Full Blood Count (FBC)
As determined by your doctor; there are many illnesses which will affect the full blood count (FBC) and the result may help to make a diagnosis
A blood sample taken from a vein in the arm or a finger-prick or heel-prick (newborns)
The full blood count (FBC) is one of the most commonly requested tests and provides important information about the kinds and numbers of cells in the blood: red blood cells, white blood cells and platelets. Abnormalities in any of these types of cells can indicate the presence of important medical disorders.
Blood is composed of a variety of living cells that circulate through the heart, arteries and veins carrying nourishment, hormones, vitamins, antibodies, heat and oxygen to the body's tissues. Blood contains three main components — red blood cells, white blood cells, and platelets — suspended in fluid, called plasma. Red blood cells contain haemoglobin, a protein that carries oxygen to all the tissues of the body. Among other functions, white blood cells are responsible for protecting the body from invasion by foreign substances such as bacteria, fungi and viruses. White blood cells also control the immune process. Platelets help the blood clotting process by plugging holes in broken blood vessels.
How is it used?
The FBC is used as a broad screening test to check for such disorders as anaemia, infection, and many other diseases. It is actually a panel of tests that examines different parts of the blood and includes the following:
- White blood cell (WBC) count is a count of the actual number of white blood cells per volume of blood. Both increases and decreases can be significant.
- White blood cell differential: looks at the types of white blood cells present. There are five different types of white blood cells, each with its own function in protecting us from infection. The differential classifies a person's white blood cells into each type: neutrophils, lymphocytes, monocytes, eosinophils, and basophils.
- Red blood cell (RBC) count: is a count of the actual number of red blood cells per volume of blood. Both increases and decreases can point to abnormal conditions.
- Haemoglobin measures the amount of oxygen-carrying protein in the blood.
- Haematocrit measures the amount of space red blood cells take up in the blood. It is reported as a percentage (0 to 100) or a proportion (0 to 1).
- The platelet count is the number of platelets in a given volume of blood. Both increases and decreases can point to bleeding or bone marrow disorders.
- Mean platelet volume (MPV) is a machine-calculated measurement of the average size of your platelets. New platelets are larger, and an increased MPV occurs when increased numbers of platelets are being produced.
- Mean corpuscular volume (MCV) is a measurement of the average size of your RBCs. The MCV is elevated when your RBCs are larger than normal (macrocytic), for example in anaemia caused by vitamin B12 deficiency or folic acid deficiency. When the MCV is decreased, your RBCs are smaller than normal (microcytic), which may indicate iron deficiency anaemia, inflammation or occasionally thalassaemias.
- Mean corpuscular haemoglobin (MCH) is a calculation of the amount of oxygen-carrying haemoglobin inside your RBCs. Since macrocytic RBCs are larger than either normal or microcytic RBCs, they would also tend to have higher MCH values.
- Mean corpuscular haemoglobin concentration (MCHC) is a calculation of the concentration of haemoglobin inside the RBCs. Decreased MCHC values (hypochromia) are seen in conditions where the haemoglobin is abnormally diluted inside the red cells, such as in iron deficiency anaemia, long standing inflammation or thalassaemia. Increased MCHC values (hyperchromia) are seen in conditions where the haemoglobin is abnormally concentrated inside the red cells, such as in hereditary or autoimmune spherocytosis.
- Red cell distribution width (RDW) is a calculation of the variation in the size of your RBCs. In some anaemias, such as iron deficiency or vitamin B12 deficiency, the amount of variation (anisocytosis) in RBC size (along with variation in shape – poikilocytosis) causes an increase in the RDW.
When is it requested?
The FBC is a very common test used to screen for, help diagnose, and to monitor a variety of conditions.
If a patient is having symptoms associated with anaemia, such as fatigue or weakness, or has an infection, inflammation, bruising, or bleeding, then the doctor may order a FBC to help diagnose the cause. Significant increases in WBCs may help confirm that an infection is present and suggest the need for further testing to identify its cause. Decreases in the number of RBCs (anaemia) can be further evaluated by changes in size or shape of the RBCs to help determine if the cause might be decreased production, increased loss, or increased destruction of RBCs. A platelet count that is low or extremely high may need further investigation.
