Greetings, Dr. Roach We have spent around 30 years living at 6,000 feet. Our mean corpuscular volume (MCV), which normally ranges from 79 to 97 fl, has gradually climbed to 100 fl over the years. Due to living at a high altitude, our primary care physician and other medical professionals have reported seeing larger red blood cells than usual in other patients.
I am in my 60s, and my spouse is in his 80s. Our blood test results have been largely normal, and we are in good health. Will we eventually need to be concerned about our MCV levels if they keep rising? — S.K.A.
ANSWER: The most widely used indicator of red blood cell size is MCV levels. Red blood cells can be larger than usual for a variety of common reasons, such as low thyroid, low vitamin B12, low folic acid, alcohol consumption, certain medications, and a wide range of blood disorders.
Your doctors are correct, though, in stating that there is a slight rise in MCV levels among those who live at higher elevations. Since their levels are often 6 points higher, the typical range at high altitude could be between 86 and 103 feet.
Since huge red blood cells of this size are not dangerous, the question is whether altitude is the only possible reason. If it continues to rise, your physician may prescribe laboratory testing or recommend that you see a hematologist, a specialist in blood disorders.
More advice
-
Dear Annie: Holiday cheer, in the form of poems, makes your season bright
-
Asking Eric: What’s an appropriate reward for person who found, and returned, my lost wallet?
-
Dear Abby: Before she died my sister promised me specific belongings. Her husband hasn t given me anything
Greetings, Dr. Roach At the age of 85, I am a woman in comparatively good health. I had taken raloxifene for around forty-five years. According to my doctor at the time, I should take it for the rest of my life to help prevent osteoporosis and breast cancer because I had a total hysterectomy. I have a normal bone density.
Because she was unfamiliar with the medication, my doctor declined to renew my prescription a few months ago. I want to know what you think about this choice. — H.W.
ANSWER: In the United States, raloxifene was authorized for usage in 1997 to prevent osteoporosis and in 2007 to lower the risk of breast cancer. The majority of medical professionals who recommend raloxifene do so with the intention of long-term use.
Osteoporosis medications that slow down bone absorption are linked to an increased risk of atypical femur fractures if taken for an extended period of time, which is one reason why many people are worried about taking them. This class includes bisphosphonate medications such as risendronate and alendronate. Devastating atypical femur fractures are also linked to RANKL activators such denosumab. After three to five years, these medications are often reevaluated and discontinued.
In contrast, there does not appear to be a substantial risk of an atypical femur fracture with raloxifene, which functions as an estrogen to strengthen bones (and an anti-estrogen to prevent breast cancer).
You are way passed the published literature because the long-term safety study on raloxifene lasted for eight years. However, I don’t believe that the appropriate course of action was to refuse to re-prescribe the medication. It could have been wise for her to send you to an osteoporosis specialist if she felt uneasy doing so.
Note: Every piece of content is rigorously reviewed by our team of experienced writers and editors to ensure its accuracy. Our writers use credible sources and adhere to strict fact-checking protocols to verify all claims and data before publication. If an error is identified, we promptly correct it and strive for transparency in all updates, feel free to reach out to us via email. We appreciate your trust and support!