Worried and not sure where to begin...
 

I recently went for a routine check up with a new GP. I'm turning 40 so I thought it was time. The doc did a cbc and a few other tests. I was not expecting a call back from anything because I had no symptoms. I received a call back stating my white blood count was 4.7 and to follow up in 3 months. Went back and white count dropped to 3.7 and red blood cells are enlarged. Doc checked for B 12 and folate and I am not deficient. Doc is referring me to a hemotologist. I'm very worried. Any advice or suggestions??

Hi ReneeC.

Checking your folate and vitamin B12 was the right thing to do, since they can explain macrocytosis (enlarged red blood cells). WBC can naturally vary from one test to another, so having a lower WBC on this test than on the previous one is a concern but not proof that your WBC will drop further. Is your hemoglobin normal? I suggest that you ask for a copy of your CBC results and ask for copies of the results of any followup CBCs too.

Did your GP do a white blood cell "differential" test, to determine the relative percentages of the types of cells (granulocytes, lymphocytes, etc.)? It's another analysis the lab can run after a blood test. Perhaps your GP didn't order one with this blood test but the hematologist is likely to.

Did your GP tell you what the possible causes of your blood test results might be or defer to the hematologist? Without knowing all of the possible explanations it's too soon to panic but you should be prepared to ask the forest-level questions: What are the possibilities? How do we find out which case it is?

I hope your appointment with the hematologist is coming up soon. Assuming these symptoms persist they need to be explained. Good luck.

Thank you
 

Neil,

Thank you so much for your reply. You have given me a place to start and the proper questions to ask. I don't have all of the specific information because I did not know what to ask at the time. I have not received a call from the hematologist to schedule the appointment. It has only been a few days. If I don't hear something soon, I will call the GP again. I will keep you posted on what I find out. Thank you so much for taking the time to help me.

Sincerely,
ReneeC

Be sure to get copies of all your test results so you have a record and can see what they are. I know it's hard to believe, but sometimes they dismiss some low normal and may miss below normal results. Your B12 should be in the mid range. A low normal, especially when hematological and neuro symptoms are present, needs to addressed.

Other nutrients to check for are iron, copper, zinc, vitamin D and B6. Also have them check for h-pylori bacteria. As there have been connections between that and blood disorders.

Update: I had my appointment with the hematologist. I only have one set of cbc's to list. The hematologist is testing five things with the white blood cells and two things with the red blood cells. I have no idea what they are because I was afraid to ask! The nurse did mention a HIV test but I all be shocked if it is positive. I was tested for this for insurance purposes and it was negative. He said if these tests come back negative, we will move on from there.

WBC - 4.3. - range - 4.1-10.9
LYM - 2.0. - range - 0.6-4.1
MID - 0.3. - range - 0.0-1.8
GRAN - 2.0. - range - 2.0-7.8

RBC - 4.14. - range - 4.20-6.30. - LOW
HGB - 13.0. - range - 12.0-18.0
HCT - 41.7. - range - 37.0-51.0
MCV - 100.8. - range - 80.0-97.0. -HIGH
MCH - 31.4. - range. - 26.0-32.0
MCHC - 31.2. - range - 31.0-36.0
RDW - 12.4. - range - 11.5-14.5

PLT - 200. -range - 140-440
MPV - 11.6. - range - 0.0-99.8

ANC - 2008
B12. - 303

Can anyone interpret these results? All of my counts are on the low end of normal with two being out of range. Is this normal for some people?

Thank you in advance for your feedback and advice. My next appointment is in three weeks.

I I don't think these numbers look that abnormal. The ones that are off are barely off. I think it's good to be checking into things because you can't ever be too cautious, but for my own labs and my daughters they never mention anything unless it's way over or under.