Abnormal bloodwork questions

Posted by emilysierra @emilysierra, Jan 19, 2023

Hi all-
My name is Emily and im 29. For the past 2 months I've been extremely fatigued, bone pain, night sweats, headaches, bruising, and dizzy. I had bloodwork Monday and my red blood cells were abnormally low along with my hemoglobin. My lymphocyte count was abnormally high. My family doctor told me i was severely anemic. I was referred to a hematologist for further testing which is the 31st. My question I guess is has anyone had something similar and was diagnosed with a blood cancer or was it all caused by the anemia? Thank you for the help.

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Hi @emilysierra, Welcome to Mayo Connect. I’m sure this has been really scary for you and being referred to a hematologist just heightened your anxiety, right? It’s human nature for us to go directly to the ‘worst thing possible’. Although I’m not a medical professional, I’m a happy & healthy survivor of a serious blood cancer, Acute Myeloid Leukemia.

From what you’re telling me, it sounds like there is something more going on besides anemia. Any cause for anemia shouldn’t be dismissed but investigated for the underlying cause because this isn’t a normal state.

There can be many causes for the symptoms you’re describing and for anemia. With the low red blood count and the low hemoglobin, yes, you are technically anemic. However with anemia, the white blood count isn’t necessarily elevated abnormally.

Let me explain a little. When there is a higher than normal white blood count in a blood sample and a very low red count it could mean that the white cells are so numerous that they are overcrowding the red cells. This happens when bone marrow disease that’s causing overproduction of white blood cells also causes underproduction of red blood cells.

A hematologist is a specialist in treating blood disorders. Whether this is anemia or something else, seeing this specialist is the right thing to do to find the cause of your blood numbers, to get the facts and not speculate.

Do you know if a blood smear was run and were any blasts cells noted?

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@loribmt

Hi @emilysierra, Welcome to Mayo Connect. I’m sure this has been really scary for you and being referred to a hematologist just heightened your anxiety, right? It’s human nature for us to go directly to the ‘worst thing possible’. Although I’m not a medical professional, I’m a happy & healthy survivor of a serious blood cancer, Acute Myeloid Leukemia.

From what you’re telling me, it sounds like there is something more going on besides anemia. Any cause for anemia shouldn’t be dismissed but investigated for the underlying cause because this isn’t a normal state.

There can be many causes for the symptoms you’re describing and for anemia. With the low red blood count and the low hemoglobin, yes, you are technically anemic. However with anemia, the white blood count isn’t necessarily elevated abnormally.

Let me explain a little. When there is a higher than normal white blood count in a blood sample and a very low red count it could mean that the white cells are so numerous that they are overcrowding the red cells. This happens when bone marrow disease that’s causing overproduction of white blood cells also causes underproduction of red blood cells.

A hematologist is a specialist in treating blood disorders. Whether this is anemia or something else, seeing this specialist is the right thing to do to find the cause of your blood numbers, to get the facts and not speculate.

Do you know if a blood smear was run and were any blasts cells noted?

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Thank you for your response. From my knowledge, a blood smear was not done. I've attached photos of my cbc. I go for additional bloodwork this Monday.. im curious to see if anything changed.

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@emilysierra

Thank you for your response. From my knowledge, a blood smear was not done. I've attached photos of my cbc. I go for additional bloodwork this Monday.. im curious to see if anything changed.

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Hi Emily, seeing the bloodwork helps. Your red cells are down enough to have you feeling pretty loagy…definitely in the anemic zone. Your white blood cell count is normal with the lymphocytes a little elevated, which could indicate you’re fighting inflammation or a little infection. But nothing eye-brow raising like I expected to see. So that’s positive. It will be interesting to see what your next set of numbers are. The hematologist will most likely order a few more blood tests to narrow down the cause of the low red count.

Before you see your new doctor, try to write down when your symptoms started and if there was anything you remember before hand. Such as, was it after an illness or viral infection.
Have you experienced any blood loss? Abnormal period?
Did you have covid?

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@loribmt

Hi Emily, seeing the bloodwork helps. Your red cells are down enough to have you feeling pretty loagy…definitely in the anemic zone. Your white blood cell count is normal with the lymphocytes a little elevated, which could indicate you’re fighting inflammation or a little infection. But nothing eye-brow raising like I expected to see. So that’s positive. It will be interesting to see what your next set of numbers are. The hematologist will most likely order a few more blood tests to narrow down the cause of the low red count.

Before you see your new doctor, try to write down when your symptoms started and if there was anything you remember before hand. Such as, was it after an illness or viral infection.
Have you experienced any blood loss? Abnormal period?
Did you have covid?

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Well thats good to hear. August of 2021 during a csection I hemorrhaged and lost alot of blood and had to get a blood transfusion in the hospital. Other than that, no blood loss, no abnormal period, and no covid.

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@emilysierra

Well thats good to hear. August of 2021 during a csection I hemorrhaged and lost alot of blood and had to get a blood transfusion in the hospital. Other than that, no blood loss, no abnormal period, and no covid.

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Good morning @emilysierra, it’s been quite a while since you’ve posted. I hope you’re feeling much better by now. Were you able to see a hematologist and get any answers for what’s causing your anemia?

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@loribmt

Good morning @emilysierra, it’s been quite a while since you’ve posted. I hope you’re feeling much better by now. Were you able to see a hematologist and get any answers for what’s causing your anemia?

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Hey Emily, my name is Jennifer. I am currently being tested for Amyloidosis which can cause the symptoms you mentioned. Evidently, Amyloid is rare but under diagnosed. Typically not diagnosed until age 30 and above. Other symptoms/diagnosis for amyloid include carpal tunnel syndrome, peripheral neuropathy, autonomic dysfunction, heart arrhythmias, low voltage on EKG, diastolic dysfunction, kidney problems, liver/spleen enlargement, diarrhea/GI symptoms, etc. Basically it can affect the nerves. skin, Gi tract, liver, spleen, heart. All of these symptoms can occur years prior to diagnosis.

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@loribmt thank you for this really helpful post, Lori! I had shortness of breath since 2013, was erroneously diagnosed with smoldering myeloma in 2019, and the year later finally diagnosed with amyloidosis and began treatment.

I know it is often under diagnosed, so it’s very important for us patients to advocate to have it tested if we have any of the symptoms or if we have multiple myeloma. My understanding is that almost 20% of patients with MM have Amyloidosis…

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