Elevated MCV Without Anemia: Potential Causes?
I am a 35-year-old woman who does not use any medications, drugs, or supplements, and I have never smoked or consumed alcohol. In my recent lab tests, my MCV level was recorded at 92.5, which is still considered normal. However, it marked an increase from 90.5 two weeks prior and 89.9 a month earlier. Historically, when my health was better, my MCV remained around 88. My B12 levels fall within the normal bracket (275 - 460), and I also have normal folate at 7.6 and hemoglobin. Interestingly, after trying B12 supplementation, my MCV rose to 92.5 again. While my MCH levels are healthy, my MCHC is slightly lower than ideal at 30.5. Additionally, both my thyroid function and other related health indicators are normal. Yet, I've noted that my heart rate and blood pressure readings are higher than usual, coming in at 120/87. I've been dealing with nerve pain, cramping sensations in my extremities, and experiencing dizziness and weakness, particularly around my menstrual cycle—though my iron levels are adequate. What could these findings suggest?
Answers (1)
6/23/2025, 8:50:33 PM
OpenHealth AI
Your rising MCV levels and associated symptoms certainly warrant attention. Elevated MCV (Mean Corpuscular Volume) without anemia can occur due to several factors beyond just vitamin levels, and it seems you're keen to identify underlying causes while considering your general health.
Context and Explanation
- Understanding MCV: MCV measures the average size of your red blood cells. An increase can indicate conditions like macrocytic anemia, which isn’t your case here because you have normal hemoglobin and B12 levels.
- Possible Causes of Elevated MCV:
- Dehydration: Can concentrate blood components, affecting volume readings.
- Increased Red Cell Production: Due to physical conditioning or changes in your diet.
- Liver Function: Liver dysfunction may alter red blood cell production.
- Dietary Factors: Deficiencies that are not initially apparent, including nutrients like zinc or other trace minerals.
- Thyroid Function: While your thyroid tests are normal, some thyroid anomalies can still present subtle effects.
- Chronic Stress or Inflammation: Can influence heart rate and lead to bodily changes, including potential nerve-related symptoms.
Given your symptoms of nerve pain, dizziness, and weakness especially around your menstrual cycle, this might also indicate that there are other underlying issues regarding nutrient absorption or hormonal balance, which could exacerbate physical symptoms.
Next Steps
- Hydration: Ensure you are drinking enough fluids daily, as dehydration can influence blood levels and overall health.
- Dietary Review: Consider assessing your diet for variety. Ensure it's rich in fruits, vegetables, whole grains, and lean proteins. Specific nutrients like B vitamins, magnesium, and zinc are crucial for neurological health.
- Monitor Symptoms: Keep a detailed diary of your symptoms, including when they occur and any potential triggers (e.g., menstrual cycle, stress). This can help identify patterns that may lead to cause identification.
- Gentle Exercise: Regular physical activity (as tolerated) can help improve circulation and may alleviate some symptoms. Activities like walking or yoga can be beneficial.
- Stress Management: Engage in relaxation techniques (e.g., deep breathing, meditation), which can help normalize heart rate and reduce dizziness or cramping sensations.
When to Seek Further Guidance
- If you experience worsening symptoms, significant changes in your health, or if dysregulation in heart rate or blood pressure continues, consider seeking additional medical insights.
- If new symptoms arise or existing ones significantly worsen, it may be prudent to reconnect with a healthcare provider for a more thorough assessment or possible referrals to specialists (e.g., endocrinologist or neurologist).
Your focus on these aspects may guide you toward a more comprehensive understanding of your condition, aiming for relief and improvement in your overall well-being. I'm here if you have further questions or need more tailored advice!
