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Is The Macrocytosis That Shows In The Test Report Something To Be Concerned About In An Elderly Person?

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Posted on Fri, 3 May 2024
Question: Hello - I had my blood tests back yesterday, and the doctor pointed to the fact that my RBC are macrocytic = +2 = 1.07. I have had this condition for many years and in fact, it is not as bad as it was. My hemoglobin is fine, my AST and ALT are perfect as is my Vit. B 12. I had an electrophoresis test done in 2011 = all good. She asked me to repeat this. I did some research on-line. This condition cannot be explained in 10% of cases. Furthermore, clonazepam (Klonapin) and other drugs plus age (I am 73) can cause it in some cases according to the FDA, since benzodiazapenes contain benzene which is the offending component. I have been taking clonazepam for many years at a dose of .5 to 1 mg. per day. Otherwise, I am very healthy with CRP under 5, LDL at 55 mg., HDL at 40mg, Total cholesterol at 119 mg; T.chol/LDL ratio at 115 mg. WBC and RBC normal, etc...kidney and liver all OK, etc.
I am confident that the electropheresis test will come back OK. Is this anything to be concerned about = the macrocystosis?
doctor
Answered by Dr. Michelle Gibson James (16 minutes later)
Brief Answer:
can be benign in some persons

Detailed Answer:

Hi,

With a normal Hb and possibly a normal ESR (looks for inflammation in the body), if this was done, then the electrophoresis will likely be completely normal.

As you mentioned the cause is not found in some persons. It is also inherited in a small percentage of persons- this is called benign familial macrocytosis, it is associated with no symptoms.

Thyroid disease, particularly a low level of thyroid hormones can also be a cause and should be ruled out , if not already done.

High blood sugar, if this is an issue with you, causes false elevation.

Summary- cause may not be found in some persons, may be due to a benign cause
Thyroid hormone levels should be checked if not previously done

I hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (22 minutes later)
I take synthroid for hypo-thyroid/borderline; blood sugar is perfect at 5.3; pH levels are OK. Urinalysis is perfect. OK, benign...that is good. What symptoms would I have if non-benign. Also, I do not drink or smoke.

Now, final question...also, my hemolysis test came back sightly elevated at +1. But all other indicators (Potassium,. etc...) were fine. What does this mean and anything to be concerned about?

doctor
Answered by Dr. Michelle Gibson James (22 minutes later)
Brief Answer:
macrocytosis itself not associated with symptoms

Detailed Answer:
HI

If the Hb is okay as well as the bilirubin levels done as part of the liver function tests, then the slight hemolysis is not likely significant.
Bilirubin levels would rise in significant hemolysis.

It is possible that the borderline thyroid disease may be playing a role in your macrocytosis if all other factors are normal

Macrocytosis on its own does not cause symptoms if it is associated with an underlying medical condition. The medical condition itself would cause symptoms. This means that the symptoms for example would be due to liver disease or kidney disease or thyroid disease or bone marrow disease ,not the macrocytosis itself

In terms of symptoms then, there are no specific symptoms of macrocytosis but of the conditions causing the macrocytosis, if there is an underlying cause
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Michelle Gibson James (18 minutes later)
Yes, I agree...bilirubin is fine (negative in urine).
Hb is at 143 = fine.
Yes, I agree, hypo-thyroid may be doing this.
But I am encouraged by the very good tests, especially the Chol., etc.
Thanks so very much for your super explanation! Greetings from Canada!

My eGFR is 83 which is excellent for my age...Life is good...
doctor
Answered by Dr. Michelle Gibson James (1 hour later)
Brief Answer:
life is pretty good

Detailed Answer:
HI

I agree with you. Life is good.

Wishing you the best.

If there are any other queries, can let me know
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Michelle Gibson James

General & Family Physician

Practicing since :2001

Answered : 16808 Questions

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Is The Macrocytosis That Shows In The Test Report Something To Be Concerned About In An Elderly Person?

Brief Answer: can be benign in some persons Detailed Answer: Hi, With a normal Hb and possibly a normal ESR (looks for inflammation in the body), if this was done, then the electrophoresis will likely be completely normal. As you mentioned the cause is not found in some persons. It is also inherited in a small percentage of persons- this is called benign familial macrocytosis, it is associated with no symptoms. Thyroid disease, particularly a low level of thyroid hormones can also be a cause and should be ruled out , if not already done. High blood sugar, if this is an issue with you, causes false elevation. Summary- cause may not be found in some persons, may be due to a benign cause Thyroid hormone levels should be checked if not previously done I hope this helps, feel free to ask any other questions