Question on enlarged Red Blood cells
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Joseph7179
- Little Blue Penguin
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Question on enlarged Red Blood cells
After a regular annual physical I had a blood test, (CBC). The results showed enlarged red cells. (RBC), The nurse told me that due to my MC and GERD, I needed more tests to determine what to do next. Any advice? Can MC cause this to happen. Ihave no symptoms and feel well otherwise. I am taking Entocort 6 mg but tapering down.
Joseph7179
Hi Joseph,
There can be many causes of enlarged red blood cells (macrocytosis). The most common are B12 and/or folic acid deficiency. Hypothyroidism and medications can also be factors. Do you have an anemia too? Most of the causes are not serious, luckily.
Polly
There can be many causes of enlarged red blood cells (macrocytosis). The most common are B12 and/or folic acid deficiency. Hypothyroidism and medications can also be factors. Do you have an anemia too? Most of the causes are not serious, luckily.
Polly
Blessed are they who can laugh at themselves, for they shall never cease to be amused.
EDIT: I see that Polly has answered your question while I was still typing. Rather than to just trash my response, I'll leave it here, since it includes the details of how this can happen with MC, which other readers might find helpful.
It's certainly possible that your enlarged red blood cells are a secondary symptom of MC. Here's how it can happen:
MC causes malabsorption problems for most of us. For some the problem is worse than for others, and typically, the longer we react, the more severe our malabsorption issues tend to become, as deficiencies of certain vitamins begin to develop. The B vitamins are especially prone to poor absorption with active MC, and deficiencies of vitamins B-12 and folic acid (vitamin B-9) are common with MC. Vitamin B-12 provides several very important functions (including digestive and neurological responsibilities). Folic acid also is critically important for several health issues, but even more importantly, an adequate level of folic acid is necessary in order for the body to be able to absorb and utilize vitamin B-12.
To get to the point of all this background information, two of the most common causes of enlarged red blood cells are deficiencies in vitamin B12 and folic acid. So this is why I'm relatively sure that the cause of your enlarged red blood cells is a deficiency of either vitamin B-12 or folic acid, or both, secondary to MC.
Fortunately this is very easy to treat, and the fastest way to get those vitamin levels back to normal is to take a sublingual B-12 supplement with folic acid. Sublingual lozenges are designed to dissolve under the tongue, where they are absorbed straight into the bloodstream, thereby avoiding any intestinal malabsorption problems that might still be present. And they are available with a correctly-proportioned amount of folic acld. For example, I used some that contained 1,000 mcg (micrograms) of methylcobalamin plus 400 mcg of folic acid. Methylcobalamin is the active form of vitamin B-12, so it is much more efficiently absorbed. Cheaper vitamin supplements contain the inactive form of B-12 (cyanocobalamin).
If you prefer, you can also get B-12 injections from your doctor, but I'm not sure if they contain folic acid or not, so it would be a good idea to ask if you decide to go that route. The problem is that if a deficiency of folic acid is the primary problem to begin with, then more B-12 won't help (without folic acid).
There can be other causes of enlarged red blood cells of course, but the odds are very high (IMO) that in your case it's due to a vitamin B-12 and/or folic acid deficiency.
I hope that this resolves the problem.
Tex
It's certainly possible that your enlarged red blood cells are a secondary symptom of MC. Here's how it can happen:
MC causes malabsorption problems for most of us. For some the problem is worse than for others, and typically, the longer we react, the more severe our malabsorption issues tend to become, as deficiencies of certain vitamins begin to develop. The B vitamins are especially prone to poor absorption with active MC, and deficiencies of vitamins B-12 and folic acid (vitamin B-9) are common with MC. Vitamin B-12 provides several very important functions (including digestive and neurological responsibilities). Folic acid also is critically important for several health issues, but even more importantly, an adequate level of folic acid is necessary in order for the body to be able to absorb and utilize vitamin B-12.
