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Ask A. Schuyler, NP Your Own Question
A. Schuyler, NP
A. Schuyler, NP, Nurse Practitioner
Category: Health
Satisfied Customers: 15925
Experience:  Board Certified NP, MS, RN. 25 years private practice & hospitalist
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low hemoglobin, low hematocrit, low mch, low mhc, high mcv,

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low hemoglobin, low hematocrit, low mch, low mhc, high mcv, high rdw 47 year old female


Answers provided are for informational use only and do not confer patient-provider relationship. My name is XXXXX XXXXX I will help you.


Why was the CBC run?


Please list the numbers for each results and the laboratory reference range (the range that the lab considers "normal" depending on the equipment they use).






Customer: replied 3 years ago.

had panic attack and high heart rate...


had a cbc done about 4 days before as well due to stomach pain


original 4/24

alkaline phosphate 70

ast/sgot 16

bilirubin total .4

bilirubin direct 0.0

albumin 4.3

protein 8.2

bilirubin indirect .4

lipase 40

alt/sgpt 13


wbc 7.1

rbc 5.26

hemoglobin 12.1

hematocrit 37.9

mcv 72.2

mch 23.0

mchc 31.8

rdw 14.8

platelet 281

mpv 9.2



neutrophil absolute 5.4

lymphocyte absolute 1.3

monocyte absolute .3

eosinophil absolute .0

neutrophil 75.5

monocyte 4.9

lymphocyte 18.6

eosinophil 1.0

basophil 0.0


then on 4/28 at different hospital location


hematocrit 33.0

hemoglobin 9.8

mpv 10.7

mch 23.0

mchc 32.4

mcv 71.2

mpv 9.8

platelet 245

rdw 15.7

rbc 4.64

wbc 6.9


on this last visit I went without anything to eat or drink since the night before - wondering if that could have had anything to do with the drop in values? different labs?


Actually, you can't diagnose anything from a simple blood test. All this shows is that you are anemic - a microcytic, hypochromic anemia. Most common cause is iron deficiency anemia or one of the thalassemias. I am sure they will also want to check for blood loss. However, all it shows is that the levels are normal, nothing about why they are abnormal. Your primary provider will have to tease out the reason for the anemia.


Fasting for 24 hours won't really affect the numbers that much. It would be unusual for any two blood tests done at different places, even on the same day, to be exact.



Best regards,



Customer: replied 3 years ago.

so the drop in hemoglobin in four days isn't worrisome? or the fact that my level is only 10.7? I have myself worried sick that I have some sort of bone marrow cancer? I do suffer from a very high anxiety disorder I should mention and can't thank you enough for understanding!


I did note to myself that my wbc looked good which may rule out such a worrisome thought? ugg...I hate anxiety

Yes, anxiety is a scourge. I hope you are being treated for that as well.


The WBC is okay.


The differences in readings aren't that significant. Had they been done at the same hospital on the same day, they could have been that different. Blood results are dynamic and you won't get the exact same readings twice in a row.


You are slightly anemic, and your primary provider will need to check for the reason for that. The numbers don't look like anything serious though. I'm afraid your anxiety is making this a lot worse than it could ever be. You know about the mountain and the mole hill. Wink


Kind regards,




A. Schuyler, NP and 2 other Health Specialists are ready to help you
Customer: replied 3 years ago.

one other question: what is anion gap? and if its low is it worrisome?

Hi again,


Anion gap is a simplified term for a calculated numer that compares positively-charged ions (sodium and pitassium) and negatively-charged ions (chloride and bicarbonate) in the blood (or serum or urine). Low anion gap can mean blood loss (hemorrhage), nephrotic syndrome (a kidney problem), an obstruction in the bowel, or liver cirrhosis. Again, your primary provider has to tease out whether the anion gap is sufficiently low to be of concern, and if it is, what the problem is.


Best regards,




Customer: replied 3 years ago.

mine was 4.0 but all electrolytes were normal except chloride which was 108 when the normal said (98-107)?


bun 13

calcium 10.0

co2 25

creatine .79

glucose 102

magn 2.0

phosphorus 2.2

potassium 4.1

sodium 137


again thank you from a very nervous nelly

Hi, Nervous Nelly,


You still can't diagnose anything from lab tests. They just point out that something is a little off, and it's up to the provider to examine that patient and the lab results and try to determine the cause.


Best regards,



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