Hi Cecilia,

No problem.

I'm not a doctor obviously so this isn't medical advice. It's just a chat between friends, ok;)?

I've had to learn rather more than I ever thought I would need to about haematology in the course of diagnosing and treating myself so I have picked up a reasonable amount of knowledge on the CBC and I obviously did have iron deficiency anaemia which I resolved so hopefully I do have some suggestions for you.

Two of the causes of iron deficiency I'm aware of are internal bleeding and low dietary intake of iron and perhaps vitamin C which is needed to absorb it. The third is folate deficiency usually with B12 deficiency too which was the cause in my case.

Folate deficiency will cause problems with your liver. The liver stores iron and B12 so when it is damaged it can no longer do so efficiently. Consequently, it releases the iron back into the blood stream which may fool your doctor into thinking that your iron is normal when it isn't. However, if you treat the folate and B12 deficiencies then eventually the liver will recover and effectively suck the iron back out of your blood and store it again. The body can only use iron released in a special form from the liver so once that happens it will do so again and your iron deficiency should then resolve itself.

I feel confident in describing this scenario because that is essentially what happened to me: once my folate and B12 deficiencies were fixed, the liver sucked the iron back which I was lucky enough to catch with two blood tests and month or so apart. I suddenly felt much better in between and the second blood test showed that my iron had fallen quite dramatically.

If they have identified an iron deficiency rather than a folate or B12 deficiency, it could be that you have a predominantly iron deficiency with a small folate and B12 deficiency which is the opposite from the case I describe. So you would probably see a low normal MCV and a low MCH. Your MCHC would be interesting to know too because there are two forms of iron deficiency: hypochromic and normachromic iron deficiencies. The MCHC will tell you which. If you have normochromic iron deficiency I think that would probably mean that your MCV and MCH tracked each other but I'm not completely sure. I'd have to think about it a bit more and see some examples.

I'd say it's definitely worth looking into possible folate and B12 deficiency too.

I'll probably write some more about testing and checking for deficiencies. In the meantime, if you could get hold of your red cell histogram it'll probably give you the answer immediately.

Regards,

Jim