Mean Corpuscular Volume (MCV) Explained by a Doctor in 4 Minutes!
MCV is the average amount of space a red blood cell occupies. Red blood cells are made by the bone marrow using a standard recipe. They aren't clones, but are usually about the same size, between 80-100 femtoliters. When the recipe goes wrong (lack of iron, B12, folate, or other ingredients) the red blood cells come out all different shapes and sizes! Since the main job of red blood cells is to carry oxygen, they need to be well made in order for you to have optimal health. Low MCV is most commonly caused by iron deficiency anemia but may also be caused by thalassemia minor / thalassemia trait. Mild thalassemias are incidentally discovered on routine blood testing and are usually asymptomatic. The MCV in mild thalassemias can be VERY low, around 55-60 femtoliters with only MILD anemia. That is a big clue that you may have a thalassemia instead of iron deficiency anemia. The way to tell the difference for sure is by getting iron studies ferritin, TIBC, and percent transferrin saturation. High MCV is often caused by B12 or folate deficiency or heavy alcohol use. Folate and B12 help with DNA synthesis. When they aren't present, DNA synthesis stops, and the baby red blood cells don't lose their nucleus at the right time. The result is those large adolescent red blood cells are released into the blood, driving up the MCV. B12/folate deficiency diagnosis starts with B12 (cobalamin) and folate levels, but may also include homocysteine and methylmalonic acid levels, as well as a blood smear and other tests.

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0:00 Intro
0:34 What is MCV?
0:50 How Red Blood Cells are Made
1:38 Normal Mean Corpuscular Volume
2:02 What Causes Low MCV?
2:53 What Causes High MCV?
3:31 What to do Next?



This content is not medical advice and is for general informational purposes only. None of the information provided constitutes the practice of medicine, or any professional healthcare services. No doctor patient relationship has been formed. Information contained here is used at the consumer’s own risk. No one should delay or disregard in obtaining professional medical advice or treatment for any health related issue. The information provided is in no way a substitute for medical advice.

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