Q. A few things are highlighted in my CBC. What is the further course of action?

Answered by
Dr. Prakash H Muddegowda
and medically reviewed by iCliniq medical review team.
Published on Aug 05, 2016

Hi doctor,

I am 50 years old. I am getting muscle pain in legs if I walk a long distance. Also, I am an asthma patient and currently on Theo Asthalin forte tablet and inhaler. Today, I had a complete blood checkup. In the report, the following are highlighted. Total bilirubin count 1.31, red cell distribution width 14.6, vitamin B12 178 and hydroxyvitamin D 13.07. Please advise the further course of action.

Dr. Prakash H Muddegowda

Geriatrics Hematology Pathology
#

Hi,

Welcome to icliniq.com.

Based on your query and attached report (attachment removed to protect patient identity), my opinion is as follows:

  • Your vitamin B12 level is mildly low, which has resulted in early changes in RBC (red blood cell) size.
  • In vitamin B12 deficiency, macrocytes are seen or MCV - mean corpuscular volume will be mildly elevated. Early changes with only increased RDW (red cell distribution width) and others are normal.
  • Vitamin D deficiency is present and requires vitamin D supplements and sun exposure. Due to working in air conditioned or non-sun-exposed atmosphere, vitamin D deficiency is very common nowadays.
  • Serum bilirubin is mildly elevated. As liver function tests are normal, there is no need to worry at present.
  • Repeat your serum bilirubin levels after two months. In the meantime, you can start on vitamin B12, vitamin D supplements and nutrition-rich diet.
  • Values are mildly abnormal and nothing to be worried about. Improve your nutrition. Repeat the test after two months and it should have returned to normal.

Treatment plan:

Vitamin B12, vitamin D supplements and nutrition-rich diet.

Regarding follow up:

Revert back after two months to a hematologist online.---> https://www.icliniq.com/ask-a-doctor-online/hematologist

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