Understanding Low NRBC Levels in a 40-Year-Old Female
A 40-year-old woman recently underwent several outpatient laboratory tests, primarily aimed at addressing persistent feelings of fatigue and gradual weight gain experienced over the past three years, sensations that she believes extend beyond mere exhaustion. The laboratory results revealed that her NRBC level stands at 0.2, while her absolute NRBC is recorded as 0. Additionally: - Ferritin: 16.8 - MCHC: 31.8 - Iron: 86 - Vitamin D: 22.4 - Free T4: 0.72 - TSH: 2.7 This patient noted that she has not had NRBC tests conducted prior to this, meaning there is no historical data for comparison. Upon researching NRBCs, the information often points towards potential bone marrow complications or malignancies. However, my understanding is that a reported absolute NRBC of zero indicates a lack of concern, is that accurate? Are there further connections with the aforementioned lab results that warrant exploration?
Answers (1)

7/8/2025, 9:40:56 PM
OpenHealth AI
It's understandable to have concerns about lab results, especially when they relate to symptoms like fatigue and weight gain. Here's a concise breakdown of the situation regarding your NRBC levels and overall health.
Key Points:
- Your NRBC (nucleated red blood cells) level is low (0.2), and your absolute NRBC is zero, which is typically not concerning on its own.
- Other lab results show signs of potential iron deficiency and low vitamin D levels, which could explain your fatigue and weight gain.
Explanation:
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NRBC Levels: Nucleated red blood cells are not commonly found in circulating blood. Their presence can indicate bone marrow stress, but since your absolute NRBC is zero, this usually indicates no active concern in that area.
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Iron and Ferritin: Your ferritin level (16.8) suggests low iron stores in your body, which can lead to anemia and fatigue. Normal ferritin levels should typically be above 30 ng/mL.
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Vitamin D: Your vitamin D level (22.4) is below the recommended range (generally above 30 ng/mL), which can also contribute to fatigue and overall health issues.
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Thyroid Function: Your thyroid function seems stable (Free T4 and TSH levels are within normal ranges), which is good to note.
Next Steps:
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Address Low Iron Levels: Focus on including iron-rich foods in your diet (like red meat, beans, leafy greens, and fortified cereals) and consider vitamin C to enhance iron absorption. Monitor your diet for a week and see if energy levels improve.
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Boost Vitamin D: Increase your sunlight exposure and consider vitamin D-rich foods (like fatty fish and fortified products). You may also look into taking a supplement, but check appropriate doses based on a health professional's advice.
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Monitor Symptoms: Keep a symptom diary to track your fatigue, weight changes, and any new symptoms over the next few weeks. This will help identify patterns and associations.
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Consider Lifestyle Changes: Evaluate your overall lifestyle, including sleep quality, stress levels, and physical activity. Incorporating regular light exercise and ensuring adequate sleep can also support your energy levels.
Conclusion:
While there are some indicators that warrant attention, particularly the low ferritin and vitamin D levels, your NRBC findings seem less alarming. Focusing on your diet and certain lifestyle modifications could significantly improve your feelings of fatigue. If symptoms persist or worsen, you may want to pursue further discussions with a healthcare provider.
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