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  #15  
Old Sun Jul 9, 2017, 11:51 PM
zent1000 zent1000 is offline
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Join Date: Sep 2016
Posts: 11
Hello again,

Thanks again to all your replies from July-Oct 2016!! That was very helpful.


My father has been seeing the same Hematologist every three months as described in Message#11. A CBC is done before the visit and he examines my father with the results.

Since Oct 2016, once every three months, he has been taking an injection (2500 micrograms) of Vitamin B12 + Folic acid as prescribed by his Hematologist. So far, he has no symptoms and is doing fine.


My father saw his Hematologist in January 2017 and again today, July 9 (he could not see him April 2017 as he was visiting us in US).

Following is a summary of the abnormal/borderline values from his CBC and other tests (abnormal values are bolded):

RBC (Reference Range : 4.5 - 6.5):
January 2017 : 4.35
July 2017 : 4.24

Hemoglobin (Reference Range : 14-18)
January 2017 : 14.41
July 2017 : 14

MCV (Reference Range : 80-96)
January 2017 : 99.9
July 2017 : 94.55

MCH (Reference Range : 27-31)
January 2017 : 33.11
July 2017 : 33.03

Packed Cell Volume (Reference Range - 42-54)
January 2017 : 43.16
July 2017 : 40.09


Vitamin B12 (Reference Range : 211-940)
July 2017 : 1788

Folic Acid (Reference Range : 2.34-17.56 ng/ml)
July 2017 : > 20.0 ng/ml

Reticulocyte count
July 2017 : 0.5
(No reference range was given in the report, but I found it to be 0.5-1.5 online)


The Hematologist told me that my father is doing well and he should see him again in Oct 2017 with the results of a CBC. My father should continue the Vitamin B12 injections (once every 3 months). No further testing of Vitamin B12 or Folic Acid were needed.

My father is 80 years old and lives alone in India. He is 5 ft 3 inches in height and weighs 119 lbs with a waist size of 35.5 inches. He is socially and physically active (walks and exercise bike).

Questions:
1) A RBC of 4.24 and a Hemoglobin of 14 is the lowest he has ever had. Also, for the first time his MCV is nromal, but his MCH is still elevated. The Reticulocyte count is at 0.5 %, which is the lower limit of normal. The Packed Cell Volume has been low the first time. Your comments?

2) I am unable to understand why my father needs the Vitamin B12 injections if his value is so high at 1788. When I asked the Hematologist about it, he told me this was because my father is a strict vegetarian (for all his life). Does this make sense? Just worried about the downsides of taking too much Vitamin B12.

3) Does my father need an Iron Profile and other tests like Urine FIGLU, Peripheral blood smear, Serum methylmelonic acid and serum homocystiene at this time for further investigation?

Thank you!!
Zent
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