Complete Blood Count Question...

[thinkertwo]

I went to a different doctor at my medical center today.  She seemed a little concerned that my HGB is low 12.00 and my MCV is low also (she said it is common for the MCV to be high when the HGB is low; something about cells being small rather than large)...in any event she asked me to follow up with my doctor.  When I went though my labs over the last two years this seems to be consistant.  Anyone know what that means and whether I should be concerned.

 I also noticed my liver enzymes were a little high.  My bilirubin has stabilized at @4.0 from 5.0 over the last two years but my ALT 56, SDY 45 and CK 561 (this is always high) has risen.  I'm on Tavada, Norvir,and Reyataz.

[bocker3]

Hey Thinkertoo,

I wouldn't be overly concerned with your HGB result.  It probably makes sense to follow up with you doctor -- a 12 HGB is a little low for a man (although, not terribly so).  If it's been consistently low over the last 2 years, then it's probably not because you are bleeding anywhere  Again, your doctor can do a proper diagnosis with some more testing, if he/she thinks it is necessary.  Of course, it is entirely possible that a 12 HGB is "ok" for you -- we are all different.
As for a low MCV (basically, the average size of your RBCs) -how low are we talking -- there are a whole host of reasons for microcytosis (low MCV) -- one of which is anemia.  I think your different doctor is wrong -- when I worked in a hematology lab, I do not recall seeing macrocytosis (high MCV) routinely when folks where anemic.  Although it can be a sign of Vit B12 or Folate deficiency - which can cause anemia.
Bottomline -- ask your doctor -- clearly he/she has not been alarmed over the last 2 yrs -- but if you are concerned, ask!

As for you enzymes -- the Bili is most likely a benign side effect of the Reyataz.  I'm on that too, and my bili tends to go up and down.  The others -- again, ask your doctor -- he/she may be able to help you understand what is/might be causing these higher reading.  BTW I've not heard of an SDY enzyme -- my clinical chemistry is not great, but this was never a routinely performed test in any lab that I've ever worked.

Mike

[John2038]

thinkertwo

On my lab, std range is 13.8   - 18.8 g/dL for the haemoglobin, on others you may find 12-18
Got a friend border line on those counts along with MCV, MCH, MCHC before meds.
Doc typically first think light anemia (if liver/kidney functions ok -ALT 56 is above 40, but under 200, the treshold where usually something may go wrong).
In his case, he get prescribed Autrin (contains B12 + Folic acid + Vitamin C + etc) and his count have improved.

He also started HAART and got perfect FBC after 6 months.

Looking at my own counts, I m seing a stable Hgb over the last year, with few lower values (2-3) of 1-2 point lower (but then back to the usual level).

The body is complex isn't it ? Still adapting.

ALT might increase not only because of the liver, but sometime because of the heart also.

As for the CD4/VL, I guess that with FBC, what matter the most is the trend.

I personnally stopped to stress for anything:

My moto: if it's new, no worries. Could it be a bad count, pimple, etc.
If it last for what I will consider as too long, treat it.

Personnally, if I were having the counts you are presenting, I won't stress at all.
But for sure, I will listen what the doc says and let me know what should I do next.

Keep Well,
John