Please explain my blood report.

Patient's Query

Hi doctor,

I just got my blood work done and would like to know exactly what these results mean. Also, I do want to mention that I am a heavy drinker. The report says that RBC is low at 3.19, MCV is high at 116, MCH is high at 39.2, RDW is high at 16.5, platelets are low at 141, calcium is low at 8.5, AST is high at 75 and ALT is high at 35. Can you give me a better explanation of these results? My bones are very achy and lately I keep seeing blood dots under my skin. It looks like a blood clot. I also feel tired most of the time. When I was about 18 years old, my doctor said I was anemic. I started drinking heavily about 10 years ago.

Answer

Dr. Sadaf Mustafa

General Medicine Internal Medicine

Hello,

Welcome to icliniq.com.

You have large RBCs (red blood cells) indicated as elevated MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin) and RDW (red blood cell distribution width). This could be either due to alcohol intake or thyroid dysfunction or folic acid or vitamin B12 deficiency.

You also have low RBC and platelet counts, which can happen either due to bone marrow suppression from your alcohol consumption history or due to alcoholic liver disease.

Elevated liver enzymes (AST and ALT - aspartate transaminase and alanine transaminase respectively), which again could be due to the alcoholic liver disease or other forms of hepatitis.

Calcium is very marginally low. It could be due to vitamin D deficiency.

Investigations to be done:

Hepatitis B surface antigen and antibodies, Hepatitis B core antibody, Hepatitis C antibodies, vitamin D, B12 and folic acid levels and TSH (thyroid-stimulating hormone). I would also recommend HIV testing and liver ultrasound.

Treatment plan:

I suggest the following medicines. Consult your specialist doctor, discuss with him or her and take the medicine with consent.
1. Vitamin D 2000 IU daily with calcium 1000 mg per day.
2. Vitamin B 500 mcg daily.
3. Folic acid 1 mg daily.

Regarding follow up:

Revert back with the reports to an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician

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