Normal MCV, low MCH, MCHC

My daughter's blood work showed normal MCV (corpuscular volume), but low MCH and MCHC. My son's is very similar, but barely in "normal ranges".
Does anyone have any advice on this?

I'd be so grateful, as their doctors are basically ignoring it, but my daughter (with EDS) is getting fatigued.

Thanks so much!
:) Diana

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I don't know if this might help you or not but I refer to it a lot

http://labtestsonline.org/understanding/analytes/cbc/tab/test

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So, even though her RBCs are the right size (Mean Corpuscular Volume) she has low total hemoglobin levels and low hemoglobin concentration in each of her RBC's. What exactly is your question? How to raise the Hb level?

http://www.livestrong.com/article/355037-how-to-raise-hemoglobin-levels/

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did you ask the doc who ordered the test?

i never ordered a test on any of my patients unless i cared about the results... so maybe it is one of those random/ doesn't affect your life oddities? you can find "norms" for almost anything, theories about your specific lab question, others have provided you with more links (and i know that you are all over medical literature already due to your work), but having been on "laboratory committees" at a few of the hospitals that i have worked at, it is a really crap shoot the way "normal ranges" are determined, and a shame on medical education and current medical practice that it is cheaper to order "panels" than to order the individual test that leads to a treatment option, all due to the computers that run the tests/ report the tests/ confuse and "dumb-ify" medicine.

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Hi Red Balloon,
Thank you for looking at this. Yes, how to raise her Hb (thank you for the link -- she has an excellent diet -- well, a good diet, and takes a ton of supplements) and why is this happening? Are we missing something here? Could these abnormal #'s be indicative of some sort of anemia I am unaware of? She has EDS and POTS, is 15, and is becoming too tired to exercise.

Her doctor was confused, I think, and I hated to embarrass her -- she said that MCH and MCHC reflected the volume of the RBC's. :/ She (the doctor) blamed it on her periods, but her younger brother is pretty much in the same boat.

One theory I am tossing around with the CCSVI researchers is that many of us have poor fluid dynamics (my kids and I have CCSVI, for example). When it takes a while for the blood to go through the brain and eventually get drained, the RBC's are robbed of their Hb, because the brain sucks out what it needs to try to keep going!

So, I wanted to throw that out there to the collective great minds, and see if anyone else dealt with this on their CBC's.

Anyone?
Thanks so much,
:) Diana

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Hi nyfrog,
Thank you so much for your thoughts. As I mentioned to the red balloon, the doctor seemed a bit confused by the numbers, so I thought I'd do a little reading and ask her again!
I wouldn't be as concerned, except that my daughter is symptomatic, and I wanted to rule out anemia. I don't want to toss the numbers aside, if they hold some clues...

And I love a good mystery...
:)Diana

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hmmm... If it were bc of her periods, wouldn't her crit be low?

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As for the Hb being stripped while in the brain, that wouldn't be true bc Hb doesn't leave the rbcs. The oxygen comes off, but the hb stays in the rbc's.

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Sorry this is coming in bits and pieces. Was working, then driving, and now have to get ready for a hot date! lol!

A few more thoughts:

1. Anemia is messy enough without POTS and CCSVI thrown in. A nutritionist and hematologist are the folks to see. Regular docs are used to saying, "Oh, that slightly out of the norm value doesn't mean anything." My numbers were slightly off for a long time. I don't know what they are now. I don't bother looking. I just know that when I feel crappy, I need to step it up bigtime in the nutrition department. Real food and lots of it. I'll drink half a gallon of milk, eat 3 pounds of chicken, drink tons of gatorade, and consume 3 pints of homemade vegetable soup. And I'll feel much, much better. (Btw, lately I've been craving Ben and Jerry's. I keep eating pints of it. I swear I must be calcium and fat deficient in the rest of my diet because I have never craved such a thing before. Usually it's something salty.) Basically, pile on the REAL food in lots of little meals and see if that improves the numbers.

2. Bioavailability of supplements. Greatly affects things. Those hard little pills rarely dissolve in my stomach which means I'm not getting whatever is in them. I have to be very careful about which pills I take. For advil, I get the gels. For vitamins, I get the gels or the gummis. What you eat with the vitamin matters. For iron, you have to take vitamin C at the same time. For iron, I gave up on the supplements and started eating real sources of iron. Meat sources are actually better than plant sources (this is coming from someone who was a strict vegetarian for 14 years). The most common cause of anemia in your daughter's age group is diet. Of course, EDS has nothing to do with common, but still, load on the meat and see what happens.

3. POTS. That really has to be affecting her ability to exercise. (btw, you live in Texas! I probably would fall down just getting off the plane! lol!) My exercises are almost all done lying down. Pilates is awesome for that. A lot of folks on here have talked about pilates being too intense. My PT alters the exercises so I can do them. I keep my head down, I don't use my arms when my shoulders can't take it, etc. Maybe some strengthening exercises lying down would help once she's vertical.

You're an awesome mom for investigating all this.

