Low hemoglobin/htc with normal rbc

Topic created · 7 Posts · 388 Views
  • Hey guys I have a question about my blood work. I’ve been on 750mg test for about 4 months now and my hemoglobin and hematocrit (as well as white blood cell count) have been steadily decreasing each month. My hct used to be high years ago so I’m confused on why it can be dropping on such high test

  • Are you doing a lot of cardio?

  • I don’t do any cardio at all. But I never have so I’m not sure that would cause such sudden drops in hematocrit/hemoglobin
    [hr]
    Also here is a snip of the cbc part of the blood work so you can see.
    https://imgur.com/a/lCuDWtm

  • [quote=“jeremy288” pid=‘65713’ dateline=‘1566362403’]
    I don’t do any cardio at all. But I never have so I’m not sure that would cause such sudden drops in hematocrit/hemoglobin
    [hr]
    Also here is a snip of the cbc part of the blood work so you can see.
    https://imgur.com/a/lCuDWtm
    [/quote]

    Looks like healthy bloodwork. Some people have increased cbc some people stay within normal range; looks like you;re one of them

    Your numbers could of been higher if you were on different/more gear prior. Everything looks normal tho

  • But shouldn’t my hct be getting higher and not lower from such high amounts of test? I’m more worried about the hemoglobin as it keeps on getting lower. This is my test about 6-8 months ago as you can see it was much higher and I haven’t donated blood so it is drastically getting lower by itself.
    https://imgur.com/a/Nw95aTB

  • [quote=“jeremy288” pid=‘65717’ dateline=‘1566364133’]
    But shouldn’t my hct be getting higher and not lower from such high amounts of test? I’m more worried about the hemoglobin as it keeps on getting lower. This is my test about 6-8 months ago as you can see it was much higher and I haven’t donated blood so it is drastically getting lower by itself.
    https://imgur.com/a/Nw95aTB
    [/quote]

    First thing I would have wanted was to make a stained slide Manual Differential to look at red cell morphology to see variations in red cell size(anisocytosis) to explain the high RDW, and whether your reds are hypochromic(lacking a central pallor) to explain the low MCV,MCH,MCHC.

    Of course I’d also QC my hemotology analyzer as well to make sure my red cells indicies MCV, MCH, MCHC, Hgb/Hct are within range and aren’t showing bias(in this case low results). If you have an unobservant technologist not paying attention to an analyzer because the results aren’t flagging panic values or new patients with no previous results to run delta checks this can happen. Keep in mind if this is a reference lab you usually have to run QC every 300 specimens and if it’s a lower volume lab(hospital,clinic) you have to run at least one level low,medium,high QC each shift(three per 24hr) through each sampling method(closed automated, manual open).

    At the end of the day with a manual differential I’m looking for red blood cells with variation in size, shape and central pallor. If the red cells are normal size, shape and have typical central pallor then i’m going to put your blood back on the rocker, I might even put your blood in a warming block at 37C for 15 minutes to get rid of any auto agglutinates(that happen from cold storage) and then on a cell rocker for a few minutes and rerun the sample.

    Most of the time we’re dealing with anemias from various causes. Of course your values aren’t in need of any urgent care, when I speak of anemia we’re paying attention to hgb

  • [quote=“Dexter” pid=‘65720’ dateline=‘1566371421’]
    [quote=“jeremy288” pid=‘65717’ dateline=‘1566364133’]
    But shouldn’t my hct be getting higher and not lower from such high amounts of test? I’m more worried about the hemoglobin as it keeps on getting lower. This is my test about 6-8 months ago as you can see it was much higher and I haven’t donated blood so it is drastically getting lower by itself.
    https://imgur.com/a/Nw95aTB
    [/quote]

    First thing I would have wanted was to make a stained slide Manual Differential to look at red cell morphology to see variations in red cell size(anisocytosis) to explain the high RDW, and whether your reds are hypochromic(lacking a central pallor) to explain the low MCV,MCH,MCHC.

    Of course I’d also QC my hemotology analyzer as well to make sure my red cells indicies MCV, MCH, MCHC, Hgb/Hct are within range and aren’t showing bias(in this case low results). If you have an unobservant technologist not paying attention to an analyzer because the results aren’t flagging panic values or new patients with no previous results to run delta checks this can happen. Keep in mind if this is a reference lab you usually have to run QC every 300 specimens and if it’s a lower volume lab(hospital,clinic) you have to run at least one level low,medium,high QC each shift(three per 24hr) through each sampling method(closed automated, manual open).

    At the end of the day with a manual differential I’m looking for red blood cells with variation in size, shape and central pallor. If the red cells are normal size, shape and have typical central pallor then i’m going to put your blood back on the rocker, I might even put your blood in a warming block at 37C for 15 minutes to get rid of any auto agglutinates(that happen from cold storage) and then on a cell rocker for a few minutes and rerun the sample.

    Most of the time we’re dealing with anemias from various causes. Of course your values aren’t in need of any urgent care, when I speak of anemia we’re paying attention to hgb

Log in to reply