Real People Stories – Michaela

Three doctors looked at me and said the tests were fine, but the anaemia continued to progress. Microcytic and iron deficiency anaemia in a general CBC blood test, what indicators to pay attention to and what other exams to take.

Well, what new can you tell in a complete count checkup? Everyone knows it; everyone understands its purpose. That’s what I thought until I received the paper with the CBC results. My eyes ran wild from the incomprehensible abbreviations. Still, the main thing is that when the GP said everything was fine and I saw several deviations from the reference range, I began tormented by vague doubts. Finally, I decided to figure out the CBC report, what was there, and why.

What is this Exam?

In short, this is a set of specific blood indicators needed for the primary diagnosis and monitoring of disease treatment.

There are many reasons for taking a general CBC Panel. Still, if we talk about why I took it, my story about examinations begins in the reviews of thyroid ultrasound and thyroid hormones.

In short – one day, far from a wonderful one, I had an attack of tachycardia. One hundred forty-five beats per minute, pressure 140 to 90, the feeling that I could not take a normal breath to fill the lungs with oxygen, pain in the heart area, my left hand went numb and became cold, and consciousness was trying to leave me. The ambulance arrived quickly, and in 15 minutes, they had already given me an ECG and an injection. Still, now I do not remember what exactly because my condition was, to put it mildly, semi-fainting.

The ambulance CBC doctor strongly recommended that I have my thyroid gland examined, and the next working day at the clinic, I was given directions for an ultrasound, hormone tests, and, of course, biochemistry.

You have to make an appointment for blood tests at our CBC clinic, and I was lucky; the queue was every other day. It was only later that I found out that a couple of days later, the queue was already booked for two weeks in advance.

Why is it prescribed?

A test Profile is a basic study with which everything begins with CBC. Although it cannot be called exclusively informative, in the sense that you did it, and that’s it, you can do nothing else. However, the report still contains indicators important for primary diagnosis and monitoring of treatment of various diseases.

Of course, you need to look at what the other parameters of the general blood test show. There are a lot of them, and some are directly related to each other. Unfortunately, some doctors tell patients openly—we don’t look at this, and I don’t even know what this is. That’s exactly what the endocrinologist told me.

In essence, the CBC test gives the doctor an idea of ​​where and in what part of the body to look for problems if such a need exists. 

Decoding a report is more complex, and yet I recommend always looking for a good doctor who can do it. Of course, you can familiarise yourself with the information, but you should avoid taking any advice and conclusions.

My Experience

My Anaemia blood test from the clinic does not have a white cell count. With all these types of white cells, the indications are slightly different from just a complaint of feeling unwell.

I don’t know how it is with a GP, but you can complete a CBC test in a private clinic.

If I had just started the tests, I would have chosen the most expensive one, which had the largest number of indicators, but I only needed to look at what gave low results two weeks ago. 

The result of my tests or how the doctor did not notice anaemia.

I have known for a long time that I have chronic anaemia, but all these years, I have been able to support my body with a diet. Naturally, I immediately warned the doctor about this while still receiving directions for the analysis. 

Anaemia Red cell counts are used to diagnose, and here we have a hitch. Something says that there is anaemia, but the amount of haemoglobin is normal. At the same time, a couple of red cell counts are reduced: MCH (average haemoglobin content in one red cell) and hematocrit. The haemoglobin itself is 119, although the analysis indicates the norm from 110 to 160. 119 is considered too little.

The doctor who handed me this analysis said that everything was normal. I had no pronounced anaemia, and the deviations from the norms were not critical. He didn’t see any reason to prescribe me anything else—no drugs, no additional tests.

Seeking a Second Opinion

Even though I am a nasty woman, I prefer not to argue in such situations because the very fact that I was prescribed a fluorography first and then an ultrasound of the thyroid gland and hormones already made me clearly understand the level of professionalism of the doctor. I said thank you and left. Well, that’s how it is often that we treat not the person but his tests without any desire to get to the bottom of the symptoms. Can you walk? Well, go ahead and get more CBC regularly further “if you want.”

