Well informed is well armed. I thought I would give you a bit more info. Proper size of the red cell is vital to adequate oxygen transport, efficient circulation and red-cell longevity.
Although vitamin B-12 and folic acid deficiency are the most common causes of megaloblastic anemia (enlarged red blood cells), diagnosis and therapy of this condition requires an understanding of the differential diagnosis and laboratory evaluation of other causes of anemia with macrocytic (large) red cells.
Macrocytosis occurs when the mean cell volume is greater than 100 fl. The finding of macrocytic indices does not necessarily imply megaloblastic anemia, since other conditions can produce a macrocytosis, however, an
elevated mean corpuscular volume (MCV) is an abnormal finding and must be corroborated by examination of the peripheral blood smear. Elevated MCV may precede, by months or years, the onset of a megaloblastic (pernicious) anemia.
The earliest sign of megaloblastic anemia reflected in the blood is the hypersegmentation of polymorphonuclear leukocytes (PMNs). This is a very simple test any physician can do in-office if they have a microscope. They
take a smear of a finger-stick (puncture the end of your finger and smear it on a microscope slide) and count the percentage of PMNs that have more than 4 nuclei.
The lab will tell you that hypersegmented PMNs in excess of 30% indicates an abnormality. In my experience, 0% is optimum and achievable with adequate supplementation of concurrent B-12 and folic acid. Since supplementation
with one or the other can mask a deficiency of the other, concurrent supplementation is suggested. Since toxicity levels of B-12 and folic acid have not been found at any consumption level, supplementation should create no problem.
The question should arise, "Why am I deficient?" This mystery should not be ignored. There are many conditions (some of them under your control - alcohol and smoking - to mention only two) that affect B-12 and folic acid sufficiency.
B-12 requires Intrinsic Factor for absorption from the diet or by oral supplementation. Impaired digestion (following antibiotic therapy, for instance, as well as advancing age) significantly reduces uptake of B-12.
Oral supplementation of folic acid is effective, but due to the need for Intrinsic Factor for utilization of B-12, most forms of B-12 are inadequate in deficient individuals. Sublingual B-12 has been shown recently to be as effective in raising tissue stores of B-12 as intramuscular injection
(formerly the preferred route of administration for deficient patients). You can find references to liposome sprays for sublingual administration of B-12 in the PDR.
Your subsequent posts indicate you have good information on the means to begin correcting the causes of your deficiency. There is cause for some concern, but not necessarily alarm. Proper followup by a professional is, however, imperative. I have presented discussion on RBC size, but not on low RBC count. There is so much more to say on this topic, but I don't want to overwhelm you. Hopefully you realize this information is meant for educational purposes and is not meant to either be complete or to substitute, in any way, for the intervention of a qualified professional in any specific case.
I hope this helps you understand more.
Best wishes in your search for better health.
Dr.B.
In Reply to: Re: Low red blood count with enlarged red blood cells (long) posted by Dr. B. on July 13, 1998 at 21:01:40:
Dear Dr. B,
Thanks for the great note! I could not have said it better & it needed to be said.
I would add one thing: Replicated research has demonstrated that there is a very wide range of "normal" for these substances related to megaloblastic anemia (and many chronic neurological conditions in young & old). This is a genomic determinant. There are documented cases of people who needed more than 1000 times as much B12 (for example) as the average person for them to function "normally".
Since these substances are relatively nontoxic, frequently massive doses will serve as a therapeutic trial while we are waiting for more specific lab tests to be developed. If you are interested in these references, I would suggest as a resource "Functional Medicine Update" at (800) 843-9660.
I appreciate your help!
Walt
Is there anything you recommend to do for myelodysplastic syndrome...newly diagnosed...platelet count 113,000? Told by doctor, there is nothing known to make it better. Do you have any suggestions? Many thanks, Carol
In Reply to: myelodysplastic syndrome posted by Carol on July 13, 1998 at 21:08:57:
Dear Carol,
Since ALL conditions that have to do with the inhibition of the formation of blood cells are at least related to environmental chemical toxicity & hypersensitivity, you could get a real start on this by going to the link:
Aplastic anemia archives and reading everything you can find about aplastic anemia.
THEN, if you still have questions, write again.
Walt
Dr. Stoll...
After reading Shirley's question posted on 7/13, and your response to her... I need to ask you this...
Just how dangerous is it when the RBC count is as low as her husbands is bu hr I believe she said it was 2.98...
I have a friend who is having this problem also... Also on hemodialysis.
Thank you...
In Reply to: LOW RED BLOOD CELL COUNT (Posted by Shirley C.) posted by Patrick on July 14, 1998 at 16:52:10:
Dear Patrick,
This is more than half normal. It is a problem but not yet life threatening. Normal varies from lab to lab but is usually 4-4.5.
Walt
Dear Dr., As you requested, I read everything about aplastic anemia...found a doctor's name in our area from the American Academy of Environmental Medicine and need to persuade my husband to make an appointment. Help me convince him please. Would he be going there to get allergy testing and be treated with shots to make his syndrome go away and his platelet count to rise? Have I interpreted the solution correctly? (He has not been exposed to chemicals.) Would this be covered by an HMO? Many thanks, Carol
In Reply to: myelodysplastic syndrome posted by Carol on July 15, 1998 at 16:53:44:
Dear Carol,
Perhaps your husband needs to read up on his syndrome & see what his future is going to be from a purely conventional medical standpoint.
THEN, he needs to go to the library and educate himself about what clinical ecology is all about.
If he cannot make a better decision THEN, his future is bleak--and so is yours.
We ALL are being exposed to more than 500,000 different chemicals every day that did not exist in nature even 150 years ago. Almost none of them have been tested (even individually), by today's standards, as to their long term effects on humans. Just within the past year has the conventional medical community come to accept that combining even just 2 of these chemicals can increase their individual toxicity by as much as 1000 times. What about combining 500,000 different ones?
Any good Clinical Ecologist will not be testing for "allergies".
I recommended the Clinical Ecologist because s/he would have more up to date information than I would to convince any person of the valididty of this cause not because they have any magical solution--other than perhaps discovering a toxic exposure that he could avoid that would give some immediate relief & prevent more damage from occurring.
If I had this problem, I would be looking to improve my "horsepower" (wellness) to better withstand the environmental burden.
Without your husband becoming a student of all this, there is NO WAY that he will do the work needed to survive this.
Walt