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Below normal RBC, HCT, elevated MCH. BONE MARROW DISEASE?

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I have a somewhat below normal range RBC and HCT (Hgb has been slightly below range but usually at the low end of normal and goes back and forth...). And yet elevated MCH.
MPV also high but platelets normal.

Neutrophils Absolute also below range but IG (immature granulocytes, I think they're called--I think :) are slightly high.

My MCV was normal, but at many times it has been elevated although I have very normal B-12 and folate levels when MCV is high..

I've wondered if I have some kind of bone marrow disease. I know that in some cases this can lead to leukemia. Of course not happy at the thought but I'm old enough (57 year old female) to know that life is very short, and we all have to go some way or another. At this stage of the game, I've learned to say, "Ok...ok to life...just the way it is, I reckon."


Category: Hematologist

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Category: Hematologist
 21 Doctors Online

Thanks for your query at
I went through your report and understand that you have a fluctuating
but (near) normal HB with elevated MCV and normal folate and B12

This may not be bothering as your rest of the parameters are within normal.

There can be innumerable causes of increased MCV. Alcohol consumption,
dietary causes, worn infection and a lot more can cause increased MCV
in spite of normal folates and B12.

I would recommend you to do a complete blood analysis and bone marrow
evaluation as needed.
Hope this was helpful,
Feel free to discuss further

Kind regards,
M.B.B.S., D.M.R.T., M.D., D.M (Onco)

Patient replied :

Dear Doctor, I don't understand how low RBCs, low HCT, low Absolute neutrophils, elevated IGs, elevated MPV...that these parameters are within normal. Do these parameters have be super low or high, well outside of the lab's reference ranges, before they are considered abnormal even though they are below range or in the case of IGs, MCH. and MPVs elevated?
I am a near teetotaler, so alcohol consumption is out as a cause of my occasionally elevated MCV and I eat well. By "worn" infection, do you mean "worm" infection? Yuck! If worm infection, what type is most closely associated with elevated MCV?

Thanks so much for your help!


The blood reports are considered in Toto while assessing a patient. I was suggesting the possible reasons for increased MCV.
I apologize for the typing error. It's any kind of worm infestation which can be present in the intestine. Take care.

Patient replied :

I am still having trouble understanding. I apologize. But help!
As I said in my initial question, my RBCs are below range, HCT is below range, Hgb is below range. You said in your response that these other parameters are within normal. I don't understand because they are below the reference ranges. What other parameters are you referring to?
Absolute neutrophils are below range. Also, which I failed to mentioned...basophils are slightly high.
I'm high on MPV and high on IGs. Both are elevated outside of the normal range.
MCV falls in the upper normal part of the RR, but it has been elevated in the past on one than more occasion.
MCH is elevated.
My question is: how are these parameters which are either below RR or elevated outside or range considered normal. Are you referring to these important parameters? If other parameters what are they?
Also the RDW SD is high, outside of RR.
Thanks so much, just trying to understand what you're saying. Help, doctor! Again, thanks so much!

I need to see all you reports before I can comment.
Please upload whatever reports you have and I will guide you further.

Dr. Prasad Eswaran
Category: Hematologist
Doctorate in Medicine (Fellowship in Oncology), DM,  Madras Medical College & Govt. General Hospital, Chennai, India.

Doctor of Medicine (Residency in Radiation Oncology) , MD, Christian Medical College, Vellore, Tamilnadu, India, 2004-06.

Diploma in Medical Radiology & Therapy (Residency in Radiation Oncology), D.M.R.T, Madras Medical College & Govt. General Hospital, Chennai, India, 2004-06.

Bachelor of Medicine & Bachelor of Surgery - M.B.B.S, Govt. Stanley Medical College & Hospital, Chennai, India, 1998-2004.
Dr. Prasad Eswaran and 4 other Medical Specialists are ready to help you

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