Two weeks passed, and the CBC symptoms remained the same, although not as strong, so I decided it would be good to retake the test. I took the first one on 3.03 and the second one on 18.03. We can already judge some dynamics.

Worsening Despite “Normal” Results

When I got the results a day later, I saw the same thing as before—anaemia, which, judging by the indicators, was getting worse.

The average volume of red cells decreases; they become small and can carry less haemoglobin. MCV in the first analysis is 80.7; in the second, it is already 80.4. MCH in the first analysis is 26.4, and in the second, it is already 25.6.

In the first, MCHC is close to the lower limit of the norm, and in the second, it is already below it. However, the figures cannot be compared because they use different units of measurement.

The body’s cells are not receiving the required amount of haemoglobin; the anaemia is worsening. And the therapist said everything is fine, go home and don’t worry. I just wanted to ask again – will you not prescribe me anything? She said no. She probably decided that I wanted to feel sick and that I was going to them to prescribe something.

An hour of searching on the Internet led me to a diagnosis that is made with such indicators – Hypochromic microcytic anaemia.

Hypochromia is usually associated with a decrease in the volume of red cells (microcytosis). But can also occur in red cells of normal volume.

Importance of Additional Exams

❗But a clinical result is not sufficient grounds for making a diagnosis!

Laboratory data confirm hypochromic anaemia by studying clinical blood tests, serum iron levels, TIBC, and ferritin.

Taking a ferritin test, serum and serum iron’s total iron binding capacity is also necessary. Since there are still several iron absorption disorders. These indicators can be reduced, but you cannot take iron supplements.

This is very important, so you can’t do it without consulting a good doctor and can’t self-medicate. Many people underestimate the severity of anaemia and consider it nonsense. But this is different, and you can only get yourself extra problems.

I plan to take all these exams shortly and finally find out the cause of my anaemia. Because you can endlessly replenish the iron deficiency, the body will still have a “hole” through which it will leak.

Connecting to My Symptoms

Considering that, according to various studies, we have not found any pathologies in my body, anaemia is our only clue for now. And by the way, it is this that can cause tachycardia, nausea and almost the entire range of my symptoms.

Well, a few words about preparation for your exam. Although, in essence, there is none. On an empty stomach, do not smoke, do not drink a lot of water. And take the sample early in the morning.

They take everything from a vein, which is considered more informative. I took the sample the first time with biochemistry and the second with TPO antibodies (yes, the story with the thyroid gland continues). And they took everything from a vein, only in different tubes. 

Conclusions and Recommendations

So, let’s move on to the conclusions. Briefly, what I would like to convey to the reader with my comments:

  • First, if the result is strange, retaking it in another laboratory BEFORE starting any treatment makes sense.
  • Second – if two (or more) analyses are strange, showing them to another doctor in another clinic makes sense. As an option, go to a haematologist. Unfortunately, the qualifications of therapists in polyclinics are usually very low.
  • Third – if the result shows anaemia, it is necessary to do other checks to clarify the type of anaemia. Surely, everyone already knows that it is not only iron deficiency. But just in case, I will remind you that you should not just take and eat pills when you see a decrease in the indicators in the general exam. Perhaps there is iron in the body, but somewhere in the chain, there is a failure, and the body cannot adequately use it. In this case, adding iron is dangerous.
  • Fourth, if the reports show worsening, you must look for the cause. Replenishing the iron deficiency or the lack of vitamins is necessary. But you must also find the “hole” where it escapes or why it does not work again.

Fifthly, train your “intuition,” my friends, if the doctor is trying to send you away because the deviations in the results are not critical. But you feel bad; you still need to look for the cause. It is always there. I showed the results to three doctors (a GP, an endocrinologist, and a cardiologist), and none suspected anything was wrong. Still, each of them needed to be more active to tell me the diagnosis of VSD.

Assessing as a Service

Well, if we talk about assessing the general CBC check itself as a service, then it is informative. But only if there is no error. And this, unfortunately, happens quite often, which is why sometimes you have to re-donate blood. Here, you’ll only need to choose the CBC laboratory you’re interested in.