High Hematocrit, Hemoglobulin, Mcv, Mch

[juliegee]

Hey All-

We've chatted about this before. There seems to be a group of us with similar blood work- showing high hemocrit, hemoglobulin, MCV, MCH. This has been true for Mack & I. Our blood work looks like that of a dehydrated mountain climber no matter how well hydrated we are We've both have had our folate & B-12 checked- as deficiencies present similarly. Alas, our folate & B-12 are normal per serum blood testing. Dr. Rowe at Hopkins has still recommended that Mack take 1,000mcg of B-12 daily in the AM as a trial. His patients have reported improved energy and cognition. He's not sure how it's helping, maybe as an anti-oxidant. There is no toxic build-up. We began taking the B-12 a few days ago. No doubt about it. I have increased energy . I am also better able to keep going throughout the day, less tired later in the day. It seems to really help.

Thought I'd share for folks with a similar blood work pattern.

Julie

[sue1234]

That's great! And something so benign as taking a vitamin. Wonderful news for y'all!

I forgot to add that I take B-12 injections. I had a "natural" doctor let me try them about 10 years ago, and I noticed an increase in energy. Even now, within a week before my next shot is due, I get overwhelming fatigue, and that reminds me it is time for the next dose. I had my daughter's levels tested, they were in the 450 range, but i told her to start an oral 1000 mcg. anyway, as it is water soluble and won't hurt.

[issie]

Just be sure to take a B-Complex daily. If you only take one B vitamin and don't take them all, you can have an imbalance occur and that would be really bad. Some doc's feel that along with the B-12 shot folic acid should be given along with this. These two B vitamins can cause a form of anemia if found to be deficient. So, if that is one of the issues - these vitamins correct the anemia. Glad you're feeling better!!!

[juliegee]

Sue, so happy it's helping you too. With injections I assume you found a true deficiency ? I know injections are a great idea as some folks don't absorb B-12 well.

Issie- We are NOT deficient in B-12. I guess that's the paradoxical twist to this treatment . Our blood work has a pattern that is similar to patients with deficient B-12, but when specifically tested for that, we are not deficient. Dr. Rowe said our abnormal blood work: high hematocrit, hemoglobulin, MCV & MCH is "to be expected in CFS." Many of his patients with similar blood work patterns have found renewed energy & cognitive function with the 1,000mcg of B-12. Weird, but wonderful- huh? He didn't recommend upping the folate (which is also normal for us when tested via blood work.) I bet in the case of true deficiencies, balancing the B's is very important. He does have Mack take a daily multivitamin and calcium as he avoids dairy.

Thanks for the info. I'd hate to mess anyone up

Julie

[firewatcher]

I tried B-12 when I first had my POTS crash in 2007 and it made me MUCH worse. I had horrible insomnia from it. My new doc immediately checked my B-12 levels on my first appointment with him and I had 5 times 2X the normal level of B-12 in my blood from the supplement. I just can't seem to use it once it gets into my system.

just rechecked my old lab report B12 = 1636pg/mL (normal range 211-911pg/mL) sorry!

still didn't work for me...

Edited September 17, 2010 by firewatcher

[juliegee]

I tried B-12 when I first had my POTS crash in 2007 and it made me MUCH worse. I had horrible insomnia from it. My new doc immediately checked my B-12 levels on my first appointment with him and I had 5 times the normal level of B-12 in my blood from the supplement. I just can't seem to use it once it gets into my system.

whoahhh- definitely not for you. We are in the normal range. I'm not sure WHY it's helping, but it is

[Noreen]

I tried B-12 when I first had my POTS crash in 2007 and it made me MUCH worse. I had horrible insomnia from it. My new doc immediately checked my B-12 levels on my first appointment with him and I had 5 times 2X the normal level of B-12 in my blood from the supplement. I just can't seem to use it once it gets into my system.

Did you notice immediate problems with taking the B-12 or did they develop after a couple weeks on it?

[comfortzone]

Would anyone mind posting what their high hemoglobin's are and the MCV and MCH kind of numbers are? And can you teach me what this has to do with anything dysautonomia wise? I am ignorant - and while I don't have my labs handy this second I did look at them just the other day - and the MCV is high and my hemoglobin for a woman over age 50 was near 15. I believe my entire life my MCV and that other M-number have been border-line high or high ... and I don't know why. Once a doctor asked me if I drank a lot...??? I told her 'no I do not' - then she said that sometimes that can be seen as an early sign of drinking 'damage' ... well that shoe didn't fit -- but I still don't know what this means....and also how it relates to this forum's kind of issues....

thanks guys!

