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Reason for elevated MCV and EO in blood test.

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Hi there,

I had some questions about some recent bloodwork (a CBC) as follows:

Test Low Normal High Flag Reference
--------------------------------------------------------------------------------------------
WBC | | 7.3 | | |3.8-10.8 TH/UL
RBC | | 4.75 | | |4.2-5.8 MIL/UL
HEMOGLOBIN | | 15.1 | | |14.0-18.0 G/DL
HCT | | 45.0 | | |38.5-50.0 %
MCV | | | 94.8 | H |80.0-94.0 FL
MCH | | 31.8 | | |26.0-34.0 PG
MCHC | | 33.5 | | |32.0-36.0 G/DL
RDWCV | | 13.2 | | |11.5-15.0 %
PLT | | 242 | | |140-400 TH/UL
MPV | | 8.7 | | |7.4-10.4 FL
NEUT | | 49.1 | | |40.0-85.0 %
LYMPH | | 35.7 | | |15.0-40.0 %
MONO | | 6.7 | | |0-10 %
EO | | | 7.7 | H |0.0-7.0 %
BASO | | 0.8 | | |0.0-2.0 %
MANUAL DIFF | | NO | | |
RBC MORPH | | NORMAL | | |NORMAL

Two values were elevated. The first was MCV (94.8 FL where normal is 80-94), and the second was EO (7.7% where normal is 0-7).

Do I need to be concerned about either of these? MCV seems less concerning than EO, as I'm aware too much EO can be very damaging to the heart, blood vessels (atherosclerosis), and other organs. Several months ago, a CBC found similar results.

Is EO at these levels over the long-term dangerous/harmful, or is it only harmful if it is much more severely elevated? Is their any additional risk having my EO at this percentage?

Thanks so much!

Category: Internal Medicine Specialist

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Category: HIV- AIDS Specialist
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Hello.
Sorry for the confusion.
Your query will be replied to shortly.
InHouse Physician,
DoctorSpring


Patient replied :

No problem, and thanks.
I have one other query we touched on before if you don't mind me asking it here as well (though I'd still like your feedback on the blood tests above).
As we discussed, I have some prehypertension. My numbers haven't been too bad lately, but tonight I alarmed myself by taking it immediately after sitting down (moderate activity beforehand but nothing major). My diastolic was quite high (98), when usually it's quite good (high 70's to mid 80's most of the time). It returned to a good level (78-80) after waiting a few minutes seated, but I repeated this, and whenever I'm standing and sit down, diastolic is high upon taking it (90's).
Should posture changes (standing to sitting) cause a rise in diastolic?
I noticed even just standing a few minutes (trying to be still) and taking it, both systolic and diastolic were raised (diastolic often in the 90's), when I've read they should be lower than sitting values, if anything. Granted, the directions for both my wrist monitor and my cuff monitor say to take it seated with no mention of standing, so I'm not sure if these devices can be accurate while standing or not. Is this something to be concerned about or likely reading errors? Does standing BP require special equipment to take, and is it true it should be lower, not higher?
Thanks!


Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Your CBC reports are excellent and eosinophils is only borderline elevated and it does not really have any significance. Only if it is severely elevated, it is a cause of concern. As in values over 20 %. Eosinophils can be elevated even in asymptomatic individuals. Or it can be elevated in some kind of allergic manifestations. Your value is definitely not significant. And regarding the MCV it is also nothing to worry about.
Regarding your BP values, yes they are slightly high, but you're supoosed to check BP in sitting position, preferable not after any activity and relaxing for 15 minutes at least. Otherwise the values will fluctuate, and it won't be proper. BP does vary a lot with posture, sudden standing from sitting position, can drop/raise BP and so proper gap needs to be there.
You're only 34 and with moderate exercise, such as walking can bring your weight as well as your BP values down. In fact treatment for pre hypertension is lifestyle and dietary changes, low salt, avoiding oily and spicy food, e.t.c
And yes one more thing these BP cuffs and equipments are not really accurate. If you really want to know your BP, then please get it checked manually, preferably in the morning and get 2 values checked in 15 minute intervals. That will be more helpful.
I once again would like to reassure you, you have nothing to worry about currently. So have an active lifestyle and you will see the positive effects soon .
Hope this was helpful,
Regards.


Patient replied :

Thanks very much for the help!
I'm glad you're not concerned about the eosinophils. So you feel there's no danger of any additional risk from them as long as they stay in this range, then, even long term?
I did try standing for a few minutes (so no quick posture) change before taking BP. Diastolic was still elevated, though not as high (low 90's instead of high). But as you mentioned, neither of these machines mention anything about taking readings while standing.
I'm doing very well with exercising regularly. I'm also eating healthier (though still need to work on portions a bit), don't smoke, have moderated drinking quite a bit, etc., so I am trying to work on a healthy lifestyle. I guess I'm just concered that my BP response to exercise, particularly diastolic, might not be normal even though it seems good at rest.
Thanks again for all your help!


Yes some people do have slight borderline elevation of eosinophils and they are completely asymptomatic.
So there is no additional risk.
The fact that you're exercising and eating healthier, itself will show results soon. Lifestyle intervention reduces BP to quite an extent.
I will recommend you get your BP checked 2 times at 15 minute intervals by a nurse/ pharmacist manually and let me know the values. It will give us an accurate picture. You should not be stressed before the BP evaluation and also avoid any kind of physical labor. It is good if you can just rest for 5-10 minutes before getting your BP checked.
Once you have the values, do get back to me.
Regards.


Patient replied :

Thank you. I've actually been exercising for quite some time (over a year pretty consistently, and sporadically before that). I look and feel a bit better, but my BP still isn't quite where I want it. I will keep trying.
I actually see a doctor tomorrow and should have a manual BP taken then. (Unfortunately I get very nervous/white coat hypertension when this happens, but I'm trying to stay calm). But I'll let you know the values once I know them.
I guess the one thing I'd like to know is, is it normal for diastolic to be somewhat elevated when standing vs. sitting? And are home wrist and cuff monitors not suitable for standing measurements anyways?
Thanks again.


Yes the diastolic does get elevated. It does not happen in every individual, some people are just prone for BP changes with posture ( more reflected by Diastolic drop/ raise ).
Home wrist and cuff monitors are suitable, however they are not accurate. Hence manual is better.
Regards.


Dr. Jaydeep Tripathy
Category: HIV- AIDS Specialist
Experience: 
MBBS from Sri Ramachandra University in December 2011
M.Med (Family Medicine) - TNMGR University, Chennai
MBA-MPH in Public Health in March 2016, SRM University
Finished AFIH in March 2016, SRM University
MRCP ( UK ), Internal Medicine, Royal College of Physicians, June 2016
Fellowship in Diabetology from Martin Luther University in January 2017

Currently Resident Physician, in MD Radiodiagnosis - Kamakshi Memorial Hospital, Chennai
Dr. Jaydeep Tripathy and 4 other Medical Specialists are ready to help you

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