Blood cells

[Fedup]

I am just hoping someone can give me a bit more insight into this. I had blood work done and part of what came back is enlarged "red blood cells" has anybody had similar experience or know about this. I believe my drugs are responsible and this is causing me problems.

 

[masterjen]

Macrocytosis can be due to anemia, low folate, low B12 , renal insufficiency, and hepatic diseaase.
There are also a couple of inherited disorders that can be associated with macrocytosis, so sometimes the condition is detected inadvertently. One would think that if it is an inherited disorder that it would be present from birth but this is not guaranteed, as I am learning. Genes have a way of "kicking in" much later in life as well.
http://emedicine.medscape.com/article/203858-clinical

 

[Nakamova]

Most common cause for enlarged red blood cells: Pregnancy (I think we can rule this out in your case), alcohol abuse (we can rule that out too) and vitamin deficiencies (folic acid and/or B12). The deficiencies can be caused by absorption problems related to stomach or bowel inflammation and bleeding, and things like celiac disease.

Some anti-seizure meds can also cause those deficiencies that in turn lead to enlarged RBC: Phenytoin (Dilantin/Epineuton), Primidone (Mysoline), Phenobarbital, Valproic Acid (Depakote). So the Epineuton you are taking could be the main problem, especially since you are taking a fairly hefty dose. It's pretty rare, but Lamictal has been associated with "macrocytic anemia" (enlarged RBC and deficiencies) when it's used long-term as an add-on drug. Zebinix is relatively new so the side effects may not be well-known, but carbamazepine (the med it's based on) isn't known to cause enlarged red blood cells. It can cause folate deficiency, so at the very least it's another reason to supplement with folic acid and/or B12.

Bone marrow disorders can also cause enlarged RBC, but those tend to be progressive (i.e. there would be a significant increase from one test to the next), and there are specific blood tests used to rule it out.

You should ask your GP for specifics about the results. You are already supplementing with B12 if I remember right, but maybe the supplement needs to be higher or done via injection?

 

[Fedup]

masterjen

Thank you for the reply and the information I have gone back on the folic acid myself.

 

[Fedup]

Nakamova

That is some good information my friend, I think your right we can rule out the Pregnancy and the drink. I am getting B12 injections already but maybe they need to be increased, I have started back on the folic acid myself. As you know I have my problem with bleeding and this bothers me a lot.

As you said and I agree I think I am on the phenytoin to long, I think this could be the root of the problem.

 

[AlohaBird]

Some anti-seizure meds can also cause those deficiencies that in turn lead to enlarged RBC: Phenytoin (Dilantin/Epineuton), Primidone (Mysoline), Phenobarbital, Valproic Acid (Depakote).

Thanks, Nak. Those are my two. I wonder if eating lots of red meat helps. I know it helps with the B12.