[firewatcher]

I tried B-12 when I first had my POTS crash in 2007 and it made me MUCH worse. I had horrible insomnia from it. My new doc immediately checked my B-12 levels on my first appointment with him and I had 5 times 2X the normal level of B-12 in my blood from the supplement. I just can't seem to use it once it gets into my system.

Did you notice immediate problems with taking the B-12 or did they develop after a couple weeks on it?

It was within two weeks, with each progressive week getting worse. I don't think it was the B-12, but the subsequent sleep deprivation it caused. Once I stopped taking it, it was another week or two before I returned to my "normal" night-owl insomnia, but the tremor never went away. I had not taken B-12 for 3 months when my levels were tested, so I don't know how much was in my system when I was actively taking it.

[firewatcher]

Would anyone mind posting what their high hemoglobin's are and the MCV and MCH kind of numbers are? And can you teach me what this has to do with anything dysautonomia wise? I am ignorant - and while I don't have my labs handy this second I did look at them just the other day - and the MCV is high and my hemoglobin for a woman over age 50 was near 15. I believe my entire life my MCV and that other M-number have been border-line high or high ... and I don't know why. Once a doctor asked me if I drank a lot...??? I told her 'no I do not' - then she said that sometimes that can be seen as an early sign of drinking 'damage' ... well that shoe didn't fit -- but I still don't know what this means....and also how it relates to this forum's kind of issues....

thanks guys!

RBC = 5.37 ref. interval: 3.80-5.10

Hemoglobin= 15.8 ref. interval: 11.5-15.0

Hematocrit = 47.5 ref. interval: 34-44

not high enough for polycythemia vera, but too high for a woman of my age. The only time mine are correct is at a lower blood thickness due to dDAVP.

[comfortzone]

Thanks for sharing that. I looked at mine over the years and the MCH and MCV are uniformly high -- but not a 'high' high -- meaning if the reference goes to 33 -- then mine will be 33.1 So almost high normal - yet not. On the hemoglobin - and hematocrit ... near 15 but not over and the corresponding hematocrit at the first number of abnormal on the high scale. So high -- but not terribly high.

But again - why would it be that an EDS'er or a POTS patient have these numbers? Is it a hydration issue? A blood volume issue that isn't hydration related? I am curious. I also wondered if these numbers ever impact the HbA1C unfavorably because no one in my family has diabetes or such issues. Yet I am always high normal at 5.9 - or 'officially' pre-diabetic with a 6.0.........

Anyone care to comment? Thank you again Firewatcher - you folks are so filled with knowledge :-)

[juliegee]

Thanks for sharing that. I looked at mine over the years and the MCH and MCV are uniformly high -- but not a 'high' high -- meaning if the reference goes to 33 -- then mine will be 33.1 So almost high normal - yet not. On the hemoglobin - and hematocrit ... near 15 but not over and the corresponding hematocrit at the first number of abnormal on the high scale. So high -- but not terribly high.

But again - why would it be that an EDS'er or a POTS patient have these numbers? Is it a hydration issue? A blood volume issue that isn't hydration related? I am curious. I also wondered if these numbers ever impact the HbA1C unfavorably because no one in my family has diabetes or such issues. Yet I am always high normal at 5.9 - or 'officially' pre-diabetic with a 6.0.........

Anyone care to comment? Thank you again Firewatcher - you folks are so filled with knowledge :-)

We've chatted about this in the past, but MY guess is that many of us with autonomic dysfunction have lower blood volume despite our true hydration status...which fools the body into thinking we are truly dehydrated when we aren't. If you have EDS in addition to POTS, perhaps your blood vessels are leaky contributing to the lower blood volume & abnormal labs.

I know that there have been other theories out there- I'd love to hear them again.

I wouldn't think that the RBC issues are related to labile blood glucose....BUT many of us do have blood sugars that drop fast and experience reactive hypoglycemia...

[firewatcher]

Thanks for sharing that. I looked at mine over the years and the MCH and MCV are uniformly high -- but not a 'high' high -- meaning if the reference goes to 33 -- then mine will be 33.1 So almost high normal - yet not. On the hemoglobin - and hematocrit ... near 15 but not over and the corresponding hematocrit at the first number of abnormal on the high scale. So high -- but not terribly high.

But again - why would it be that an EDS'er or a POTS patient have these numbers? Is it a hydration issue? A blood volume issue that isn't hydration related? I am curious. I also wondered if these numbers ever impact the HbA1C unfavorably because no one in my family has diabetes or such issues. Yet I am always high normal at 5.9 - or 'officially' pre-diabetic with a 6.0.........

