Possible Reasons Behind Persistently Elevated MCV Levels Alongside Digestive Complications
I am 34 years old, standing 5 feet 3 inches tall and weighing 123 pounds. My heritage is a mix of Asian and White. I manage asthma effectively, have been diagnosed with ovarian endometrioma, struggle with androgenic alopecia, and might possibly be experiencing Irritable Bowel Syndrome (IBS). My alcohol consumption has recently decreased to two drinks weekly, and I do not use recreational drugs. The medications I take include montelukast, a Wixela inhaler, probiotics, digestive enzymes, oral minoxidil (which is currently on hold as I am undergoing an egg-freezing procedure), prenatal vitamins, and low-dose aspirin. Due to my upcoming egg retrieval, I underwent extensive blood tests. The initial results from early June showed a slight elevation in my mean corpuscular volume (MCV) at 98, although everything else was normal. My fertility specialist recommended I consult my primary care physician (PCP). However, the follow-up tests revealed a rise in MCV to 100, alongside slightly low red blood cell count and elevated iron saturation at 55%. This raised concerns about potential hemochromatosis, prompting another round of tests. In the latest testing, which focused on iron levels, methylmalonic acid (MMA), ferritin, folic acid, homocysteine, and a complete blood count (CBC), all parameters returned to the normal range except for a lingering high MCV of 99. Just this past week, I repeated the tests for a fourth time within two months, and my MCV remains at 100. I have yet to discuss these outcomes with my doctor, so I am uncertain of the next steps. In addition to these blood results, I have been grappling with undiagnosed digestive issues that have persisted intermittently for several years. My symptoms include sporadic right-sided abdominal pain accompanied by diarrhea. It is known that I am lactose intolerant, a condition identified in childhood. A previous PCP suggested I might have IBS. After my diagnosis of ovarian endometrioma last year, I opted for a Mirena IUD, adopted a diet aimed at reducing inflammation, and began taking digestive enzymes and probiotics. Consequently, my digestive discomfort has significantly decreased. My alcohol intake has notably diminished from approximately four drinks per week to eight per month, and I plan to abstain entirely from alcohol this month while I focus on the egg-freezing process. I have a follow-up appointment with a gastroenterologist next month, and I’m curious about what tests they might suggest. Additionally, my mother is battling stage IV cancer, so I'm anxious that my health concerns might point to something serious!
Answers (1)
8/9/2025, 7:31:03 PM
OpenHealth AI
It's understandable to feel anxious given your situation with elevated MCV levels and digestive issues, particularly with your family health background. Elevated mean corpuscular volume (MCV) can be due to several factors, and your ongoing digestive symptoms may also be contributing to these concerns.
Main Points:
- Persistently elevated MCV can be linked to various conditions, including nutritional deficiencies, liver issues, or bone marrow disorders.
- Your digestive symptoms may be related to conditions like IBS or malabsorption, which can influence your overall health and blood parameters.
- It’s important to address both the elevated MCV and your gastrointestinal (GI) symptoms, especially since you have an upcoming appointment with a gastroenterologist.
Explanation:
MCV measures the average size of your red blood cells, and while a slight increase can indicate potential issues, it doesn't provide a complete picture. In your case, elevated MCV combined with low red blood cell count and high iron saturation could suggest several possibilities, including:
- Vitamin deficiencies: Low levels of Vitamin B12 or folate can cause MCV to rise.
- Liver health: Conditions affecting liver function (like alcohol use or certain medications) can impact blood cell production.
- Bone marrow influences: Some disorders may affect red blood cell formation, but given your current blood tests returned to normal in other areas, this seems less likely.
Your digestive symptoms, including IBS and lactose intolerance, can lead to malabsorption of nutrients, which might exacerbate or explain the changes in your blood tests. Your focus on a diet to reduce inflammation is positive, and reducing alcohol intake further supports liver health and overall well-being.
Next Steps:
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Continue Your Dietary Adjustments: Maintain a balanced diet rich in whole foods, focusing on plenty of fruits, vegetables, whole grains, and proteins. This may help with both your digestive health and nutrient absorption.
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Stay Hydrated: Proper hydration is crucial for digestive health and overall bodily functions. Aim to drink enough water throughout the day.
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Monitor Symptoms: Keep a diary of your digestive symptoms, noting what you eat and when symptoms occur. This will provide useful information to your gastroenterologist and may help identify triggers.
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Prepare for Your Gastro Appointment: Write down your symptoms, current medications, dietary habits, and any blood test results showing MCV and iron levels. Discuss your concerns about the elevated MCV and get clarity on possible tests (like B12 and folate levels, liver function tests, or stool tests) that could be performed.
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Manage Anxiety: Given the stress around your mother's health, practice mindfulness or relaxation techniques that could help reduce anxiety. Consider speaking with a counselor if you find the anxiety feels overwhelming.
Above all, you're taking the right steps by following up with your healthcare providers. Keep track of your health closely and ensure regular communication with your specialists. If you experience any significant changes in symptoms, such as increased pain, fever, or significant changes in bowel habits, reach out to your healthcare provider sooner rather than later.
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