Blood Count: Reading the Report, Abbreviations and Values
The complete blood count is the most common test you will ever hold in your hand and, more often than not, the one nobody explains. The report carries about twenty abbreviations, and most people look only at the asterisks next to the numbers. In this article every abbreviation is explained in one sentence, together with reference values for adults, the patterns a doctor looks for when reading the report, and the point beyond which a blood count is no longer a matter of interpretation but of an appointment with a hematologist.
The red cell line: red blood cells, hemoglobin and their indices
| Abbreviation | What it is | Reference values (adults) |
|---|---|---|
| RBC (Er) | The number of erythrocytes, the red blood cells | men 4.3 to 5.7; women 3.9 to 5.1 ×10¹²/L |
| HGB (Hb) | Hemoglobin, the protein that carries oxygen. The main number for anemia. | men 138 to 175; women 119 to 157 g/L |
| HCT | Hematocrit, the share of red cells in the volume of blood | men 0.41 to 0.53; women 0.36 to 0.46 |
| MCV | The average size of a red cell. Small cells (a low MCV) most often mean iron deficiency, large ones (a high MCV) a shortage of vitamin B12 or folate, alcohol, liver disease or thyroid disease. | 83 to 97 fL |
| MCH | The average amount of hemoglobin in a single red cell; it tracks MCV | 27 to 33 pg |
| MCHC | The concentration of hemoglobin in the red cells; low in iron deficiency | 320 to 360 g/L |
| RDW | How much the red cells differ from one another in size. A raised RDW with a low MCV is typical of iron deficiency, because new, small cells are circulating alongside older, normal ones. | 11.5 to 14.5 % |
A low hemoglobin means anemia, but only the indices say which kind. A low MCV with a high RDW points to iron; a high MCV to B12 or folate; a normal MCV to chronic disease, the kidneys or recent bleeding. That is why ferritin, iron, TIBC, B12 and folate are requested as soon as anemia is suspected, because the blood count says that anemia is there but not why. There is more on treating iron deficiency in the article on iron infusion.
The white cell line: white blood cells and the differential
| Abbreviation | What it is | Reference values (adults) |
|---|---|---|
| WBC (Le) | The total number of leukocytes, the white blood cells | 4.0 to 10.0 ×10⁹/L |
| NEU | Neutrophils; they rise with bacterial infections, stress, corticosteroids and smoking | 40 to 70 % (2.0 to 7.0 ×10⁹/L) |
| LYM | Lymphocytes; they rise with viral infections and fall after some viruses and with corticosteroids | 20 to 40 % (1.0 to 3.5 ×10⁹/L) |
| MON | Monocytes; mildly raised in chronic infections and in recovery | 2 to 8 % |
| EOS | Eosinophils; raised with allergies, asthma and parasites | 1 to 4 % |
| BAS | Basophils; rarely clinically important on their own | 0 to 1 % |
Mildly raised white cells with raised neutrophils are most often an infection, and can just as easily follow stress, training, smoking or corticosteroids. Mildly lowered white cells are often viral or caused by medication and come back to normal at a check in two to four weeks. The result that must not wait: white cells above 30 or below 2 ×10⁹/L, or a note from the laboratory that immature cells were seen, alongside a low hemoglobin or low platelets. That combination belongs with a hematologist, not on a forum.
Platelets: PLT, MPV, PDW and PCT
| Abbreviation | What it is | Reference values (adults) |
|---|---|---|
| PLT (Tr) | The number of platelets, the blood cells that clot | 150 to 400 ×10⁹/L |
| MPV | The average size of a platelet; high when new, large ones are being made | 7 to 11 fL |
| PDW | The spread of platelet sizes; on its own it rarely changes a decision | by laboratory |
| PCT | Plateletcrit, the share of platelets in the blood; it tracks PLT | 0.1 to 0.3 % |
Raised platelets are surprisingly often the consequence of iron deficiency or of inflammation in the body, and they normalize once that is dealt with. Platelets below 100 ×10⁹/L, and especially below 50, together with bruising or bleeding from the gums or nose, go to a hematologist without delay. The first step the laboratory often takes by itself is to repeat the sample in a citrate tube, because in some people the platelets clump together inside the tube and come out “falsely” low.
