Content
Macrocytosis is a term that can appear in the blood count report that indicates that the red cells are larger than normal, and the visualization of macrocytic red blood cells may also be indicated in the exam.Macrocytosis is assessed using the Average Corpuscular Volume (VCM), which indicates the average size of red blood cells, with the reference value between 80.0 and 100.0 fL, however this value may vary according to the laboratory.
Thus, macrocytosis is considered when the VCM is above 100.0 fL. For macrocytosis to have clinical relevance, it is important that the CMV is evaluated together with other indices present in the blood count, such as the number of red blood cells, hemoglobin, RDW, which assesses the variation in the size of red blood cells, Average Corpuscular Hemoglobin (HCM) and Average Corpuscular Hemoglobin (CHCM).
Main causes
The increase in the size of red blood cells is more common to happen in older people, because it is common that there is a decrease in the amount of available oxygen, with the need to increase the uptake of this gas to transport it to the organism, resulting in an increase in red blood cells.
However, macrocytosis can happen at any age and is mainly related to nutritional changes, however it is also possible that it is a consequence of other health conditions such as alcoholism or bone marrow changes.
Thus, the main causes of macrocytosis are:
1. Vitamin B12 deficiency
The decrease in the amount of vitamin B12 in the body is one of the main causes of macrocytosis and can happen due to the change in the absorption process of this vitamin in the intestine or due to the decrease in the amount of vitamin B12 consumed throughout the day.
In addition to macrocytosis, it is common for people with this vitamin deficiency to have anemia, also called pernicious anemia, and for this reason it is common to develop some symptoms such as weakness, tiredness and shortness of breath. Learn to identify the symptoms of vitamin B12 deficiency.
What to do: It is important that in addition to the blood count, the dosage of vitamin B12 is made, as it is possible to confirm the diagnosis and start the most appropriate treatment, which may include changes in diet or use of supplements according to the doctor or doctor's recommendation. nutritionist.
2. Folate deficiency
Folate deficiency, also known as folic acid or vitamin B9, is also a major cause of macrocytosis and can happen due to decreased consumption of this vitamin or due to inflammatory bowel diseases or increased demand for this vitamin, as it happens in pregnancy, for example.
In addition to macrocytosis, in this case it is also possible to observe in the blood picture the presence of changes within the red blood cells, the presence of hypersegmented neutrophils and variation in the shape of the red blood cells, known as poikilocytosis. Understand what poikilocytosis is.
What to do: After identifying the cause of folate deficiency, the most appropriate treatment is indicated, and an increase in the consumption of this vitamin or use of supplements may be recommended. In the event that folate deficiency is related to intestinal changes, the doctor may recommend the treatment of the disease, as it is also possible to regulate the levels of folic acid in the body.
3. Alcoholism
Frequent consumption of alcoholic beverages can lead to a progressive decrease in folic acid, which can favor the development of larger red blood cells, in addition to inducing other biochemical changes.
What to do: It is recommended to reduce the consumption of alcoholic beverages, as it is thus possible to promote the proper functioning of the body. However, in some cases, the chronic consumption of alcoholic beverages can lead to changes in the liver, mainly, and in these cases it is recommended to change eating and living habits and carry out the treatment according to the doctor's recommendation.
4. Bone marrow changes
The bone marrow is responsible for the production of blood cells, and can produce larger red blood cells due to changes in their functioning, as a consequence of leukemia or being just a body's response against anemia, for example.
What to do: In this case, if other changes are found in the blood test, it may be recommended by the doctor to perform a myelogram or bone marrow biopsy to identify the cause of the changes and, thus, initiate the most appropriate treatment.