is minimal, and there is a positive correlation—meaning as B12 levels go up, MCH goes up too. However, even if B12 concentrations rise by several hundred pg/ml, the MCH would only increase by about 1 pg. Theoretically, in someone without anemia who has high B12 concentrations, you'd expect a higher MCH, not a lower one. So, having an MCH value at the lower limit doesn't really support the idea of high B12 levels.

As for how B12 concentration affects the MPV parameter (platelet volume), the effect is similar: higher B12 levels should lead to an increased MPV. Again, that is the exact opposite of what your results show. A lower MPV indicates smaller platelets, which can sometimes be seen in various inflammatory conditions. But honestly, that isn't significant unless there is also an issue with the actual platelet count, which isn't the case here.

If we look at the impact of omega-3 fatty acids from fish oil capsules, they don't significantly affect MCH, nor do they influence MPV in otherwise healthy individuals—though they might lower MPV in diabetics.

Based on all of this, I would conclude that the MCH and MPV parameters you mentioned aren't deviating significantly from normal, and in your specific situation, they probably shouldn't be linked to taking Vitamin B12 or fish oil supplements.

Everything makes sense to me now. Thank you so much for such a professional and detailed response. 🙏

Hello everyone! I am looking for some help interpreting lab results for my daughter, who is 16 months old. Aside from her waking up constantly during the night—on average, every single hour—she hasn’t really had any other issues.

Back on May 11, 2021, we had blood work done just to make sure she wasn't anemic. Here were the results:
RBC 4.44[x10e12/L] (4.00 – 5.00)
Hemoglobin 108[g/L] (109 - 138)
Hematocrit 0.324[L/L] (0.320 – 0.404)
MCV 73.0[fL] (73.8 – 89.4)
MCH 24.3[pg] (24.3 – 29.2)
MCHC 333[g/L] (300 – 350)
Platelets 756[x10e9/L] (150 – 450)
WBC 10.6[x109/L] (6.0 – 16.0)

Her pediatrician's take was that everything looked fine and she wasn't actually anemic—though, if you look at those numbers, isn't there a slight discrepancy?—but suggested we try an iron supplement to see if it might help with her sleep patterns. So, for the last week, she's been taking 2.5 ml of a pediatric iron suspension along with some Vitamin C drops.

Then, on Sunday, May 23, 2021, she had white stools. She seemed cheerful otherwise and didn't have a fever, so I called the after-hours pediatric line. They told me it wasn't an emergency and to just wait until I could see our regular doctor. Naturally—because why wouldn't it?—she developed a fever later that Sunday evening. Yesterday, we ended up at the doctor's office, and because of the fever, the white stools, and swollen lymph nodes in her neck, she sent us straight to the Pediatric ER. They ran more blood tests, and here are the findings (note: no reference ranges were provided on this specific printout):
CRP 8.6 mg/L – Monocytes 25%
WBC 6.59[x109/L]
RBC 4.56[x1012/L]
Hgb 105[g/L]
Hct 0.333[L/L]
MCV 73.0[fL]
MCH 23.0[pg]
MCHC 315[g/L]
RDW-SD 43.8[fL]
RDW-CV 16.5[%]
Plt 342[x109/L]
MPV 8.2[fL]
NEUT% 39[rel %]
LYM% 35[rel%]
MONO% 25[rel %]
EO% 0[rel %]
BASO% 1[rel %]
NEUabs 2.58[x109/L]
LYMabs 2.33[x109/L]
MONOabs 1.64[x109/L]
EOabs 0.01[x109/L]
BASOabs 0.03[x109/L]
Note: Monocytosis

The doctor diagnosed her with mononucleosis. For now, the plan is to stay home, administer Tylenol every six hours, and ensure she gets plenty of rest. We have to go back for follow-up testing in two days.

Could anyone please help me make sense of these results? Is everything else looking okay aside from the mono?

Thanks so much!

What does NSE mean? This blood test needs to be turned in immediately.

NSE stands for neuron-specific enolase.
The actual significance of this protein depends entirely on the clinical context in which it was measured.

I'll have everything written up in about half an hour. Hopefully, this helps.

Seeking: CEA, CA 19-9, CA 125, CA 15-3, AFP & HCG, LDH, and Cyfra 21-1

A few shadows were found near the top of the left lung. The pulmonologist says they don't look like typical scarring. We need to rule out tuberculosis and any potential tumors.

neonfalcon99 said:Looking for: CEA, CA 19-9, CA 125, CA 15-3, AFP & HCG, LDH

A few shadows near the top of the left lung. The pulmonologist claims they don't look like old scarring, so he wants to rule out tuberculosis and various tumors.

But what did the radiologist actually say about these shadows? Like, how big are we talking here? Is there any indication if it’s a primary tumor or potential metastases? And more importantly—are these shadows just from a standard X-ray, or was this a CT scan with contrast?

Look, I’m not a pulmonologist, and I’m certainly no oncologist, but since my field falls under internal medicine, I can tell you that ordering this massive battery of tumor markers is like trying to swat a fly with a hydrogen bomb. Sure, some of these markers are specific to the lungs, but others aren't; and even the ones that are "specific" aren't even 100% sensitive or accurate. It's overkill.
At the end of the day, if this doctor has decided this is the way to go, then do what he says. Ultimately, he's the one who actually saw the patient—I'm just sitting here reading what you typed on a screen.

