Do low RBC count and high IG count have any underlying pathology?

Q. I have high IG count and low RBC count. What could be the cause?

Answered by
Dr. Goswami Parth Rajendragiri
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Sep 15, 2020 and last reviewed on: Jul 27, 2023

Hi doctor,

I am a 58-year-old male with a height of 6.3 feet and weight 315 lbs. I had a CBC test done this week. The RBC, HGB, and HCT results were below average. There was an IG, and it was 0.05, and the reference range is 0.00 to 0.003. The IG % was 0.90, and the reference range is 0.00 to 1.00. This is on the upper end of normal. All other CBC results were normal, and the WBC count was 5.8. The RBC count was 4.44, and the reference range is 4.5 to 5.7. The hemoglobin was 13.3, and the reference range is 13.9 to 17.1. Finally, the Hematocrit was 40.6, and the reference range is 40.9 to 49.7.

I have noticed a lot of fatigue; however, I only get four to five hours of sleep daily. My concern with the CBC count is that I might have leukemia because of low RBC count and high IG count. The doctor wants to repeat the test in a few weeks. He stated the low red counts might be due to some hemorrhoids that I have, and sometimes I have excessive bleeding from these. He stated the high IG number is usually related to an infection. I asked him if he thought this could be leukemia, and he said no. He stated that my WBC count would normally be higher than normal for leukemia to be present. I have researched this on the internet, and as you know, there are many different opinions. He did tell me if the count does not return to standard, he would refer me to the GI doctor. I have colonoscopy every five years, and each time they find polyps, but none have been cancerous. My last one was three years back. The current medication I am taking is Gabapentin, Xanax, Glimepiride, and Lisinopril for blood pressure.



Welcome to

Sorry for the delayed response. Following is my opinion on your asked question. The low hemoglobin and hematocrit were due to mild anemia. It could be due to any internal or intestinal bleeding or due to piles. RBC (red blood cells) count can come low due to low hemoglobin levels. So hemoglobin and RBC count are related to each other, and low values are due to anemia induced mostly by bleeding. But your total WBC (white blood cells) count is normal, and no premature cells are mentioned in the differential count. So it does not seem to be leukemia. So you need not worry about leukemia. You need to consult a gastroenterologist for repeated colonoscopy to check polyp and for the management of piles. I hope I have answered your question. Let me know if you have a more specific question in mind.

Best regards.

Thank you doctor for the reply.

Can you explain why the IG is above normal and the IG percentage is on upper end of normal? Does not this mean immature granulocytes and as I understand that a healthy person should not have these in their blood count. Do you feel that bleeding from hemorrhoids can actually cause the red blood cell count to fall below normal? I had a colonoscopy a little over three years ago and they removed three or polyps, none of which were cancerous although if they were not removed could have developed into cancer at some point. Is it possible to develop colon cancer in three years? I thought it took many years from the onset of polyps, as many as ten years for them to become cancerous. I have always done a colonoscopy every five years or as recommended by the gastroenterologist. I think my concern was the abnormal IG numbers and the low red blood cells, thus my reasoning for possible beginning stages of leukemia. You mentioned no premature cells were found in the CBC. Let me ask this another way. If you had leukemia would the white blood cells be out of the normal range and would other numbers also be out of normal range? If leukemia was present does the lab automatically add another line for premature cells or is the IG number referencing premature cells? Thanks.



Welcome back to

I can understand your concern and questions arising in mind. In leukemia, the total WBC count usually goes above 50000, at least. The second point in leukemia, premature cells means IG immature granulocytes goes very high, like more than 30% at least. Your IG value is cell counter derived, so it shows a slightly high value. But it does not make sense to think about leukemia. It is not much elevated. It is within range. Your total WBC count is 5600, which is in a relatively normal range. So I do not think it is leukemia or the beginning of leukemia. Your polyp was noncancerous, so the chance of colon cancer seems less. But the possibility of cancer development depends upon histopathological types of the polyp, duration of the polyp, genetic factors, etc. You can attach histopathological reports of that polyp if available to give more comments. Piles can cause bleeding, and so RBC can go down due to that, it is not due to cancer. I hope I have solved your concern. You can ask further if you have more questions in your mind.

Best regards.

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