macrocytosis/macrocytic anemia?

[BrassicaBabe]

I had a broad ranging private blood test recently for my HRT medic. The test included the results she needed as well as some that she didn't.

MCV was 104.3 fl
MCH was 33.6

Dr Google says macrocytosis or macrocytic anemia.

"Macrocytosis means that the red blood cells are larger than normal. Macrocytic anaemia occurs when there is also a fall in haemoglobin levels in the blood."
(Haemoglobin was 149g/l with is within normal range I believe)

Dr Google also says the causes are:
B12 or folate deficiency
Liver disease
Hypothyroidism
(Blood test results for the above were fine)

The other cause is heavy alcohol drinking.

Of the options, it'll be that one.

I am confident that my drinking isn't in the addition category. But I will put my hands up to it being unhealthy levels.

So, if I reduce my white wine habit, how long would it take to restore this level?

For my understanding, putting aside the unhealthy drinking and focusing on the test results alone, what is the impact of this test result? If it weren't for this broad blood test I'd have not known this detail.

Thanks! Some interpretation would be very helpful

As the other blood tests were ok and you think you drink to unhealthy levels, it’s likely that the raised MCV reflects the direct toxic effect of alcohol on your bone marrow, which makes blood cells.

Alcohol can cause ‘faulty’ cells to be made in the bone marrow - usually this doesn’t have any big/long-term impact (and cells may just be bigger than normal - reflected by the high MCV result), and wouldn’t lead to progressive problems - but by exposing bone marrow to high levels of alcohol over time you increase the risk of developing an abnormality that could cause longer-term issues with how blood cells are made and mature, which can impact on your health.

So at the moment this is likely to not have any immediate implications, as macrocytosis is in itself is not a problem, but whatever causes it might be a problem! If alcohol is the cause then it will probably be reversible with abstinence/decreased alcohol, but the result now does reflect that the amount of alcohol you are drinking is impacting your bone marrow, and so likely other organs too.

Red blood cells live around 3 months before being destroyed, so if you abstain/cut down to lower levels of alcohol intake your MCV should normalise by around 4 months after that change.

Best to discuss the results with your Dr now to make sure no other cause are overlooked, (and if you decide to cut down alcohol intake to arrange to have repeat bloods after cutting down, as if MCV doesn’t normalise afterwards then looking in more detail for other causes may be worthwhile), although the main causes for high mcv are those you listed above (and have had bloods for already).

Thank you @PeppyC Thank you for taking the time to write such a comprehensive answer. Four months then. That makes total sense.

I'm a runner. (Ish-ly 🤣) While reducing my alcohol I've also been trying to work out what impact this high MCV might be making me feel during training. (Not the MOST important I concede. But any negative effects would focus my resolve the reduce).

Mine are always at this level. Even though my vitb12 and folate seemed fine, they suspected I wasn't getting enough folate so I took folic acid for 6 months and it improved slightly.

But even with that, mine remained higher than normal and as mine always looks like this, I've been told it's normal for me

They did say that as long as you're not unwell with other things, then it may just be normal for you.