What is a MCV count and how can I lower it?

The MCV or Mean Corpuscular Volume count, is tested as part of a routine blood test called the full blood count and measures the average size of our red blood cells. You may have found that your MCV level is slightly raised incidentally as part of a routine blood test, or this may have been specifically tested to try and discover a cause for any underlying symptoms.

Red blood cells are responsible for transporting oxygen from our lungs to all other areas of the body, so it’s important that we know whether these are ‘healthy’ or not.

What is the normal MCV range?

The normal range for the MCV result is usually between 80-100fl for an adult, when we have an abnormal MCV count, a number of symptoms may become apparent.

Low MCV (Microcytic Anemia): This may suggest conditions such as iron deficiency anemia, thalassemia, or chronic disease. In these cases, the body is producing smaller than normal red blood cells, which may not carry enough oxygen, leading to fatigue and other symptoms.

High MCV (Macrocytic Anemia): This could indicate deficiencies in vitamin B12 or folate, liver disease, or hypothyroidism (also known as underactive thyroid). Larger than normal red blood cells can also affect the efficient transport of oxygen, potentially leading to similar symptoms.

Symptoms of abnormal MCV (either high or low)

Symptoms may include:

• Shortness of breath
• Tachycardia (fast heart rate)
• Chest pain
• Pale skin
• Headache
• Fatigue or weakness

Fatigue can be caused by numerous factors, including sleep deprivation, stress, and chronic illnesses, and is not solely linked to MCV abnormalities.

Similarly, symptoms such as tachycardia (fast heart rate) and chest pain can arise from cardiovascular issues or anxiety. This highlights the importance of evaluating the overall clinical picture.

However, it's essential to remember that these symptoms are quite general and can be related to multiple underlying causes, so it is always best to discuss your symptoms with your doctor for a proper assessment.

If someone is experiencing:

• Fatigue
• Bruising or bleeding easily
• Unexplained weight loss
• Jaundice
• Cold hands and feet
• Looking paler than usual

Then doctors may check MCV levels, as these above symptoms can indicate that the size of red blood cells are either smaller or larger than normal.¹

What can cause an abnormal MCV count?

There are some underlying health conditions that may lead to an abnormal MCV count.

Reduced MCV

This is when a person’s MCV level is below 80fl, and possible causes of this could be:

• Chronic inflammatory disorders: Conditions like rheumatoid arthritis can impact the production of red blood cells and cause them to be smaller.
• Iron deficiency: This is one of the most common causes of low MCV, often arising from a lack of iron in the diet, chronic blood loss, or malabsorption issues.
• Thalassaemia: an inherited blood disorder that affects the amount of haemoglobin a person creates.

Increased MCV count

This is when the MCV level is above 100fl and potential causes could be:

• Folate or Vitamin B12 deficiency: Insufficient levels of these vitamins can disrupt red blood cell production in the bone marrow, leading to larger cells.
• Excess alcohol intake: Chronic alcohol consumption can impair the body’s ability to absorb vitamins and produce healthy red blood cells; resulting in macrocytic anemia.
• Liver disease: Liver dysfunction can affect the production of proteins needed for red blood cell formation, leading to changes in cell size.
• Underactive thyroid: An underactive thyroid can slow down the body’s metabolic processes, including the production of healthy red blood cells.
• Pregnancy: Increased plasma volume during pregnancy can dilute the concentration of red blood cells, resulting in macrocytic readings.
• Some bone marrow disorders: Conditions that affect bone marrow function can lead to abnormal red blood cell production and size.

How to help keep your MCV level normal

There are some natural steps we can take to help ensure our MCV level remains within the healthy range.

Diet

Eating a balanced and varied diet full of vitamins and nutrients can help keep our blood levels on track. Ensuring we’re having enough iron and folate in our diet through foods such as:

• Spinach
• Quinoa
• Beans, such as red kidney beans, edamame beans and chickpeas
• Nuts
• Dried fruit – such as dried apricots
• Fortified breakfast cereals
• Soybean flour²

As well as enough B vitamins such as:

Vitamin B9 (also known as folate) – this can be found in broccoli, brussels sprouts, leafy green vegetables, peas, chickpeas and kidney beans and breakfast cereals fortified with folic acid. Folate helps the body form healthy red blood cells.³

Vitamin B12 – this can be found in meat, fish and dairy products, however sources for vegans are limited and a vitamin B12 supplement may be needed. Sources of vitamin B12 for vegans include:

• breakfast cereals fortified with B12,
• unsweetened soya drinks fortified with vitamin B12,
• yeast extract, such as Marmite, and nutritional yeast flakes which are fortified with vitamin B12.⁴

>Find some inspiration for maintaining a healthy diet with our top 10 superfoods article

Alcohol

Excessive alcohol consumption can lead to a high MCV (Macrocytic Anemia) and has numerous adverse effects on the various types of blood cells and their functions. Heavy alcohol consumption can cause generalized suppression of blood cell production and alcoholics frequently have defective red blood cells that are destroyed prematurely.⁵

If your blood test results show that your MCV levels are higher or lower than the normal range, your doctor may recommend additional tests to identify the underlying cause. Additionally, if you are experiencing any of the symptoms mentioned earlier, it’s advisable to make an appointment with your GP for an evaluation.

References

1. Why do doctors measure MCV levels? - Medical News Today
2. Good sources of iron - NHS
3. Folate and folic acid - NHS
4. The vegan diet - NHS
5. The Hematological Complications of Alcoholism – National Library of Medicine
6. Mean Corpuscular Volume – National Library of Medicine