Related Questions
Struggling to Find Answers: My Health Journey and Test Results
At 31 years old and standing at 5'2", I currently weigh 160 lbs, a significant increase from my typical weight of 125 lbs when I was quite fit. For the past four years, I have faced significant difficulties in obtaining a clear diagnosis regarding my health issues. I would be grateful for any insights or guidance regarding my symptoms and test outcomes. I have consulted with my primary care physician, two rheumatologists, three endocrinologists, and an allergist; however, none have provided a definitive diagnosis. One rheumatologist suggested the possibility of Lyme disease, pointing to a positive ANA Titer as a potential indicator. I was prescribed amoxicillin to alleviate chronic sinus infections, which had plagued me for a year; this treatment improved my condition remarkably. However, when I tried doxycycline for Lyme, it made me feel extremely unwell. An ultrasound of my ovaries revealed potential indicators of polycystic ovary syndrome (PCOS) on one side, but the doctor refused to provide a formal diagnosis since I do not exhibit symptoms such as elevated testosterone levels or facial hair. Additionally, during the same abdominal ultrasound, my liver appeared notably hyper-echoic, leading to concerns about its density. I also have a significant family history of thyroid diseases and autoimmune disorders, such as hypothyroidism, various cancers, Hashimoto's thyroiditis, alongside other serious conditions like lupus, Raynaud's phenomenon, and scleroderma, all notably among the women in my family. Throughout my life, I've suffered from severe allergies, including reactions to seasonal triggers and various pollens, which lead to unbearable symptoms like intense itching, swelling, and even anaphylaxis. Since contracting COVID-19, I have experienced a considerable weight gain and recurrent sinus infections. Thankfully, this year, I managed to control my sinus issues with a regimen that includes sinus rinses, homeopathic allergy medications, Patanol eye drops, and olopatadine hydrochloride nasal spray. While these allergies have often been dismissed, they have been debilitating since my teenage years. I recently discontinued Zyrtec due to concerns it may exacerbate any thyroid conditions, especially since it had become ineffective for me. Other than an occasional pain reliever, I am not on any medication and have only taken birth control for one year at the age of 24. I experience an array of symptoms, such as: - Significant and rapid weight gain, approximately 30-40 lbs within a year at age 28 while maintaining an active lifestyle of walking around 12,000 steps daily and consuming under 2000 calories primarily through two nutritious meals, with occasional cucumber or celery juice. - An inability to tolerate heat, in stark contrast to my previous appreciation for summer weather. - Persistent fatigue, lack of energy, and weakness, despite having been a previously active person. - Discomfort in my heels due to historical plantar fasciitis, chronic back pain in both lower and upper areas, neck pain, and worsening joint pain, leading me to apply topical pain relief daily. - Swelling in my neck and face along with puffy eyes. The results of my recent bloodwork and thyroid scans reveal troubling findings, including: - A complex hypoechoic nodule on the right lobe of my thyroid, measuring 0.5 x 0.4 x 0.6 cm. - A left parathyroid adenoma, also complex and hypoechoic, measuring 0.3 x 0.4 x 0.2 cm. In terms of lab results: - My ANA Titer is abnormal at 1:160, while a normal value should be 1:80. - Cholesterol is borderline high at 200 (normal is <200). - Eosinophils are elevated at 7.5% (normal range is 0-5%). - Anti TPO antibodies are significantly elevated at 269, despite the doctor claiming it should not contribute to any symptoms. In a urinalysis: - Leukocyte Esterase: 2+ - Squamous Epithelial Cells: 10-20 (normal is <5) - Bacteria: a few (normal is none) Thyroid levels appear stable: - TSH: 1.970 (normal range 0.270-4.200) - FT3: 3.2 (normal range 2.1-3.9) - FT4: 1.15 (normal range 0.92-1.68) I am open to any thoughts or suggestions anyone might have. Potential conditions I've contemplated include hypothyroidism, Hashimoto's, rheumatoid arthritis, other unidentified autoimmune disorders, possibly lingering Lyme disease, PCOS, or even an unresolved STD, although I have been with the same partner for three years. I have, however, discounted the likelihood of Cushing's syndrome, endometriosis, and lupus after thorough discussions with my doctors. Your insights would be most appreciated—thank you!
