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Hematology/Hypersegmented neutrophils


Hello Dr. Kulkarni,

Are hypersegmented neutrophils ever found in normal blood? Folate, B12, ESR, and MMA all came back normal.
I have megaloblastic changes in polys on peripheral smear, as well as large platelets and a few basos. While still within "normal" range, platelet count has risen by 43 (from 301 to 344) within the last month and a half. (No physical trauma or bleeding to account for this)
RBC 4.1
WBC 5.1
Platelets 344
MCV 93
MPV 7.1
Again, are hypersegmented neutrophils ever found in healthy blood? Or could there be a beginning problem with the bone marrow?

Thank you for your time and consideration!

Hello Robin Roberts!
Warm welcome to you!
Typically we dont see a hypersegmented neutrophil in normal person. Its mostly seen when the person is anemic either due to lack of vit B12 or folic acid in diet or when he is unable to absorb them from the diet. In your case I can say that you are in the earliest stages of onset of either folate/vit B12 deficiency or pernicious anemia. Because the neutrophils show this hypersegmentation well before the onset of anemia. So you being diagnosed early is a good thing. Now as a preventive measure you have to take some vit B12 and folic acid supplements. And also get stomach examined by your doctor, whether there are any atrophic changes due to hypersecretion of gastric acid which results in pernicious anemia. No need of worrying about bone marrow.

Hope that helps.

Take care. Have a great day. Bye.


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Dr.Shrinidhi Kulkarni


I can answer all questions related to hematology. RBC, WBC, Platelet and blood forming organs etc and related questions. hematology also includes blood proteins, hemoglobin and disorders related to clotting abnormalities. So questions about all aspects of hematology are welcome!


Working as a Doctor in Primary Health care Centre.

KIMS Banglore

MBBS, Internship in Internal Medicine

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