The shadows measure about 2 cm. On the X-ray, there were two, and on the CT scan, it looks like there might be a few smaller ones. He wants to rule out anything serious like tumors or tuberculosis. There aren't any symptoms at all—just those shadows showing up on the scans. It might be nothing at all.🤷

Look, there could be plenty of other factors at play, but one thing is absolutely certain: if we're talking about that specific tumor marker you mentioned, then NSE is the culprit here, not some other random variable.
Next time you actually get a chance to sit down with that pulmonologist, make sure you grill them with more specific questions. You’ll get much more accurate answers from a medical professional than you ever will by scavenging for info on the internet.

My red blood cell count, hemoglobin, hematocrit, and platelet volume are all running slightly high.
Any thoughts or suggestions?
https://iili.io/Bb0nig.jpg

How much water had you actually had in your system when they drew your blood? Honestly, hemoconcentration caused by being dehydrated is the most likely culprit here, though it isn't the only possibility.

Unlike my last two tests, I actually had something to drink this morning...
But this isn't the first time things have spiked; it’s the third time I've seen an elevation.
I used to struggle with anemia, so I was taking Iron Mountain, but I had to stop once these levels started climbing.
The increase isn't massive, just a slight uptick.
Here is the timeline:
https://iili.io/Bb7CmX.md.jpg
https://iili.io/Bb5civ.md.jpg
Back in March 2018, I started on Iron Mountain.
https://iili.io/Bb7oIn.md.jpg
https://iili.io/Bb7xXs.md.jpg
https://iili.io/Bb7zLG.md.jpg
By December 2020, I stopped taking Iron Mountain.
https://iili.io/Bb7TBf.md.jpg
https://iili.io/BDTVzx.jpg
https://iili.io/BDuaQR.md.jpg

Even so, my immunologist-rheumatologist referred me to a hematologist.
( I have SLE & APL Sy )

Brenda Alvarez24 said:…
But my immunologist-rheumatologist still sent me over to a hematologist.
( I have SLE&APL Sy )

Look, just wait until the hematologist gives you their take—that’s going to be the definitive word here. They aren't just going to stare at lab results; they're actually going to examine you and weigh everything against your entire medical history. That's how this works.

I was just wondering if anyone here has dealt with similar test results.
What did the doctors end up saying? What was the verdict?
Don't get me wrong, I'm not looking for a medical diagnosis...
Just feeling a bit restless waiting for answers. 🕺

Brenda Alvarez24 said:Unlike the last two times, I also had some drinks this morning...
But this isn't just once; it's the third time levels have been elevated.
I used to be anemic and took Iron Mountain, which I stopped once these numbers started climbing.
The elevation isn't massive, but it's there.
Timeline:
https://iili.io/Bb7CmX.md.jpg
https://iili.io/Bb5civ.md.jpg
Started taking Iron Mountain in March 2018
https://iili.io/Bb7oIn.md.jpg
https://iili.io/Bb7xXs.md.jpg
https://iili.io/Bb7zLG.md.jpg
Stopped Iron Mountain in December 2020
https://iili.io/Bb7TBf.md.jpg
https://iili.io/BDTVzx.jpg
https://iili.io/BDuaQR.md.jpg

Still, my immunologist-rheumatologist referred me to a hematologist.
( Dealing with SLE & APL Sy )

Dear Nicholas Davis4,

Generally speaking, polycythemia is considered when hemoglobin exceeds 160 g/L or hematocrit rises above 0.48.

The values you provided are borderline. From what I can see, hemoglobin was only above 160 g/L in a single test.

There are numerous reasons for results like this. It is more likely a secondary cause—meaning it isn't a primary blood disorder, but rather linked to oxygen deprivation (hypoxia) or increased erythropoietin production.

Given the respiratory symptoms you discussed extensively in the lupus thread, and considering your underlying condition (SLE), the first priority should be ruling out pulmonary pathology.

Your MVP reading isn't significantly high. In clinical practice, values up to 11.5 fL are still considered normal. That said, patients with antiphospholipid syndrome often show higher MVP levels. Elevated MVP can also be seen in lung disease.

Since the list of potential causes is quite long, given your specific symptoms, I would rule out respiratory issues first before looking elsewhere.

Felix, thanks for getting back to me!
I’ve also been dealing with some SLE issues lately 🤦
I have a few questions, so would it be okay if we moved this conversation over to the SLE thread? I don't want to clutter up this space...

Brenda Alvarez24 said:Felix, thanks for the reply.
Yeah, I've been dealing with some SLE issues lately. 🤦
I have a few questions, so maybe we should move this over to the SLE thread? Don't want to hijack this one...

By all means.

Hi there,

Is there a radiologist or someone here who might be able to take a closer look at a neck X-ray? I’m not actually looking at the bones, but rather something else—on all four images, I noticed a shadow near my throat area. I can't tell if it's my thyroid or what; I've been searching for neck X-rays online, but I can't find anyone else with this specific shadow (it looks somewhat like a spiderweb) on the front of the neck.
I originally went in for an X-ray due to some neck issues and really nasty symptoms, but now I’m just shaken up by this little spot I found.
I’m honestly not even sure if the radiologist will mention it in the official report, which makes me even more anxious because I have no idea what it could be. 😠
If anyone here has a bit more expertise in reading internal imaging, could you please help me out? 🙂

I'm wondering if elevated immunoglobulin levels (31) and ANA (1:2500) could be linked to antibody reactions seen two weeks after getting the first dose of Pfizer. Everything else seems fine...

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