Concerns About Possible Colon Cancer: Seeking Reassurance
I'm a 19-year-old female, weighing 108 pounds and Caucasian. Over the last six months to a year, I've noticed significant changes in my bowel habits. Previously, I would have a bowel movement every two days, but now I find myself going every day, often several times. The consistency of my stools has also changed, frequently being quite soft, almost liquid. Alongside this, I've been experiencing intense stomach cramps that feel similar to gas pains, unlike any cramping I’ve encountered before during my menstrual cycle. On occasions when my stool is firmer, I struggle to pass it, and the shape has altered to resemble a long, thin pencil. Earlier today, I had a strong urge to go to the bathroom, but the experience was uncomfortable. I felt as if I was releasing a large stool, yet it turned out to be no bigger than a fingernail. My sleep has been disrupted; I find it difficult to fall asleep and stay asleep, and even on the nights I manage to get a good rest, I wake up feeling drained. I haven’t made any dietary adjustments, I abstain from alcohol, and I maintain a moderate level of hydration. To assist with my sleep, I use THCA/D9 (essentially shop marijuana) but have been gradually reducing my intake over the past few weeks. Additionally, I've noticed that the urgency is extreme; when I feel the need to go, it’s an immediate situation. If I don’t respond within a minute, I struggle to make it to the bathroom on time. I’ve also encountered bright red blood in my stool on about four occasions.
Forgotten Medrol During Travel - Inquiry About Tapering
I’m a 24-year-old male, standing at 5'6" and weighing 170 pounds. I don't smoke, and my only current medication is Medrol, which I take for a rash affecting my hands and feet. I’m posting here since my doctor and pharmacist are unavailable right now, but I will reach out to them in the morning. I was prescribed 4mg Medrol tablets to be taken over a period of 6 days to address some unusual blistering on my hands and feet. Yesterday was Day 1, and I took a total of 6 tablets (24mg) in the evening, as directed. Today, on Day 2, I managed to take 1 tablet with breakfast and another with lunch. However, after that, I boarded a flight and realized I left the rest of my pills at home. I was supposed to take 3 additional tablets today—2 at lunchtime and 1 before bed—and then reduce the dosage over the following 4 days. Unfortunately, I won’t be able to take any doses for about 48 hours because I’m traveling until Wednesday evening. My main concern is whether missing this taper schedule could lead to immediate issues. The medication has significantly alleviated my blistering symptoms so far; how likely is it that those symptoms will return strongly due to this gap in treatment? Any advice would be appreciated, as it would help me to relax better tonight, and I’ll make sure to resolve this with my healthcare team tomorrow. Thank you!
Identifying a Mysterious Bite on My Fiancé
My fiancé is a 29-year-old man, approximately 5'5" tall and weighing around 250 pounds. He is currently taking Metformin and Lisinopril; he doesn’t smoke. The Metformin is indicated for managing prediabetes, which typically involves high blood sugar levels, while Lisinopril is likely prescribed for hypertension. The bite in question is located on his calf, and he suspects it began to develop last Thursday, but only brought it up to me today, Monday. Although I wanted to include an image for clarity, it seems I’m unable to due to community restrictions on attachments. Therefore, I’ll provide a detailed description to the best of my ability in hopes of receiving useful feedback. On his calf, there’s a suspicious mark that resembles a bug bite. At the center, there’s a small blister, surrounded by a circular rash. It could possibly resemble a bullseye pattern, but I find it challenging to accurately compare it to online images. I’m leaning towards the possibility of it being a spider or tick bite, with increasing concern over Lyme disease. Recently, we both lost our jobs and relocated to a different state, initiating new jobs in the process, so we currently lack health insurance. I am uncertain whether this situation requires urgent medical attention, what home remedies might help, and to what extent we should be concerned about it—especially since a few days have passed since its appearance.
(24F) Unexplained, Large Bruise on Thigh: Should I Be Worried?
At 24 years old, I occasionally find myself with random bruises on my legs, but this particular one is far more severe than any I have encountered before, and it appeared without me sustaining any obvious injury. I’m currently dealing with several health issues that I believe might contribute to this situation, but I can’t help but worry that it could be indicative of something serious that requires immediate attention. To provide some context, I am anemic, frequently experience headaches for which I take BC powder (about 1-2 packets daily), and my diet is largely unhealthy due to my tendency to consume processed foods. As a full-time online student, I spend the majority of my time at my desk, with only occasional exercise (approximately once or twice a month). Additionally, I have been vaping since I was 16 years old and currently take prescribed medications, including Adderall and fluoxetine. Clearly, the factors I’ve mentioned could lead to health complications like this bruise, but my financial situation is tight, and I’ve been struggling with depression. This leaves me feeling quite uncertain about how to improve my situation or where to start. I am reaching out to find out whether this bruise is something that needs urgent medical evaluation or if it might be manageable on my own. Any insights or advice would be greatly appreciated!