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Fatigue and AnemiaFatigue and Anemia
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Hello again, Dr Bob...
May 12, 2002

Dear Dr Bob, wrote to you sometime back, that is after I was shortly infected about 6 months back. I'm much calmer now except that I'm feeling a little fatigue. I'm finding myself getting tired more easily lately. I have just completed my CBC test which results are as follow (RBC 6.3 / Hemoglobin 16.1 / PCV 49 / MCV 78 / MCH 25 / MCHC 33 / Platelet Count 324 / WBC 8.4 / Neutrophil 71 / Lymphocyte 25 / Monocyte 3 / Eosinophil 0 / Atypical Lymphocyte 0). Except for MCH which is on a low of 25, rest of the counts are OK. What does a low MCH means? Is it normal for a recent infected individual to have a low MCH? One last question, will my CBC change as time passes as I saw in some articles stating that the white blood cell will increase as the disease progress. Is that true? Thanking you in advance. Luv. HW

Response from Dr. Frascino

Hello HW,

Glad you are feeling calmer now. Your CBC results are fine. In particular, there is no anemia (hemoglobin is normal). The MHC and MCHC are red blood cell indices. They measure the average amount of hemoglobin in red blood cells. Although these two tests are included in most CBC reports, they do not deserve much attention. The MCV (mean corpuscular volume) is somewhat more important, as is RDW, which measures the average size and uniformity of red blood cells. These tests help us evaluate the various potential causes of anemia. For instance, AZT frequently causes the MCV to increase.

Will your CBC change over time? Sure, it changes somewhat day by day. The important thing is to look for trends. For instance, is your hemoglobin progressively decreasing with each blood test? If so, you may be becoming anemic. Is your white blood cell count consistently dropping below the normal range? If so, you may be more susceptible to infections. Is your platelet count dropping below the normal range? If so, you may have increased bruising and risk of prolonged or excessive bleeding.

Right now, your counts look fine H.W. If you are concerned about other tests in the future and can't get or don't understand the explanations your doctor gives you, please write back and we'll try to help out.

Stay well, stay calm, stay informed!

Dr. Bob

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