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Forum Name: Hematology Topics

Question: Low B12, High RBC, High Hematocrit, Low MCH and MCHC


 npilant - Sat Dec 01, 2007 4:36 pm

I am a 28 yr old male in currently residing in Florida, originally from Maryland. For the past 5-6 years I have had an onslaught of neurological symptoms including tingling, stinging in my legs, upper back, head, eyes, knees. Additionally I have chronic diarrhea (this last episode has been every day for 5 months and is accompanied by moving severe abdominal pain). I have had just about every digestive system test known to man, without and significant findings. I've had MRI's, CT's, EEG's, EKG's etc..... same thing. I additionally have tremors, muscle spasms, double vision.

The only informative test results I have thus far are that my hematocrit ranges between 50 and 52, my rbc ranges between 5.9 and 6.2 MIL/UH, My MCH (27.1 ) and MCHC (33) are always just below normal and my recent B12 test was Low (178).

How can your HCT and RBC be high if your B12 is low? If I am overproducing red blood cells already and received B12 injections, would that cause me to make even more red blood cells? Is this some type of rare blood disorder/condition? Help.
 Dr. Chan Lowe - Sat Dec 01, 2007 9:34 pm

User avatar Hi Npilant,

I suspect that your B12 is not low enough to produce an anemia. There is another red blood cell measurement that can indicate B12 deficiency as well. If the MCV is elevated (usually defined as >100) it is more consistent with a B12 deficiency.

B12 deficiency can cause neurological symptoms, though I can't be sure that this is the cause of your symptoms. Getting B12 replacement is unlikely to cause an increased production of red blood cells for you.

You may want to see a hematologist to further evaluate your red cells if there is concern.

Best wishes.
 npilant - Wed Dec 05, 2007 9:45 pm

Thank you for replying Dr. Lowe as any additional information would be helpful at this time. I have a CT tomorrow to see if I have a hole in a middle ear or inner ear bone. My ENT doc said it's rare but could explain my symptoms. I looked up the condition (superior canal dehiscence), and it only seems to answer part of the problems that I am going through (Dizziness, headaches, balance problems.)

I have thought for some time and continue to believe that I have Lymes Disease. This is do to the fact that when all the symptoms started, well maybe a month or so later when I noticed it, I had a weird pinkish tan, irregularly shaped oval mark on my back. It was gone less than a month later. It did not have a bullseye but I've heard that doesn't matter. This was back in 2002, but I was never tested for Lymes disease until about two weeks ago. I had a Lyme Titer done, which came back negative. I do not know what type of Titer was done, if they did the old ELISA test or the ELISA6 test and I assume they did not do the western blot. Additionally, I have heard that other tick borne illnesses can cause similar symptoms (babesiosis, erlichiosis). I should add that I lived in Maryland until about a year ago and individuals I knew, specifically the neighbor across the street, had contracted Lymes Disease there. I had heard that the IGeneX is the best lab to use to have your blood or other fluids tested.

Should I just cough up the money and have samples sent there to be tested or are all labs the same? Also, my neighbor across the street had a giant bullseye on her leg when she got Lymes Disease and she tested negative the first time as well.
 Dr. Chan Lowe - Wed Dec 05, 2007 10:13 pm

User avatar I would recommend you talk with your doctor about the need for further testing for Lyme Disease. For most tests, most labs are equally good. Unfortunately, I cannot speak to the quality of your lab. Your doctor will probably know better about this.

I would recommend you ask your doctor about your lab's reliability before paying the money yourself.

Best wishes.

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