Anemia--macrocytic, Microcytic, Normacytic?

[mimommy]

Does anyone know what it means to have a low RDW (red cell distribution width) and normal MCV? I know these two tests are usually done in conjunction to diagnose anemia, but I read that in certain situations it can indicate villis atrophy. What about b-12 and folic acid--can just a low RDW affect them? Does anyone out there with anemia have blood counts like this?

[TrillumHunter]

Microcytic anemia would be most likely and this would indicate iron anemia. My hemotologist said the MCV is a good indicator of stored iron. So, you may have an issue with using both your dietary and stored iron because of damaged villi. Are you newly diagnosed? If so, it's best to give yourself some time to heal and then reassess your blood work. I'm one of the lucky who, despite a strict gluten-free diet and healing, still cannot absorb iron.The dr calls it anemia of chronic autoimmune disease. Now I get to have iron infusions!!Yeah! But this is only after trying for two years to correct it through diet and supplements. Lots of us have anemia issues, both iron and B12.

Hope that helps. You aren't alone!

[trents]

I think low RDW (red cell distribution width) is good. It indicates little variance in the diameter of the red blood cells, i.e. few poorly formed ones.

Normal MCV is also good. Just looking at those two indcators, I would not think you have low iron stores. What about your hemaglobin and hematocrit levels? Blood cells parameters don't affect folic acid and B12 levels. It is the other way around. And by the way, if you are taking a folic acid supplement it will mask B12 deciency, a serious problem that causes acute anemia. You need to be off of folic acid for a period if you suspect B12 deficiency and are getting tested for it. If this is the case, talk to your doctor to see how long.

[mimommy]

Thank you for responding. I guess I need to clarify--I have not been diagnosed with celiac, although I was tested recently. I am here for my daughter, who was diagnosed celiac earlier this year. However, the anemia question was for me. I have been experiencing many celiac symptoms, the worst of which is the inflammation/joint pain. My husband and I were both just tested for celiac, results negative. I recently saw an orthopedist for joint pain and he tested me for rheumatoid--also negative. I called around to have copies of all my blood work sent to me and came across this:

January, 2008 saw internist for joint pain ESR/CRP only showed

RDW 11.2 on an 11.6-14.8 range Low

MCV 96.4 on an 80-97 range High normal?

December, 2008 saw Ortho who ran CBC tests which only showed

RDW 10.9 on an 11.6-14.8 range still Low

MCV 94.8 on an 80-100 range normal?

I did some online reading and found a lot of info about macrocytic anemia and the b-12/folic acid connection. I also found an article suggesting that a low RDW and high normal MCV can indicate flattening of the villi.

So, my questions are--is 'normacytic anemia' actually anemia? If my ttg and IgA are normal, why am I having so many symptoms--D, C, nausea, dizziness, joint pain, visual disturbances, soy sensitivity, etc, etc, ad nauseum? Regarding dizzy spells, dry mouth and nose, fatigue, irregular periods--aren't these all symptoms of anemia? Finally, doesn't it seem odd that neither doctor ever mentioned the low RDW to me or found it to be a cause for further investigation?

This is a lot, I know, but I have been desperatley searching for an answer. Any advice from the forum would be very welcome.

[ravenwoodglass]

Thank you for responding. I guess I need to clarify--I have not been diagnosed with celiac, although I was tested recently. I am here for my daughter, who was diagnosed celiac earlier this year. However, the anemia question was for me. I have been experiencing many celiac symptoms, the worst of which is the inflammation/joint pain. My husband and I were both just tested for celiac, results negative. I recently saw an orthopedist for joint pain and he tested me for rheumatoid--also negative. I called around to have copies of all my blood work sent to me and came across this:

January, 2008 saw internist for joint pain ESR/CRP only showed

RDW 11.2 on an 11.6-14.8 range Low

MCV 96.4 on an 80-97 range High normal?

December, 2008 saw Ortho who ran CBC tests which only showed

RDW 10.9 on an 11.6-14.8 range still Low

MCV 94.8 on an 80-100 range normal?

I did some online reading and found a lot of info about macrocytic anemia and the b-12/folic acid connection. I also found an article suggesting that a low RDW and high normal MCV can indicate flattening of the villi.

