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Dr. SH
Dr. SH, Board Certified Physician
Category: Medical
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Experience:  Doctor of Medicine
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I have had a blood test as on methotrexate,it showed a hgb

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I have had a blood test as on methotrexate,it showed a hgb of 10,a low htc of 0.31.5 and a mch of 24.4 and a count of 15 in nucleated red blood cells.can this be linked to anaemia or methotraxate please and is it anything to worry about as I shouldn't have a reading of nucleated rbc I don't think ? I am iron deficient and take iron tablets which I have not taken recently,and my hgb has fallen,I am concerned about the nucletaed rbc count.can you please explain many thanks.all my other fbc were in normal range.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. SH replied 1 year ago.
Hi there.
Thank you for your question.
I will be helping you out with your queries.
A hemoglobin of 10 is slightly on the lower side but is not something alarming.
Methotrexate can by itself cause anemia and you not taking iron is actually worsening the issue as far as I am concerned.
Methotrexate also causes anemia by reducing the availability of folic acid for red cell production. I hope you are also taking folic acid as well while on methotrexate.
The nucleated RBCs is not something to worry about a great deal.
It only means release of immature blood cells from the bones.
Immature blood cells can be released when iron or folic acid are low.
So the nucleated RBCs in itself is not something that I would worry about too much at all.
Let me know if you have more questions.
I would appreciate it if you rate me by clicking on one of the smilies below.
Kind regards
Dr. SH, Board Certified Physician
Category: Medical
Satisfied Customers: 8765
Experience: Doctor of Medicine
Dr. SH and other Medical Specialists are ready to help you
Customer: replied 1 year ago.
I will start taking my iron tablets daily now I know I'm not helping the blood test results.what about the low hct and low mch is this all low cos I have low hgb too please .thankyou so much for your advice I was worrying for nothing I think. thankyou
Expert:  Dr. SH replied 1 year ago.
Low hematocrit is because of the low hemoglobin.
Both of these are interrelated.
Low MCH happens with low iron.
So there is nothing out of the ordinary in your report or anything serious to worry about.

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