Should I be worried about a blood count issue?
September 21, 2013 12:12 PM Subscribe
I regularly give blood in the UK and am currently taking part in an interval study, which involves studying the donors' blood.
Yesterday, I received a letter from the organisers of the study that includes the rather alarming sentence, "We have noticed that part of your blood count is outside the range we would have expected." The letter then says, "There are no urgent issues regarding your health. However, we would like to take a second sample and recheck your blood count." Should I be worried?
The letter says they will have to suspend me from donating blood until they check my blood count. I didn't get the letter until after work on a Friday so I can't ring up to talk to them or make an appointment to give a blood sample until Monday. After the appointment, I have to wait two weeks to find out the results.
I'm not that alarmed because the letter does seem to stress that there is nothing urgent to worry about. But I am slightly concerned, as well as rather curious. What could be minor enough that there are no urgent health implications but major enough that they won't allow me to give blood until it's checked?
My haemoglobin levels are fine; that's tested every time I give blood. I have no health issues that I'm aware of.
Thanks in advance for any light people can shed on this!
The letter says they will have to suspend me from donating blood until they check my blood count. I didn't get the letter until after work on a Friday so I can't ring up to talk to them or make an appointment to give a blood sample until Monday. After the appointment, I have to wait two weeks to find out the results.
I'm not that alarmed because the letter does seem to stress that there is nothing urgent to worry about. But I am slightly concerned, as well as rather curious. What could be minor enough that there are no urgent health implications but major enough that they won't allow me to give blood until it's checked?
My haemoglobin levels are fine; that's tested every time I give blood. I have no health issues that I'm aware of.
Thanks in advance for any light people can shed on this!
it is not problematic to be out-with the parameters of the study especially if female. The human body is way more complex then the easy diagrams in Grey's Anatomy, and many women show no adverse effects from a Haemoglobin of less than 11.
My wife has had a normal Haemoglobin on 9 her entire life, in fact she was investigated for Leukaemia twice despite being the picture of health! In pregnancy they really want you to take extra iron or ferritin to bring you up to "normal" but to be honest if you feel fine, you are probably fine.
having said that as a Medical researcher we do have to exclude the non-average in order to make our datasets make sense, so I really wouldn't be worried if I were you.
posted by kairab at 12:57 PM on September 21, 2013
My wife has had a normal Haemoglobin on 9 her entire life, in fact she was investigated for Leukaemia twice despite being the picture of health! In pregnancy they really want you to take extra iron or ferritin to bring you up to "normal" but to be honest if you feel fine, you are probably fine.
having said that as a Medical researcher we do have to exclude the non-average in order to make our datasets make sense, so I really wouldn't be worried if I were you.
posted by kairab at 12:57 PM on September 21, 2013
so if one of the other parameters are out for completely natural reasons, they have to exclude you for accuracy sake.
posted by kairab at 12:59 PM on September 21, 2013 [1 favorite]
posted by kairab at 12:59 PM on September 21, 2013 [1 favorite]
Researchers have an ethical obligation to inform prospective subjects if their intake evaluation shows something that might be of concern. It's difficult to say more about your specific situation because they do not mention what part of the blood count is outside the normal range. In general, if you show signs of possible anemia, then you will not be allowed to donate blood, and this can be true even if your haemoglobin is normal. I should point out that this aspect really has nothing to do with the study; if the blood count is abnormal, then your doctor would be telling you the same thing. How often have you had a routine blood test done?
Measuring haemoglobin is an inexpensive and quick test, but it doesn't tell you about a wide range of possible haematological abnormalities. Your red blood cell count could be low and you would still be healthy; it could be high and you would still be healthy. As kairab points out, some people are anomalies; they can have blood parameters that are way outside the normal range and still feel fine (and some people can have apparently normal parameters and feel atrocious, as was the case for me for many years). There's a lot we don't know, especially about the genetic factors involved.
I wouldn't worry about it, but I can understand why you are curious. Perhaps could update us when the results of your second test come back. You've made me curious, too :)
posted by rhombus at 1:05 PM on September 21, 2013
Measuring haemoglobin is an inexpensive and quick test, but it doesn't tell you about a wide range of possible haematological abnormalities. Your red blood cell count could be low and you would still be healthy; it could be high and you would still be healthy. As kairab points out, some people are anomalies; they can have blood parameters that are way outside the normal range and still feel fine (and some people can have apparently normal parameters and feel atrocious, as was the case for me for many years). There's a lot we don't know, especially about the genetic factors involved.
I wouldn't worry about it, but I can understand why you are curious. Perhaps could update us when the results of your second test come back. You've made me curious, too :)
posted by rhombus at 1:05 PM on September 21, 2013
Keep in mind it's also possible an error occurred in processing the sample and they just need a new specimen to recheck their data. I'm a nurse; I send blood down to our hospital lab usually several times a night. I've received calls from lab a few times requesting a re-draw. I'm typically given some vague explanation of how the sample was hemolyzed/insufficient/etc. On at least one occasion, the lab had actually lost the sample I'd sent but didn't want to admit it initially and it only came out later. All this to say, it may be something with the lab. I wouldn't worry until I'd called and gotten more information.
posted by pecanpies at 1:15 PM on September 21, 2013
posted by pecanpies at 1:15 PM on September 21, 2013
Not a doctor, but I've had some out of range blood tests.
