How does thyroid function impact blood tests?

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Question: Could you help me understand my blood work? rbc 6.70 H, hgb 12.7, hct 41.6, mcv 62.1 L, mch 19.0 L,mchc30.5, also tsh .0352 L. What does this all mean? Can the thyroid affect all this?

Answer from Dr. Leclair:

RBC - 6.70

    This is the number of red blood cells in a specific volume of blood. Women tend to have a lower number of red cells when compared to men. If you look at the right-hand columns on your report, you should see two values in parentheses or in another column. Those are the ranges of acceptability for each test.  Your RBC is higher than it should be.

Hgb 12.7    

    This is the amount of hemoglobin that is found in a specific volume of blood. Again—you need to look at the reference ranges. As a stand-alone value, this looks a little low to be acceptable.

Hct 41.6

    This is the percentage of your blood that is composed of red blood cells. As a stand-alone value, this too looks okay for an adult woman.

BUT these values are never looked at as stand-alone figures.  Hemoglobin accounts for one-third of the volume of the red cell. So if you were to take the hemoglobin value and multiply it by 3, you should get the hematocrit. You do not. Your red cells are "empty" of hemoglobin.

MCV 62.1

    If I were to take your cells and measure each one of them for volume, I could get the average size (volume). If the mean cell volume (MCV) is lower than accepted (as yours is), it means that the cells are not making adequate amounts of hemoglobin.  

MCH 19

    If I were to weigh each of your red cells, I could get the weight of the hemoglobin in each cell, and then I could calculate the average weight of hemoglobin per cell (mean cell hemoglobin or MCH). Your cells have less than one-third the total amount of hemoglobin necessary for proper function. 

MCHC 30.5

    This is a ratio between the size of the cells and the amount of hemoglobin. Again, you do not have enough hemoglobin in your red cells.

Causes of cells that are too small (microcytic) and do not contain adequate amounts of hemoglobin (hypochromic) include=:

    1.    iron deficiency. The most common anemia in the world.  

           A.    This can be caused by having a diet poor in iron-rich foods, especially red meats. Yes, vegetables have iron but preparation may cause the iron to be leached out of the vegetable and other vegetables have iron that is not absorbable by the human intestine.

           B.    Poor absorption. Iron needs to be acted on by stomach acid, so anything that alters the production of stomach acid (antacids, anti-GERD medications, foods such as dairy, sodas, etc.) or any condition that damages the small intestine where iron is absorbed can be involved here.

           C.    liver disease in which the carrier proteins of iron once it gets from the GI tract to the blood are not made or are made poorly, etc. 

           D.    bleeding—from anywhere for any reason

           E.    exposure to heavy metals such as lead

           F.    an inherited disorder called thalassemia—found in people of Mediterranean descent (or where those people explored and stayed for a while

           G.   rarely - hypothyroidism

So while the answer is yes, hypothyroidism can influence these tests, there are lots of other things that can as well.

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Have a question for the experts? Send them to questions@patientpower.info.

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Page last updated on April 9, 2015