To get to the point of all this background information, two of the most common causes of enlarged red blood cells are deficiencies in vitamin B12 and folic acid. So this is why I'm relatively sure that the cause of your enlarged red blood cells is a deficiency of either vitamin B-12 or folic acid, or both, secondary to MC.
Fortunately this is very easy to treat, and the fastest way to get those vitamin levels back to normal is to take a sublingual B-12 supplement with folic acid. Sublingual lozenges are designed to dissolve under the tongue, where they are absorbed straight into the bloodstream, thereby avoiding any intestinal malabsorption problems that might still be present. And they are available with a correctly-proportioned amount of folic acld. For example, I used some that contained 1,000 mcg (micrograms) of methylcobalamin plus 400 mcg of folic acid. Methylcobalamin is the active form of vitamin B-12, so it is much more efficiently absorbed. Cheaper vitamin supplements contain the inactive form of B-12 (cyanocobalamin).
If you prefer, you can also get B-12 injections from your doctor, but I'm not sure if they contain folic acid or not, so it would be a good idea to ask if you decide to go that route. The problem is that if a deficiency of folic acid is the primary problem to begin with, then more B-12 won't help (without folic acid).
There can be other causes of enlarged red blood cells of course, but the odds are very high (IMO) that in your case it's due to a vitamin B-12 and/or folic acid deficiency.
I hope that this resolves the problem.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
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Joseph7179
- Little Blue Penguin
- Posts: 25
- Joined: Sat Oct 29, 2011 1:04 pm
Red Blood Cells
Thanks so much for the help with this RBC issue and the probable cause you suggest. I have never been anemic but the las MC flare in July has been harder to get under control. I also had a GERD problem but that seems to be resolved now without having to resort to a PPI.
I have a good physician who is very familiar and helpful with MC patients. I am most grateful.
I will follow up as I get more information and treatment.
Thanks Tex for the suggestions about the B12 and folic acid supplements, and for your quick replies to my question.
I have a good physician who is very familiar and helpful with MC patients. I am most grateful.
I will follow up as I get more information and treatment.
Thanks Tex for the suggestions about the B12 and folic acid supplements, and for your quick replies to my question.
Joseph7179
It seems like every time I have blood work done, my RDW is just above the normal range (everything else in the CBC looks okay). From what I've read, it sounds like that could point to similar deficiencies, right? The last time I had my B-12 tested (about a year ago, just before my MC diagnosis), it was 686 (ref. range 200-1100 pg/mL). My doc isn't very good about testing for deficiencies (or anything else) unless I specifically ask her to, which is frustrating, given my known digestive problems.
Kristen
Kristen
Hi Kristen,
As you are probably aware, RDW (red cell distribution width) is a measure of the variation in red blood cell size or red blood cell volume. Higher RDW numbers usually indicate increased variation in red blood cell size.
With elevated RDW, sometimes a clue can be found in MCV results. IOW, high RDW, low MCV may be due to iron deficiency anemia, whereas high RDW, high MCV often correlates with a deficiency of either B-12, or folate, or both.
Interestingly (this borders on trivia, so it may or may not be of interest), researchers have discovered that patients with an RDW level equal to or greater than 12.9 % tend to have an increased risk for depression, and the higher the RDW, the greater the risk of depression. But that's an association, not necessarily a cause and effect relationship.
Tex
As you are probably aware, RDW (red cell distribution width) is a measure of the variation in red blood cell size or red blood cell volume. Higher RDW numbers usually indicate increased variation in red blood cell size.
With elevated RDW, sometimes a clue can be found in MCV results. IOW, high RDW, low MCV may be due to iron deficiency anemia, whereas high RDW, high MCV often correlates with a deficiency of either B-12, or folate, or both.
Interestingly (this borders on trivia, so it may or may not be of interest), researchers have discovered that patients with an RDW level equal to or greater than 12.9 % tend to have an increased risk for depression, and the higher the RDW, the greater the risk of depression. But that's an association, not necessarily a cause and effect relationship.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