Blood counts report a number for many different blood components and a reference range for each value. The reference range is usually given as the 5th to 95th percentile of healthy people. That means 10% of all normal people will fall outside the reference range. Usually if you fall outside the reference range, you'll be retested and the number will likely come back into range. Only when a number is significantly out of range should you be worried.
posted by Durin's Bane at 2:15 PM on September 21, 2013
Blood counts report a number for many different blood components and a reference range for each value. The reference range is usually given as the 5th to 95th percentile of healthy people. That means 10% of all normal people will fall outside the reference range. Usually if you fall outside the reference range, you'll be retested and the number will likely come back into range. Only when a number is significantly out of range should you be worried.
posted by Durin's Bane at 2:15 PM on September 21, 2013
Many possibilities here.
- Anemia. (despite having your hemoglobin checked when you give blood, unless you gave blood within the past few days, it could have changed, this can be due to various issues including all the anemias listed below, hemolysis, etc - low Hgb/Hct)
- Polycythemia (too MANY blood cells. Polycythemia vera, dehydration, etc - high Hgb/Hct)
- Your blood cells could be microcytic. (iron deficiency, vitamin deficiency - low MCV)
- They could be macrocytic. (vitamin deficiencies, etc - high MCV)
- They could be hypo chromic (vitamin deficency, lead toxicity, infection, etc. - low MCHC)
- Leukopenia or leukocytosis (usually out of whack due to infection, rarely cancer - high or low WBC)
- Thrombocytopenia or thrombocytosis (stress, chronic disease, infection, etc - low or high platelets)
Another possibility not to forget is that lab error is a very common cause of abnormal blood tests. One of the most common causes of lab error is hemolysis of the blood sample.
I suspect just about any of the abnormalities above would prompt them to stop you from giving blood again until you've had it checked out. Giving blood is a completely elective procedure, so why do it if there might be an issue, however minor?
posted by treehorn+bunny at 5:45 PM on September 21, 2013
- Anemia. (despite having your hemoglobin checked when you give blood, unless you gave blood within the past few days, it could have changed, this can be due to various issues including all the anemias listed below, hemolysis, etc - low Hgb/Hct)
- Polycythemia (too MANY blood cells. Polycythemia vera, dehydration, etc - high Hgb/Hct)
- Your blood cells could be microcytic. (iron deficiency, vitamin deficiency - low MCV)
- They could be macrocytic. (vitamin deficiencies, etc - high MCV)
- They could be hypo chromic (vitamin deficency, lead toxicity, infection, etc. - low MCHC)
- Leukopenia or leukocytosis (usually out of whack due to infection, rarely cancer - high or low WBC)
- Thrombocytopenia or thrombocytosis (stress, chronic disease, infection, etc - low or high platelets)
Another possibility not to forget is that lab error is a very common cause of abnormal blood tests. One of the most common causes of lab error is hemolysis of the blood sample.
I suspect just about any of the abnormalities above would prompt them to stop you from giving blood again until you've had it checked out. Giving blood is a completely elective procedure, so why do it if there might be an issue, however minor?
posted by treehorn+bunny at 5:45 PM on September 21, 2013
By tomorrow you'll get to know more when you talk to them. In the meantime, it could help to think of it as if you were just having your blood checked as part of a routine physical, and the doctor came back and said "X" is value "e" and normal range is "b through d". Any thing outside of "normal" is by nature "unexpected" but does not at all necessarily mean there is any problem of clinical or health significance.
posted by gubenuj at 8:43 AM on September 22, 2013
posted by gubenuj at 8:43 AM on September 22, 2013
Response by poster: Thanks everyone, I really appreciate your comments. I definitely feel reassured now.
pecanpies, your story about the lab losing the sample made me laugh.
If/when I find out what the issue was, I'll update you all. Thanks again for all the very knowledgeable comments.
posted by badmoonrising at 3:14 PM on September 22, 2013
pecanpies, your story about the lab losing the sample made me laugh.
If/when I find out what the issue was, I'll update you all. Thanks again for all the very knowledgeable comments.
posted by badmoonrising at 3:14 PM on September 22, 2013
Response by poster: In case anyone looks back at this - I had the blood test and eventually got a letter saying my blood count was normal and I could go back to donating. They didn't say what the issue had been and wouldn't tell me when I rang up to ask. It will have to remain a mystery!
Thanks all.
posted by badmoonrising at 9:43 AM on October 19, 2013 [1 favorite]
Thanks all.
posted by badmoonrising at 9:43 AM on October 19, 2013 [1 favorite]
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posted by LobsterMitten at 12:21 PM on September 21, 2013