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What Does It Mean If Your MCV Blood Test Is High?
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Are you looking at your blood test and finding elevated MCV levels? What does MCV actually mean when your mcv blood test is high, and what's causing your elevated MCV levels? My name's Dr. Terranella, and in this video, we're going to look at what it means if your MCV blood tests are high.
We're going to look at some of the causes behind this, what levels on your MCV tests might be significant, and some other things surrounding the MCV that are important to understand when you're trying to get this number under control.
What does it mean if your MCV blood test is high?
Well, first of all, MCV stands for mean corpuscular volume (MCV). It is a blood test that looks at the relative size of the red blood cells, or the average size of the red blood cells (erythrocytes). If it is larger than normal or outside the reference range, it is called macrocytosis.
MCV is a measurement of the relative volume or size of the red blood cells. A red blood cell is referred to as a corpuscle, so MCV means mean corpuscular volume. It is typically reported in units of femtoliters (fL), and the range that is typically given is somewhere around 85 to 100, with optimal being somewhere around 90 or a little bit higher. As it gets above 93, that could be more of an indicator of a problem with DNA production in particular.
An elevated MCV outside of the normal range is called macrocytosis, which can have several underlying causes. The most commonly associated with this is called megaloblastic anemia, which just means you have really large red blood cells. And because that's going on, it leads to not enough red blood cells overall, and that's where the anemia comes from. Let's break this down a little bit more.
Megaloblastic anemia is characterized by impaired DNA synthesis, and it results in larger than normal red blood cells. The most common cause for this is deficiency in vitamin B12 or folate. These are essential nutrients needed for normal red blood cell maturation. That's because these nutrients are needed for DNA production, and that DNA production is needed for normal maturation of the red blood cells.
Sometimes these deficiencies are due to not enough consumption of those vitamins, folate, and B12. Sometimes it's for genetic reasons. For example, if you have MTHFR mutation or other single nucleotide polymorphisms in folate metabolism or B12 utilization, that could lead to some of these problems. And other times it's from increased excretion of these vitamins. And a lot of times it's just a combination of all the above.
A classic example of this combination is with chronic alcohol consumption. With chronic alcohol consumption, you're basically commonly going to see on your CBC macrocytosis. Now, it's not always going to lead to megaloblastic anemia or frank elevations outside the reference range. But generally speaking, if you're consuming alcohol on a daily basis, you're going to have an MCV that's on that higher side of one. Why is that? Well, alcohol can interfere with folate metabolism, utilization, and excretion, as well as the same for B12. And the result is an impairment in the production and full maturation of those red blood cells. So more of them are getting released in that larger stage.
So in terms of what does it mean when you have an elevated MCV blood test, it means that a lot of your cells are being released in that larger stage. Now, of course, B12 and folate deficiency aren't the only reasons, but a lot of the other reasons are going to be connected to that in some way. But not every reason.
So some other reasons that are connected to an elevated MCV are certain medications that interfere with B12 and folate utilization. And then of course, there are other types of anemia that can affect this. Bone marrow disorders, which of course can lead to anemia as well. And then liver disease can also cause this in some instances.
It's important to note on this topic that an elevated MCV alone does not provide a specific diagnosis and doesn't tell us for sure that it is a problem for you. Most of the time when you initially spot this, it means further testing and understanding of what's going on with B vitamins, bone marrow, and other things related to this are going to be needed. Sometimes it'll just be high on one test, and the next test you do, it looks normal.
But of course, some of the blood tests that you're going to want to follow up on are things like B12 and folate to verify if this is or isn't an issue now.
One thing that I have noted in my practice is that people who do consume alcohol on a regular basis and have this chronic elevated MCV, supplementing with folate and B12 doesn't seem to correct the problem. So there seems to be something with the alcohol that's interfering with the utilization of those B vitamins in some ways.
We're going to look at some of the causes behind this, what levels on your MCV tests might be significant, and some other things surrounding the MCV that are important to understand when you're trying to get this number under control.
What does it mean if your MCV blood test is high?
Well, first of all, MCV stands for mean corpuscular volume (MCV). It is a blood test that looks at the relative size of the red blood cells, or the average size of the red blood cells (erythrocytes). If it is larger than normal or outside the reference range, it is called macrocytosis.
MCV is a measurement of the relative volume or size of the red blood cells. A red blood cell is referred to as a corpuscle, so MCV means mean corpuscular volume. It is typically reported in units of femtoliters (fL), and the range that is typically given is somewhere around 85 to 100, with optimal being somewhere around 90 or a little bit higher. As it gets above 93, that could be more of an indicator of a problem with DNA production in particular.
An elevated MCV outside of the normal range is called macrocytosis, which can have several underlying causes. The most commonly associated with this is called megaloblastic anemia, which just means you have really large red blood cells. And because that's going on, it leads to not enough red blood cells overall, and that's where the anemia comes from. Let's break this down a little bit more.
Megaloblastic anemia is characterized by impaired DNA synthesis, and it results in larger than normal red blood cells. The most common cause for this is deficiency in vitamin B12 or folate. These are essential nutrients needed for normal red blood cell maturation. That's because these nutrients are needed for DNA production, and that DNA production is needed for normal maturation of the red blood cells.
Sometimes these deficiencies are due to not enough consumption of those vitamins, folate, and B12. Sometimes it's for genetic reasons. For example, if you have MTHFR mutation or other single nucleotide polymorphisms in folate metabolism or B12 utilization, that could lead to some of these problems. And other times it's from increased excretion of these vitamins. And a lot of times it's just a combination of all the above.
A classic example of this combination is with chronic alcohol consumption. With chronic alcohol consumption, you're basically commonly going to see on your CBC macrocytosis. Now, it's not always going to lead to megaloblastic anemia or frank elevations outside the reference range. But generally speaking, if you're consuming alcohol on a daily basis, you're going to have an MCV that's on that higher side of one. Why is that? Well, alcohol can interfere with folate metabolism, utilization, and excretion, as well as the same for B12. And the result is an impairment in the production and full maturation of those red blood cells. So more of them are getting released in that larger stage.
So in terms of what does it mean when you have an elevated MCV blood test, it means that a lot of your cells are being released in that larger stage. Now, of course, B12 and folate deficiency aren't the only reasons, but a lot of the other reasons are going to be connected to that in some way. But not every reason.
So some other reasons that are connected to an elevated MCV are certain medications that interfere with B12 and folate utilization. And then of course, there are other types of anemia that can affect this. Bone marrow disorders, which of course can lead to anemia as well. And then liver disease can also cause this in some instances.
It's important to note on this topic that an elevated MCV alone does not provide a specific diagnosis and doesn't tell us for sure that it is a problem for you. Most of the time when you initially spot this, it means further testing and understanding of what's going on with B vitamins, bone marrow, and other things related to this are going to be needed. Sometimes it'll just be high on one test, and the next test you do, it looks normal.
But of course, some of the blood tests that you're going to want to follow up on are things like B12 and folate to verify if this is or isn't an issue now.
One thing that I have noted in my practice is that people who do consume alcohol on a regular basis and have this chronic elevated MCV, supplementing with folate and B12 doesn't seem to correct the problem. So there seems to be something with the alcohol that's interfering with the utilization of those B vitamins in some ways.
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