Many conditions will result in increases or decreases in the cell populations. Some of these conditions may require treatment, while others will resolve on their own. Some diseases, such as cancer (and chemotherapy treatment), can affect bone marrow production of cells, increasing the production of one cell at the expense of others or decreasing overall cell production. Some medications can decrease WBC counts, and some vitamin and mineral deficiencies can cause anaemia. The FBC test may be requested by the doctor on a regular basis to monitor these conditions and drug treatments.
What does the test result mean?
The following table explains what increases or decreases in each of the components of the FBC may mean.
Components of the FBC
Test Name Increased/decreased WBC White Blood Cell May be increased with infections, inflammation, cancer, leukaemia; decreased with some medications, some autoimmune conditions, some viral or severe infections, bone marrow failure, enlarged spleen, liver disease, alcohol excess and congenital marrow aplasia (marrow doesn't develop normally). For more information, see Blood Film and WBC. % Neutrophil This is a dynamic population that varies somewhat from day to day depending on what is going on in the body. Neutrophils are one of the first lines of defence against bacterial infection. The 'normal' level of neutrophils differs between ethnic groups. Lymphs Lymphocyte Can be increased or decreased by viral infections. Can be increased in conditions such as chronic lymphocytic leukaemia % Mono Monocyte Can be increased with some types of infection eg. TB and and bone marrow disorders eg. Myelodysplasia % Eos Eosinophil Can be increased due to atopy (asthma, hay fever, eczema) drug allergies, some parasitic infections and with other conditions including vasculitis, Hodgkin’s lymphoma and bone marrow disorders % Baso Basophil Can be increased in some infections, inflammatory disorders and in bone marrow disorders eg. chronic myeloid leukaemia RBC Red Blood Cell Decreased with anaemia; increased when too many made and with fluid loss due to diarrhoea, dehydration, burns Hb Haemoglobin Mirrors RBC results Hct Haematocrit Mirrors RBC results MCV Mean Corpuscular Volume Increased with B12 and Folate deficiency, liver disease, underactive thyroid, pregnancy, alcohol excess, some bone marrow disorders; decreased with iron deficiency, longstanding inflammatory disorders and thalassaemia MCH Mean Corpuscular Haemoglobin May be low in iron deficiency, inflammatory conditions and thalassaemia MCHC Mean Corpuscular Haemoglobin Concentration Helps with interpretation of MCH and in diagnosis of specific red cell disorders e.g. hereditary spherocytosis RDW RBC Distribution Width Increased RDW indicates abnormal variation in RBC size. Can indicate iron, B12 or folate deficiency or bone marrow disorders Platelet Platelet Increased numbers of platelets occur after bleeding, inflammation, infection and surgery in bone marrow disorders and in patients with absent or underactive spleens. Decreased numbers are associated with immune conditions such as ITP and SLE, vitamin deficiencies, some drugs (especially chemotherapy), alcoholism, liver disease, enlarged spleens, bone marrow disorders and with some rare inherited disorders (such as Wiskott-Aldrich, Bernard-Soulier) MPV Mean Platelet Volume Vary with platelet production; younger platelets are larger than older ones
Is there anything else I should know?
Many different conditions can result in increases or decreases in the cell populations. Some of these conditions may require treatment, while others may resolve on their own.
Recent blood transfusions affect the results of the FBC.
Normal FBC values for babies and children are different from adults. The laboratory will supply the reference ranges for various age groups, and a healthcare professional will take these into consideration when interpreting data.
What can a patient do about their FBC?
Patients who have a keen interest in their own healthcare frequently want to know what they can do to change their WBCs, RBCs, and platelets. Unlike “good” and “bad” cholesterol, cell populations are not generally affected by lifestyle changes unless the patient has an underlying deficiency (such as vitamin B12 or folate deficiency or iron deficiency) or increased alcohol intake. Addressing any underlying diseases or conditions and following a healthy lifestyle will help optimise your body’s cell production and your body will take care of the rest.
On This Site
Tests: Haemoglobin, Haematocrit, Red blood cell (RBC) count, White blood cell (WBC) count, White blood cell differential count, Platelet count
Conditions: Anaemia, Thalassaemia, Vitamin B12 and Folate Deficiency, Sickle Cell Anaemia, Bone Marrow Disorders