I'll write more if I think of anything else while I'm getting ready :) Wish me luck on my date! Being single is so annoying sometimes, but what can you do? I refuse to lower the bar. Being single is better than being with someone who thinks EDS is me being lazy. Now if I could only convince my PT to marry me... :)

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hope your date is great ;)

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I have joked that I want to take my PT home with me. I just want access to being adjusted at any hour of the day. LOL. Hope your date went well.

Dr. D, I can't offer any input on this subject but wonder what my blood work showed. I know mine is outside the norms for a lot of things but that gets ignored or brushed off.

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OK Red,

Now we are all DYING to hear about your date!

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Have you had her ferritin level checked? Personally, I am never "technically" anemic, but my ferritin was as low as 5 (good is closer to70) until I started taking iron (Ferrochel- ferrous bis-glycinate). My hematologist was annoyed that no one cared about the ferritin, said it was way too low.

Iron deficiency (low ferritin) can show symptoms just as anemia can and can make POTS symptoms worse!

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Hi Red Balloon -- EXCELLENT point. Doy! You are so right, the oxygen leaves, the Hemoglobin stays.

An interesting finding (well, to me, anyway), is that in M.S. (and likely EDS -- my personal thought) it takes so long for the blood to exit the brain that the % of OXYGEN (not hemoglobin, Duh...) goes to zero (as measured in the internal jugular vein bulb). Normally, it exits with about 65% oxygen remaining. Isn't that interesting?

Thank you! :) Diana

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Hi Red Balloon,
I was wondering about the crit being low (it was "low normal"), but just kind of discounted it because I guessed that it wouldn't take too long for our bodies to regenerate some more RBC's after our periods. I guessed that the crit may or may not be low, depending on when her last period was... (which she doesn't remember!).

Excellent point. :) Diana

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Hi Red Balloon,
In order of importance:

* Good luck on your date!!! What a challenge, my friend, but when the right person comes along, they won't care about illness. You'll see! (check out chronicallyinlove on YouTube). :)

* My daughter eats like a sumo-wrestler. :) She's always been quite the carnivore, too. Because her diet is so good, although she takes supplements, honestly, I don't think poor absorption of those is her issue (but I think it is for MANY of us). I HAD to share something with you. This is something I just put in my "ponder pot". I tended to eat high fat foods for about a year. I just FELT better on them. And a friend with the same EDS/POTS noticed the same thing. He said that if he lost his job, he would be upset. But if BEN AND JERRY'S went out of business, he would sob like a little girl! ha. I have ideas about this, but nothing concrete.

* POTS and TEXAS. She exercises indoors, mainly. We could see that she was losing the ability to exercise, even on a recumbent bike. She came to me, frustrated because she wanted to step up the exercise, but was unable to do it any more. Hence, our search. I don't think it's solely the POTS -- just a mother's instinct on that one.

* I DID hit on something, though! She and her brother are on Diamox for high intracranial pressure. As you probably know, it can make us somewhat acidic, and we MUST keep our CO2 levels above 22. I read that high CO2 and acidity can mess with the oxygen binding capability. Here's a Wiki quote (I didn't know there were 2 kinds of hemoglobin!):
"Hemoglobin exists in two forms, a taut form (T) and a relaxed form (R). Various factors such as low pH, high CO2 and high 2,3 BPG at the level of the tissues favor the taut form, which has low oxygen affinity and releases oxygen in the tissues. The opposite of these aforementioned factors at the level of the lung capillaries favors the relaxed form which can better bind oxygen."
She and her brother ARE a bit too acidic. We reverse it with baking soda capsules -- it works like a charm. BUT, you have to actually ingest the capsules to make them work (i.e. I betcha they're sneaking a few of these to our dogs or something).

Teenagers!

Thank you so much, and for your kind comment. I'm not doing any more than any other mom would do... But I AM motivated to find answers for everyone (I share). :)

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Isn't that the truth, Palomino? I've been known to say more than a few times (sweetly, of course), "This abnormal reading may be a clue to what is wrong. Can we look closer at what it may mean?". Of course, inside I'm saying, "Why the heck did you run the (freaking) test, if you don't know how to interpret an abnormal result?!"

But that is my evil twin speaking in my ear, of course...
:)

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Thank you, so much Kitty

I don't believe she had this checked. I'm on it!!! GREAT advice.

:) Diana

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Slapasmileon,

ABSOLUTELY! And we want "dete's" (for those of you without kids, that stands for 'details'). We may be ill, but we need to stay "cool".
:)

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My kids are now tweens, so I'm struggling to stay cool! I do insist they text me in English!

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When my ferritin dropped, my other indices also did, but b/c they were in (low) normal range, no one cared. I'd bring it up and they'd make me look like it was all anxiety related...

I used to always be mid to upper end of range- never worried about iron. My levels dropped due to heavy periods, as things were good when taking oral contrceptives and flow was lighter.

The hematologist who DID care is the one who diagnosed my EDS!

I'm with you on the "why did you order the test then?" and why can't they interpret a test THEY order?

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