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Forum Name: Hematology Topics

Question: Slowly Rising RDW and LDH


 misschris772 - Sat Jan 24, 2009 8:33 pm

Hello. Over the last 3 years, my blood work has slowly been changing. Initially, in April of 2006 my RDW was 12.7, which is within normal range. In July of 2007, my LDH was 190 and my RDW was 14.8 - slightly elevated. My iron in July of 2007 was 131, normal. In December of 2007, my RDW went to 15.1 and my B12 was 250. I was told to take B-12 supplements. Finally in July of 2008, my LDH was 251 - very high above normal, my iron was 32 way below normal and my RDW was 15.6 even more elevated. My hemoglobin, hematocrit, MCV, MCH, MCHC and platelets are all okay on all. My MPV was 10.2 in July of 2008 --- right at the cut off for high. I have had increasingly heavy menstrual cycles and need to have surgery because of the bleeding. I feel like this is probably the cause of the iron issue, but what about the RDW and LDH? Doesn't this signify something wrong with my blood or blood production? I've read a little on the net, but I'm not sure what exactly it means. Could you guide me in a direction I should go to have this checked? Let me know what your take on the readings are, please. I would very much appreciate it. I feel fatigued every day and have lots of joint pain, thinning skin, hair falls out some, and tachycardia issues for over 9 years. My TSH has slowly went down from .85 in 4/06 to now .60 in 7/08. Not sure what's going on.

Thank you for your help!

Chris
 John Kenyon, CNA - Wed Feb 25, 2009 11:24 pm

User avatar Hi Chris --

The progressive increase in RDW and LDH are suggestive of some sort of organic anemia, most likely hemolytic anemia, which has several forms and a lot of possible underlying causes. While the RDW and LDH could indicate this or something similar, the findings also could be due to the heavy menstrual periods -- or vice versa.

The drop-off in TSH also suggests you may have an autoimmune disease which could be causing both the lowered TSH and some autoimmune cause for the anemia and even the abnormal menstruation.

You may need to have a consult with a rheumatologist and/or endocrinologist to sort this out, but this is typical of autoimmune problems (if that is the case). They can be infuriatingly difficult to diagnose and pin down to a specific area of concern, often moving from one to another system or involving one then more.

I wish I could give you a more concrete answer, but there's more detective work to be done by your doctor (or doctors). At this point it seems fairly certain you at least have some form of anemia, even if it is "only" due to heavy periods. The rest, however, still needs to be clarified, diagnosed and managed.

Good luck to you. Please follow up with us here as needed.

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