Anyone care to comment? Thank you again Firewatcher - you folks are so filled with knowledge :-)

It IS a hydration issue, at least for me. I am not short of RBC, but the measurement is the amount of red blood cells in whole blood, so I am short of plasma, not the stuff in it. When my plasma volume is up, my bloodwork looks normal. If I don't take the dDAVP then my plasma and free body water levels drop and my blood gets thicker so that the "stuff" in it makes up a higher percentage than it should. Any clearer? I'll try to find a better explanation and paste it in.

WebMD:

# Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood's volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present.

# Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's ability to carry oxygen throughout the body.

# Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes.

Edited September 17, 2010 by firewatcher

[juliegee]

It IS a hydration issue, at least for me. I am not short of RBC, but the measurement is the amount of red blood cells in whole blood, so I am short of plasma, not the stuff in it. When my plasma volume is up, my bloodwork looks normal. If I don't take the dDAVP then my plasma and free body water levels drop and my blood gets thicker so that the "stuff" in it makes up a higher percentage than it should. Any clearer? I'll try to find a better explanation and paste it in.

WebMD:

# Hematocrit (HCT, packed cell volume, PCV). This test measures the amount of space (volume) red blood cells take up in the blood. The value is given as a percentage of red blood cells in a volume of blood. For example, a hematocrit of 38 means that 38% of the blood's volume is made of red blood cells. Hematocrit and hemoglobin values are the two major tests that show if anemia or polycythemia is present.

# Hemoglobin (Hgb). The hemoglobin molecule fills up the red blood cells. It carries oxygen and gives the blood cell its red color. The hemoglobin test measures the amount of hemoglobin in blood and is a good measure of the blood's ability to carry oxygen throughout the body.

# Red blood cell indices. There are three red blood cell indices: mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC). They are measured by a machine and their values come from other measurements in a CBC. The MCV shows the size of the red blood cells. The MCH value is the amount of hemoglobin in an average red blood cell. The MCHC measures the concentration of hemoglobin in an average red blood cell. These numbers help in the diagnosis of different types of anemia. Red cell distribution width (RDW) can also be measured which shows if the cells are all the same or different sizes or shapes.

That's a good explanation, BUT may not explain the whole picture. Mack's last RBC numbers were high and his serum osmolality was low, meaning that there was plenty of plasma in the blood... That's a conundrum I think there's also something else going on.

[firewatcher]

"That's a good explanation, BUT may not explain the whole picture. Mack's last RBC numbers were high and his serum osmolality was low, meaning that there was plenty of plasma in the blood... That's a conundrum I think there's also something else going on."

Julie,

I agree. High RBC/Hematocrit can also be a normal response to chronic hypoxia. I think that this is also a part of what is going on with me as well as low plasma volume. I think that as I hyper-constrict that my kidneys are being deprived of blood and O2 and ramping up the red blood cell production. Dehydration doesn't fully explain the amount of elevation in my bloodwork either.

[sue1234]

It would be nice if we could add up all the variables and come up with a solution!! It feels like we keep finding puzzle pieces, but can't seem to make them fit to make a picture. But hashing out these odd findings people have helps in the long run. I hope one day we can say, "Aha!".

I just had an iron panel and CBC done the other day, but won't find out anything for about 3 weeks. If I have anything similarly abnormal as y'alls, I will post about it.

[juliegee]

It would be nice if we could add up all the variables and come up with a solution!! It feels like we keep finding puzzle pieces, but can't seem to make them fit to make a picture. But hashing out these odd findings people have helps in the long run. I hope one day we can say, "Aha!".

I just had an iron panel and CBC done the other day, but won't find out anything for about 3 weeks. If I have anything similarly abnormal as y'alls, I will post about it.

Do let us know. IF you have the high RBC numbers that many of us have, consider the B-12, even if you're not deficient. It's certainly not a cure, but has made a noticeable difference for both Mack & I.

[sue1234]

I wanted to bring this up again. I do most of my labs in the afternoon, not fasting. Maybe once a year I HAVE to do a fasting, which is very unpleasant for me to have to get up, dressed and driven 30 miles to the lab to do this. So, my CBC has not looked too bad in the past. But, by the time I do it in the afternoon, I have probably drank 2-3 quarts of fluid by then.

Well, a few weeks ago I HAD to do a fasting for blood sugar, and a whole gamut of labs were drawn at the same time. I found my CBC not abnormal, but almost.

RBC 4.87 (3.8-2-5.1)

Hemoglobin 14.6 (11.5-15)

Hematocrit 43.7 (34-44)

I definitely wake up feeling dehydrated every morning. It seems these are a little too close for comfort, and I think could point to an almost dehydration issue. Who in the world might look into a possible metabolic dehydration issue? The few endos and cardios I've mentioned it to don't address it.

Has anyone else besides us few on this thread found similar results??