One of the most common, and yet most confusing blood tests ordered.  Lots of numbers, letters, and little to explain it all.

This is known as a CBC.  It’s a basic look at the cells that make up your blood cells, along with the specific components in them.  It’s a critical component for knowing current iron status.

Ranges given are from MY laboratory ranges.  Yours may vary slightly.  Adapt as needed.  My ideals are simply that – my ideals.

The CBC normally includes:

• Red blood cells – number of red blood cells given as an absolute number per liter; Range: 3.5-6.0 X10^12/L
  • Mean corpuscular volume  or “mean cell volume” (MCV) - measure of the average red blood cell volume (i.e. size); in patients with anemia, this measurement classifies as either microcytic (MCV below normal), normocytic (MCV within normal range), or macrocytic anemia (MCV above normal); in pernicious anemia (macrocytic), normal range is 80-100; MCV can range up to 150 fL; B12 and/or folic acid deficiency has also been associated with macrocytic (high MCV) anemia; most common reasons for microcytic anemia are iron deficiency, thalassemia, or chronic disease; in iron deficiency anemia (microcytic anemia), it can be as low as 60-70 fL; in thalassemia, MCV may be low without being iron deficient; Range: 80.0-100.0 fL
  • Mean corpuscular hemoglobin or “mean cell hemoglobin” (MCH) – the average mass of hemoglobin per red blood cell; MCH is diminished in hypchromic anemias; Range: 26.0-32.0 pg
  • Mean corpuscular hemoglobin concentration (MCHC) – measure of the concentration of hemoglobin in a given volume of packed red blood cells; diminished (“hypochromic”) in microcytic anemias and normal (“normochromic”) in macrocytic anemias (due to larger cell size, though, the hemoglobin amount, or MCH is high, the concentration remains normal); MCHC is high (“hyperchromic”) in hereditary disorders; Range: 32.0-36.0 g/dL
  • Red blood cell distribution width (RDW or RCDW) – measure of the variation of the red blood cell width;  usually RBC’s are a standard size (6-8mcm) but differences indicate certain disorders; higher RDW indicate greater variation in size;  normal reference range is 11-14%; RDW and MCV is used to help differentiate type of anemia of mixed causes from anemia of single cause – Example:  B12 deficiency produces macrocytic anemia w/ normal RDW; however iron deficiency anemia presents with varied size distribution of RBC’s with increased RDW — mixed iron and B12 deficiency, will normally be a mix of both large cells and small cells causing RDW to be elevated; Range: 11.6-16.0%
• Hemoglobin (HGB) – the amount of hemoglobin in the blood; hemoglobin is the protein that binds oxygen to red blood cells in order to help oxygenate tissues throughout the body; low hemoglobin is considered an anemic state; Range: 12.0-15.0 g/dL (Andrea’s ideal MINIMUM of 12.0)
• Hematocrit (HCT) or packed cell volume (PCV) – the fraction of whole blood that is just red blood cells; measured in a percentage; Range: 35.0-49.0% (Andrea’s ideal 38+)
• Total white cells – all white cell types are given as percentage and given as an absolute number per liter; if CBC w/diff, then following:
  • Neutrophil granulocytes – may indicate bacterial infection; may also indicate acute viral infections; Range: 1.4-6.5 X10^9/L
  • Lymphocytes – higher with some viral infections; Range: 1.2-3.4 X10^9L
  • Monocytes - may be raised in bacterial infections; Range: 0.1-0.6 X10^9L
  • Eosinophil granulocytes – increased in parasitic infections, asthma, or allergic reactions; Range: 0.0-0.7 X10^9L
  • Basophil granulocytes – may be increased in bone marrow-related conditions; Range: 0.0-0.2 X10^9L
• Platelets - numbers given as well as info about there size, range of sizes in the blood; platelets are small cell fragments that are rich in growth factors and are important to blood clotting action; too few lead too bleeding disorders, too many could lead to blood clots; Range: 150-450 X10^9L