ALT, AST, GGT and CRP are not part of the blood count
Many people ask for them under “blood count”, so it is worth clearing up. ALT, AST, GGT, bilirubin, creatinine, glucose, cholesterol and iron are biochemistry, a separate panel run from a different part of the sample. ALT and AST are liver enzymes (usually below about 40 U/L, somewhat lower in women), and GGT is the enzyme that rises with alcohol, fatty liver and medication. CRP and the sedimentation rate are markers of inflammation and have an article of their own: CRP and sedimentation rate: what raised values mean. When you ask for “a blood count and biochemistry”, you get both groups together.
How a doctor reads the report, and when to repeat it
A doctor does not look at the asterisks but at patterns: the red line as a whole (Hb, MCV and RDW together), the white line with its differential, the platelets, and all of it against how you feel. A single value a hair outside the range, with no symptoms, is most often biological variation and is rechecked in four to eight weeks. It is worth knowing that dehydration thickens the blood and lifts hemoglobin and hematocrit, that training and smoking raise the white cells, and that pregnancy physiologically lowers hemoglobin and platelets.
You see a hematologist when anemia has no clear cause or does not improve on iron, when white cells or platelets are markedly high or low, when two or three cell lines are affected at once, or when the laboratory notes atypical cells. At the Miren Medic clinic the hematology appointment is held by Assist. Prof. Dr Danijela Leković, a subspecialist in hematology, with no referral needed, and the blood count and biochemistry are run in the clinic laboratory. More about the service on the hematologist Belgrade page.
Prices
| Service | Price |
|---|---|
| Hematologist appointment (Assist. Prof. Dr Danijela Leković) | 12.000 RSD |
| Follow-up hematology appointment | 10.000 RSD |
| Internal medicine appointment (Dr Andreja Kovačević) | 6.000 RSD |
| General practitioner appointment | 4.000 RSD |
Check it now
- Blood count interpreter: enter your values and see what is low or high and which doctor to see.
Frequently asked questions
What is MCV in a blood count?
The average size of a red blood cell, normally 83 to 97 fL. A low MCV most often means iron deficiency, and a high MCV a shortage of vitamin B12 or folate, alcohol, or liver and thyroid disease. It is read together with hemoglobin and RDW.
What does a raised RDW mean?
That the red cells are not all the same size. With a low MCV that is the classic picture of iron deficiency, and with a high MCV of a B12 or folate shortage. A raised RDW on its own, with a normal hemoglobin and MCV, is rarely significant.
What are normal white blood cell values?
In adults 4.0 to 10.0 ×10⁹/L. Mildly raised white cells are most often an infection, stress, training or smoking, and mildly lowered ones a virus or medication. Values above 30 or below 2 call for a hematologist.
Are ALT and AST part of the blood count?
No. ALT and AST are liver enzymes and belong to biochemistry, as do GGT, glucose, creatinine and cholesterol. When you order “a blood count and biochemistry”, you get both groups from the same blood draw.
When should a blood count be repeated?
A single value slightly outside the range with no symptoms is rechecked in four to eight weeks. A report with a very low hemoglobin, platelets below 100 or white cells outside the 2 to 30 range does not wait for a recheck, it goes to an appointment.
Which doctor interprets a blood count?
A routine report is interpreted by a general practitioner or an internist. A hematologist steps in for anemia with no clear cause, for disorders of the white cells or platelets, and when more than one cell line is affected at once. At the Miren Medic clinic both appointments are booked without a referral.
Book an appointment
If your blood count holds values you do not understand, or your anemia is not improving, book an appointment at the Miren Medic clinic. The blood count, biochemistry, iron and vitamins are run in the clinic laboratory, and you get the interpretation and the plan in the same place, without a referral.
