“CBC with DIFF?”

Okay, let me start with the low hematocrit. The low hematocrit means that you are most likely anemic. The most likely causes are either acute blood los due to trauma and internal bleeding, or chronic blood loss due to an that cause a significant anemia and they can be seen in ulcers, colon cancer. High NCH (high mean corpuscular hemoglobin) is a sign of macrocytic anemia. This condition is a result of not having sufficient vitamin B12 or Folic acid. High MCH is a sign of liver disease. Low red blood cell count indicates that you have anemia. Since you are taking medication and this condition could continue, I recommend for you to go to your healthcare provider or any urgent care facility to review and do the necessary tests and procedure to have a final diagnosis for your condition. Remember, this could be result quit and easy if care is provided sooner than later. Thank you.

All laboratory/imaging results need to be interpreted in the clinical context and the doctor who ordered the tests is usually in the best position to do that. Talk to the doctor who ordered the tests. Having said that, it would have helped had you provided the actual results, not high and low. Wish you good health!

Not too concerned about the anion gap. Request serum B12 and folate testing and also an RBC folate test. You may have megaloblastic anemia. Probably time to see a hematologist.

What are the actual numbers listed for your hematocrit, mean cell HDG, red blood count and low anion gap? You may be anemic but hard to say how seriously anemic without these numbers. Do you have a primary care doctor? Someone needs to be looking at all of your lab test numbers plus examining you to really find out what is going on. Thanks! David Gordon, M,D.

The incidences of low anion gap are very rare, and, in this case, a repeat analysis is definitely needed. However, if after a repeat analysis the anion gap is still law, the conditions associated with low anion gap are decreased albumin level in the blood, decreased sodium level in the blood, bromide ingestion, or Multiple Myeloma. All of these conditions require further investigation to be able to confirm or rule it out. Low Hematocrit, Low MCHC, and Low Erythrocytes (Red Blood Cells), all are consistent with Anemias, irrespective of cause, and chronic fatigue could be attributed to that. The combination of Adderall (a central nervous system stimulant), Zoloft (SSRI antidepressant), and Gabapentin (antineuralgic), contributes also to migraine headache and might lead to serotonin syndrome.