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Here is my blood work from 2 months ago. Besides me finding…

Hey Doc here is my...
Hey Doc here is my blood work from 2 months ago. Besides me finding out that i had diabetes my doctor wasn't concerned about any of the results. Is there anything that i should be concerned about? High RBC?2) Also doc once i reverse my diabetes even though i have to be careful will i be able to put Carbs back in my diet? As long as I don't have weight gain which would cause the diabetes to come back correct?WBC 5.7
RBC 6.19 (HIGH)
HemoGlobin 15.3
Hematocrit 46.5
MCV 75.1 (LOW)
MCH 24.7(LOW)
MCHC 32.9
RDW 14.1
NEUTROPHILS 66.9
LYMPHOCYTES 21.9
MONOCYTES 9.1
EOSINOPHILS 1.2
BASOPHILS 0.9
PLATELET COUNT 292GLUCOSE 138
BUN 9
CREATINE 1.02
EGFR AFRICAN AMERICAN 108
EFGR NON AFRICAN AMERICAN 93
CALC BUN/CREAT 9
SODIUM 140
POTASSIUM 4.3
CHLORIDE 100
CARBON DIOXIDE 26
CALCIUM 8.6
PROTEIN,TOTAL 7.4
ALBUMIN 4.5
CALC GLOBULIN 2.9
CALC A/G RATIO 1.6
BILIRUBIN TOTAL 0.6
ALKALINE PHOSPHATASE 54
AST 18
ALT 24
TSH 1.150
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Answered in 39 minutes by:
3/12/2018
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,461
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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Hello again. I am sorry for the delay, but I had to step away from the computer.

Was any additional labs done, such as an iron profile?

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Customer reply replied 1 month ago
hi doc no iron profile was done

The elevated RBC would not be a concern, by itself, as both the hemoglobin and hematocrit are both normal. However, the elevated RBC means that the calculated MCV and MCH are both low.

The MCV and MCH are primarily useful in the evaluation of people that are anemic, and you obviously are not anemic. It is possible that the MCV/MCH is simply the way you are (because of a genetic trait), but the one condition that can cause a low MCV/MCH would be iron deficiency. If the iron deficiency is more severe, then there would be some anemia, but early in the process when the person is first starting to be iron deficient, there may be a low MCV without anemia.

If there are old values that showed similar results, then it is more likely that this is not a concern. But if there is no previous MCV for comparison or if there are previous MCV results that were normal, then I would typically check an iron profile and a ferritin (a blood test that reflects iron storage). If a male is found to be iron deficient, then the next issue is why. It is virtually impossible to become iron deficient solely by poor intake, so iron deficiency indicates that there is some iron loss somewhere. In a menstruating woman, it is obvious where iron loss is happening. But in a male or a post-menopausal female, the identification of iron deficiency also means that there should be an evaluation for identification of where iron loss is occurring.

If I can provide any additional information, please let me know.

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Customer reply replied 1 month ago
i could have internal bleeding somewhere if my iron is indeed low? I have never had low MCV or MCH from previous blood test. My urine test did come back with cloudy urine but no blood in urine.

Yes, if the iron is low, then it is possible that it could be from blood loss through the gut or the kidneys. Many conditions that cause blood loss will have only intermittent blood loss, so a single urine test that did not show blood is not sufficient to say that it is not from the kidneys. However, in someone that has no history of visible blood loss, it is far more common to have blood loss in the GI tract, as small amounts of blood can be easily missed in the stool. But we are getting ahead of ourselves. The first issue is to check an iron profile and ferritin.

Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19,461
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
Verified
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Customer reply replied 16 days ago
Hello Doc. I've lost a total of 75 pounds and my A1C is now 7.0 from 8.7 since a little over 2 months ago. Last week i started feeling short of breath all of sudden. The feeling comes and goes so i'm fine then it come on. On a scale of 1/10 its a 1. I only feel it like when i'm talking on the phone i feel like my breathing is off. Im not gasping for air or anything like that i just feel like my breathing is off . I'm still doing a lot of cardio every day with no issues i feel fine 4 miles walking and 30 minutes of high intensity stair master. Im sleeping fine at night and i have energy. I do have a past history of anxiety and panic attacks (chest sensations and palpatations) and lately i have been stressed and especially stressed this last week. Can anxiety be causing this feeling of shortness of breath? my blood work is listed below again also.WBC 5.7
RBC 6.19 (HIGH)
HemoGlobin 15.3
Hematocrit 46.5
MCV 75.1 (LOW)
MCH24.7(LOW)
MCHC 32.9
RDW 14.1
NEUTROPHILS 66.9
LYMPHOCYTES 21.9
MONOCYTES 9.1
EOSINOPHILS 1.2
BASOPHILS 0.9
PLATELET COUNT 292GLUCOSE 100
BUN 9
CREATINE 1.02
EGFR AFRICAN AMERICAN 108
EFGR NON AFRICAN AMERICAN 93
CALC BUN/CREAT 9
SODIUM 140
POTASSIUM 4.3
CHLORIDE 100
CARBON DIOXIDE 26
CALCIUM 8.6
PROTEIN,TOTAL 7.4
ALBUMIN 4.5
CALC GLOBULIN 2.9
CALC A/G RATIO 1.6
BILIRUBIN TOTAL 0.6
ALKALINE PHOSPHATASE 54
AST 18
ALT 24
TSH 1.150

I responded in the other thread.

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Customer reply replied 1 day ago
Hey doc since our previous conversation we had before about my low MCV and MCH I recently found some old blood work results from 2011. My most recent blood work was in January 25 2018. My MCH was low then but my MCV was an 81 which was normal. My RBC was also high on that test also the same number that it is now. Doc this last week i've been feeling more tired like i have no energy ( I never feel like this). Groggy headed also at times. Now i have been dieting and working out a lot i mean a lot. Cutting my carbs way back. (i Have lost a lot of weight in the past 3 months) Ive been to my the doctor who says my blood work is fine. I brought up low iron and he says i'm not anemic in any way. Could I be low on another nutrient that could be making me feel this way? low B12? My diabetes has been in check fasting 85-95 a1c 6.9

This is more than a clarification of our previous discussion, so should be posted as a new question.

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