Section 7.1 Laboratory

Laboratory Report #29

Date

Collection Date: July 19, 2023
Report Date: July 20, 2023

Laboratory

Labcorp

Ordering Physician

Dr. Billy R. Boring, Jr.

Report Type

Complete Blood Count (CBC) Follow-up Evaluation

Laboratory testing included:

Complete Blood Count (CBC) with Differential and Platelets

Original Report

PDF: Labcorp – July 19, 2023

One-Page Summary

Purpose of Testing

This laboratory evaluation was performed approximately three weeks after the June 28, 2023 comprehensive laboratory study to reassess the newly identified anemia. Rather than repeating the full chemistry profile, this report focused exclusively on the Complete Blood Count (CBC) to determine whether the decline in red blood cell indices represented a temporary variation or a continuing trend. The results confirmed that the anemia had progressed slightly, while white blood cells and platelets remained stable.

Major Findings

Complete Blood Count

Results

Test	Result	Reference Range
WBC	6.4 ×10³/µL	Normal
RBC	3.96 ×10⁶/µL	Low
Hemoglobin	11.8 g/dL	Low
Hematocrit	35.6%	Low
MCV	90 fL	Normal
Platelets	228 ×10³/µL	Normal

Interpretation

This report confirms that the mild anemia identified in June 2023 continued to worsen slightly.

Comparison with June 28, 2023:

Test	June 2023	July 2023
RBC	4.05	3.96
Hemoglobin	12.3	11.8
Hematocrit	36.5%	35.6%

All three measurements declined over the three-week interval.

Importantly:

MCV remained normal (90 fL).
MCH and MCHC remained normal.
RDW remained normal.

This pattern is still most consistent with a mild normocytic, normochromic anemia, similar in character to the anemia documented during your inflammatory illness, although inflammatory markers were not measured in this study.

White Blood Cells

Results

WBC: 6.4 ×10³/µL
Neutrophils: Normal
Lymphocytes: Normal
Monocytes: Normal
Eosinophils: Normal
Basophils: Normal

Interpretation

The white blood cell count and differential remained entirely normal.

There was no laboratory evidence of infection, leukemia, or significant bone marrow suppression based on this CBC.

Platelets

Result

228 ×10³/µL

Reference Range:

150–450 ×10³/µL

Interpretation

Platelet count remained stable and completely normal.

The presence of isolated anemia with preserved platelet and white blood cell counts suggests that the abnormality was limited to the red blood cell line rather than representing generalized bone marrow failure.

Historical Trend

The historical graphs on page 3 visually illustrate the progression:

Hemoglobin

April 2022: 13.1
December 2022: 13.8
June 2023: 12.3
July 2023: 11.8

Hematocrit

April 2022: 39.7%
December 2022: 42.1%
June 2023: 36.5%
July 2023: 35.6%

These graphs clearly demonstrate the gradual decline that prompted continued monitoring.

Overall Interpretation

This focused CBC follow-up confirmed that the anemia identified in June 2023 was persistent rather than transient. Hemoglobin, hematocrit, and RBC count all declined modestly over a three-week period, while white blood cells and platelets remained normal. The persistence of a normocytic anemia suggested the need for continued clinical evaluation and additional laboratory monitoring to determine the underlying cause.

Longitudinal Significance

This report contributes to:

CBC Trend Table
Hemoglobin Trend Table
Hematocrit Trend Table
Red Blood Cell Trend Table
Medical History Timeline
Anemia Evaluation

This report documents the lowest hemoglobin value recorded since recovery from the 2021 inflammatory illness.

Clinical Importance

⭐⭐⭐⭐ Anemia Monitoring Milestone

Although this report contains only a CBC, it is clinically important because it demonstrates that the anemia seen in June 2023 was not simply a laboratory fluctuation. The downward trend justified continued follow-up and further evaluation.

Key Changes Since Previous Report

Compared with June 28, 2023:

RBC decreased from 4.05 → 3.96 ×10⁶/µL.
Hemoglobin decreased from 12.3 → 11.8 g/dL.
Hematocrit decreased from 36.5% → 35.6%.
White blood cell count remained normal.
Platelet count remained stable.
Red blood cell indices remained normocytic and normochromic.

Related Reports

June 28, 2023 – Comprehensive Health Follow-up Evaluation
December 7, 2022 – Annual Health Evaluation
CBC Trend Table
Hemoglobin Trend Table
Anemia Evaluation
Medical History Timeline

Navigation

Previous Report: June 28, 2023 – Comprehensive Health Follow-up Evaluation
Next Report: Subsequent 2023 Laboratory Evaluation
Return to Laboratory Library
Return to Health Inventory

Observation

This report highlights why serial laboratory testing is often more informative than a single laboratory result. The June 2023 study raised concern by showing the return of mild anemia. This July 2023 follow-up confirmed that the decline was continuing rather than resolving.

Looking across the entire Health Inventory, the sequence now appears as:

2021: Significant normocytic anemia associated with severe systemic inflammation.
2022: Complete hematologic recovery.
Mid-2023: Gradual recurrence of mild normocytic anemia despite otherwise stable laboratory findings.

Because your later laboratory studies document further improvement following your dietary changes, this report becomes an important reference point in understanding the full course of your hematologic health. The trend charts on page 3 effectively visualize this temporary decline and should be referenced when discussing your history with your physicians.