Haematology - interpretation
(By Dr Sarah Myhill and Craig Robinson)
Stylistic note: Use of the first person singular refers to me, Dr Sarah Myhill. One can assume that the medicine and biochemistry are mine, as edited by Craig Robinson, and that any classical and mathematical references and quotes or historical and linguistic notes are Craig’s!
Haematology - this looks at the red and white blood cells together with platelets (responsible for clotting) and signs of inflammation. See Full blood count
Red blood cells
Haemoglobin - measures the oxygen carrying capacity of the blood.
- A low count means anaemia - see Anaemia - not enough blood - symptoms and diagnosis of. Low normal could mean anaemia for some!
- High haemoglobin could be carbon monoxide poisoning. The commonest cause is smoking. But also think of polycythaemia Wikipedia:Polycythaemia
- Mean corpuscular volume - the size of the red cells. Too low points to mineral deficiency, most often iron. Start by checking Ferritin levels in serum. A common cause of mineral deficiency is hypochlorhydria, see Heartburn - at last I have sussed out why this is such a common problem. Also see Anaemia - not enough blood - symptoms and diagnosis of as a low MCV may be an early warning sign of anaemia.
Too high an MCV points to Hypothyroidism, B12 deficiency or folic acid deficiency or drinking too much alcohol!
White blood cells
The normal distribution of white blood cells is negatively skewed, so most people run levels towards the bottom end of the normal range. This is because stress will cause a white cell count to spike high - most people are not in that state and so most results are towards the bottom end of the range. Any stress can do this including infectious stress such as an infection or any inflammation. What I commonly see are low white cell counts, especially in chronic fatigue syndrome, and this result has often been ignored.
- Low or low normal white cell count – can be a sign of poor immune function which most commonly is secondary to nutritional deficiencies, such as low zinc, low magnesium, low B vitamins, low essential fatty acids.
- High neutrophil count points to bacterial infection, or stress response.
- High lymphocyte count points to viral infection. Atypical lymphocytes often seen in glandular fever.
- High eosinophils or basophils can point to allergy or a parasitic infection
- High monocytes is inflammation or stress. Often high in glandular fever or "mono" as it is known in the USA!
Low or low normal platelet count – can be a sign of toxic stress
ESR, plasma viscosity, C reactive protein
Raised levels of any of these point to inflammation in the blood. These tests do not tell us why there is inflammation - this needs investigating as a separate issue. See Inflammation. But just because these tests are normal does not mean there is no inflammation in the body!
- Full blood count
- Anaemia - not enough blood - symptoms and diagnosis of
- Heartburn - at last I have sussed out why this is such a common problem
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