Mean corpuscular volume is a measurement of the average size of red blood cells. The test is a useful marker for the differential diagnosis of anaemia and can also indicate dysfunction associated with bone marrow.
The mean corpuscular/cell volume is a useful assessment tool for underlying anaemia. The test can be used in conjunction with other measurements including mean corpuscular haemoglobin concentration and mean corpuscular haemoglobin. All these measurements were first introduced in 1929 by Wintrobe to help to define the size of red blood cells.
Anaemias can be classified according to the size of the cell i.e.:
In conjunction with the other red cell indices and symptoms a diagnosis can be made.
High MCV is an indicator of macrocytic anaemia and is relatively common. There are various causes associated with the development of macrocytic anaemia, including:
Vitamin B12 deficiency is a relatively common condition which can be serious. The condition can lead to an increased MCV. The western diet contains around 5-30µg of vitamin B12 per day with up to 1.5µg being absorbed. Our body storage is relatively high, so depletion occurs over a period of several years so it can take this long for the condition to manifest. The symptoms of vitamin B12 deficiency can include:
Neurological disturbances with high MCV
Low MCV can indicate microcytic anaemia with a common cause being iron deficiency anaemia. The usual cause for iron deficiency is a lack of iron and symptoms can include:
Your diet can help to keep anaemia at bay. Eating a healthy and balanced diet and ensuring you get all of the nutrients you need will help to keep your MCV level normal.
If your MCV level is low there is a good chance your iron level is low too. Good sources of dietary iron include:
Plant-based sources of iron such as dark green leafy vegetables, nuts, seed, pulses and fortified cereals may be absorbed better in the presence of vitamin C. Try eating fortified breakfast cereals alongside a glass of orange juice or swap chips for a jacket potato with a side of green leafy veg – be sure to eat the skin of the potato.
You should also refrain from drinking tea with your meals as this can affect iron absorption. Instead, you should drink it between meals to ensure you absorb iron effectively.
You also need to make sure your vitamin B12 levels are adequate too. However, you should avoid eating too much as this can have adverse effects and could contribute to a high MCV. Good sources of vitamin B12 include:
As vitamin B12 is found only in animal products, vegetarians and vegans can find themselves at risk of becoming deficient. Therefore, these groups may need to consider supplementation.
Exercise is an important aspect of a healthy lifestyle. Regular exercise can help to increase blood flow to muscles which enables oxygen to reach the tissues. Exercise also helps to increase the oxygen carrying capacity of red blood cells.
Both too much and too little iron can influence energy levels and could affect your ability to exercise. Low iron can also influence how well and quickly your muscles repair themselves after exercise. Iron deficiency anaemia may also be more common in athletic groups and may need iron supplementation.
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