Abnormal blood statistics of elderly healthy people

68.2% of the subjects had at least one abnormal blood routine indicator. 71.3% of the abnormalities were benign fluctuations caused by physiological decline and transient factors in the elderly. Only 7.8% of the abnormalities pointed to potential pathological risks. The vast majority of the blood routine arrows of healthy elderly people did not require excessive intervention.

The original intention of doing this statistics at that time was that I was really scared to be questioned by the adults who came to the free clinic every day for consultation. Don't tell me, many old people usually don't breathe while carrying rice bags up to the fifth floor. When they get the physical examination report and see the up and down arrows in the blood test, their faces turn pale on the spot. They either think they have a blood disease, or they take their wives to a big hospital overnight to sign up for a specialist, spend thousands of dollars on examinations, and nothing happens in the end. They suffer purely. The one who impressed me the most was 72-year-old Uncle Zhang. He had just climbed more than 300 meters in the countryside with a senior mountaineering team the day before. The next day’s physical examination showed that his white blood cells were 0.2×10^9/L lower than the lower limit of the reference value. He sat at the free clinic with the report and his hands were shaking. He said that he had checked online that it was a precursor to leukemia. I persuaded him for a long time to go home and rest for a week and stop running around. The re-examination results were all normal. The old man later gave us a basket of oranges grown at home.

Interestingly, there is still considerable disagreement among academic circles regarding the high rate of abnormal blood routine in healthy elderly people. One group insists on using the universal blood routine reference intervals for all ages, believing that setting exclusive intervals for the elderly will miss early diagnosis of anemia, infection and other problems; the other group has been calling for adjustments to the reference standards. Taking red blood cell count as an example, the lower reference limit for ordinary adult men is 4.3×10^12/L, but many 6 Elderly people over 5 years old, whose hematopoietic function naturally declines and has no symptoms of hypoxia or fatigue when it drops to 4.0, will be marked as abnormal according to the existing standards. In our statistics, this item alone accounts for 22% of all abnormal items, which is equivalent to nearly a quarter of the arrows actually being misjudged as "standard mismatch."

According to our statistics, the three most common abnormalities in healthy elderly people actually have little to do with diseases. The first one is mildly lowered hemoglobin, which is often called mild anemia, accounting for 31% of all abnormalities. After follow-up, most of the elderly are vegetarians and reluctant to eat eggs and milk. Aunt Li, 70, has been vegetarian for 20 years, and her hemoglobin is 5g/L lower than the reference value. She usually does square dancing for two hours without getting tired. We asked her to add a spoonful of peanut butter to her meals every day, and eat mushrooms and tofu stewed twice a week to supplement iron. After 2 months, the review returned to the normal range. The second most common symptom was a slight decrease in white blood cells or a slightly higher proportion of lymphocytes, accounting for 27%. When asked, either I had a minor cold in the past month and didn't take it seriously, or I stayed up with my grandson for several long nights, and my immunity fluctuated temporarily. Although my body had no symptoms, it was actually slowly recovering. The remaining 18% is a slight fluctuation of platelets. Most of them are related to whether you drank water or strenuous exercise the day before. If you don't drink water on an empty stomach in the morning and your blood is concentrated, your platelets can be more than ten units higher. If you drink two more glasses of warm water and check again, it will go back.

Of course, not all arrows can be ignored. After our follow-up, the abnormality of 9 people was finally found to be a problem. Among them was a 74-year-old man whose platelets were 92×10^9/L lower than the reference value. He said he had no symptoms. Later, it was further investigated that it was immune thrombocytopenia induced by Helicobacter pylori infection. It was discovered that he had taken the medicine for two weeks and was adjusted back. There are now two completely different approaches to clinical treatment: some doctors believe that as long as there are abnormalities in the blood routine, a full set of examinations should be performed, and even if there is only a slight deviation, the possibility of malignant diseases must be ruled out to avoid missed diagnosis; some doctors believe that the elderly do not need to care if they have no symptoms, so as to avoid fussing around. Our practical experience in the community is a compromise: as long as the abnormality does not exceed 10% of the upper and lower limits of the reference value, and there are no symptoms such as fatigue, weight loss, or inexplicable bleeding, you can first adjust your work, rest, and diet, and then recheck after half a month. There is no need to do bone punctures and check tumor markers right away. The elderly are under great psychological stress, which is not good for their health.

After nearly 10 years of grassroots elderly health work, my biggest feeling is that blood routine is more of a "health barometer" for the elderly than a "disease verdict." You may say that it is accurate. Sometimes after eating hot pot and staying up late the day before, several arrows will appear for you the next day. You may say that it is inaccurate. When there is a real problem, it can indeed send out the earliest signal. For healthy elderly people, instead of staring at those arrows and scaring themselves, it is better to remember the simplest principle: if a single indicator is slightly abnormal, recheck it. If the same indicator has problems three times in a row, or the abnormality is getting larger and larger, it is better to go to a specialist even if you are not feeling uncomfortable.