So, my questions are--is 'normacytic anemia' actually anemia? If my ttg and IgA are normal, why am I having so many symptoms--D, C, nausea, dizziness, joint pain, visual disturbances, soy sensitivity, etc, etc, ad nauseum? Regarding dizzy spells, dry mouth and nose, fatigue, irregular periods--aren't these all symptoms of anemia? Finally, doesn't it seem odd that neither doctor ever mentioned the low RDW to me or found it to be a cause for further investigation?

This is a lot, I know, but I have been desperatley searching for an answer. Any advice from the forum would be very welcome.

I can't answer about the original question but am wondering if you are giving the diet a good try? With a DD firmly diagnosed and all your symptoms I would question whether your test was a false negative.

[mimommy]

Thanks, Raven--you are always so kind and caring in all your repsonses. People need that kind of compassion in this world--the forum is lucky to have you as a member!

Yes, I am giving the gluten-free diet a good try. Two weeks and counting, although accidentally had some gluten last Saturday at a family gathering--geez, they slip that stuff into everything, even cole slaw!

Haven't really noticed any difference, but am going completely gluten-free in whole household for daughter's sake. Too many cc's lately.

I found it's harder to make an adult diet gluten-free than a child's, as for the difference in palate. Having to learn to cook again.

Also, all other tests were normal--hgb, hct, wbc, rbc. I have had anemia several times in my life, and have had low b-12 bad enough that my head would shake and I would hum in my sleep (had a tendency toward starvation more than once--when the going gets tough I stop eating and gain a lot of weight.)

Anyway, thanks for your answers. I feel like I keep saying, "But..it HURTS. How can nothing be wrong?" The dizziness is so bad just scrolling on the computer makes me spin

[ravenwoodglass]

Thanks, Raven--you are always so kind and caring in all your repsonses. People need that kind of compassion in this world--the forum is lucky to have you as a member!

Yes, I am giving the gluten-free diet a good try. Two weeks and counting, although accidentally had some gluten last Saturday at a family gathering--geez, they slip that stuff into everything, even cole slaw!

Haven't really noticed any difference, but am going completely gluten-free in whole household for daughter's sake. Too many cc's lately.

I found it's harder to make an adult diet gluten-free than a child's, as for the difference in palate. Having to learn to cook again.

Also, all other tests were normal--hgb, hct, wbc, rbc. I have had anemia several times in my life, and have had low b-12 bad enough that my head would shake and I would hum in my sleep (had a tendency toward starvation more than once--when the going gets tough I stop eating and gain a lot of weight.)

Anyway, thanks for your answers. I feel like I keep saying, "But..it HURTS. How can nothing be wrong?" The dizziness is so bad just scrolling on the computer makes me spin

I am glad to hear you are sticking with it. It is hard at first but it will become easier with time. I am glad your other tests were good. I can certainly identify with that last paragraph! It sounds like you may have some strong neuro issues going on and unfortunately many of us tend to be on the supersenstive side. It would be a good idea at first to avoid the gluten grain vinegars and alcohols, wait until your feeling good then challenge them and see if you tolerate them. Be as strict as you possibly can in the beginning, it will help you heal quicker and the nerves can take awhile so you want to make that process as quick as you can. You may also want to make sure you take some sublingual B12 for a while it helps the nerves fire the way they should and may help with the 'spinning'.

Thank you also for your kind words, they mean a lot to me. You really brightened my day.

[thleensd]

Does anyone know what it means to have a low RDW (red cell distribution width) and normal MCV? I know these two tests are usually done in conjunction to diagnose anemia, but I read that in certain situations it can indicate villis atrophy. What about b-12 and folic acid--can just a low RDW affect them? Does anyone out there with anemia have blood counts like this?

Your RDW isn't all that low...it's really pretty close to range. Keep in mind that different labs set different "normal" standards, too. Some define "low" as below 10.2.

However, you should insist that your doc follows up to be sure. I'd be more concerned with the low RBC count.

If your low RBC count is caused by iron deficiency, your doc needs to do iron studies (serum, ferretin, TIBC). They should also "routinely" check for B12...but, you may have to ask. I had to be very insistent with my doc to follow up on blood tests, but I'm glad I did. (then I found a new doc!!) =)

Good luck.