Lab results - looking for opinions [PLEASE READ 1ST POST]

Urinary amylase levels can be quite a fickle diagnostic tool, showing significant variability from one person to the next. 😁 In any event, looking at your husband's results, everything appears perfectly normal, and one could even argue that those minor kidney stones might partially account for the current readings. 😁 Of course, this assessment assumes there aren't any underlying health issues at play, as we don't have the full picture regarding his medical history or the prior status of his kidney and liver function.

Can anyone help me make sense of these labs?
My eleven-month-old was sent in for some testing because of some tics, and now the globulin levels are all over the place compared to the reference range.

Albumin (s) 67.1 H % 55.8 - 66.1
Alpha-1-globulins (s) 5.0 H % 2.9 - 4.9
Alpha-2-globulins (s) 13.4 H % 7.1 - 11.8
Beta globulins (s) 9.3 % 8.4 - 13.1
Gamma-globulins (s) 5.2 L % 11.1 - 18.8
Albumin (s) 40.93 g/L 40.2 - 47.6
Alpha-1-globulins (s) 3.05 g/L 2.1 - 3.5
Alpha-2-globulins (s) 8.17 g/L 5.1 - 8.5
Beta globulins (s) 5.67 L g/L 6 - 9.4
Gamma-globulins (s) 3.17 L g/L 8.0 - 13.5
Albumin/Globulin 2.04

Are the standard reference ranges for kids the same as they are for adults (since my own labs use these exact same numbers)? What do these results actually mean, and is there going to be more follow-up testing needed?

Dana Morales5 said:Can someone help me interpret these results?
An eleven-month-old baby was sent for testing due to some tics, and the globulin levels are outside the reference range.

Albumin (s) 67.1 H % 55.8 - 66.1
Alpha-1-globulins (s) 5.0 H % 2.9 - 4.9
Alpha-2-globulins (s) 13.4 H % 7.1 - 11.8
Beta globulins (s) 9.3 % 8.4 -13.1
Gamma-globulins (s) 5.2 L % 11.1 - 18.8
Albumin (s) 40.93 g/L 40.2 - 47.6
Alpha-1-globulins (s) 3.05 g/L 2.1 - 3.5
Alpha-2-globulins (s) 8.17 g/L 5.1 - 8.5
Beta globulins (s) 5.67 L g/L 6 - 9.4
Gamma-globulins (s) 3.17 L g/L 8.0 - 13.5
Albumin/Globulin 2.04

Are reference values for children the same as for adults (mine seem to follow adult ranges)? What do these numbers suggest, and will further workup be necessary?

Hello,

Reference values are certainly not identical for adults and children. In fact, even within pediatric populations, they vary significantly based on age. Regardless, a gamma-globulin level of 3.17 g/L in a child this age is low. These levels would typically sit at the lower end of the normal spectrum around 4 to 6 months old—that's when maternal IBM begins to taper off and the infant's own IBM production is still ramping up.

Since gamma-globulins encompass immunoglobulins G, A, M, and E—essentially the antibodies responsible for fighting infection—a low gamma-globulin reading suggests low immunoglobulin levels. At this stage, we'd primarily be looking at IBM. Consequently, an immunoelectrophoresis or specific immunoglobulin testing would be a logical next step.

I am assuming this finding is incidental, perhaps caught during the workup for the tics, and that the child doesn't suffer from frequent infections—things like recurring bacterial sinus issues, ear infections, bronchitis, or pneumonia.

Linda Gray said:Hi, my uric acid levels came back at 385. The lab range goes up to 337. Should I be worried?

A level of 385 μmol/L isn't typically a cause for concern. Crystal precipitation—the kind that risks buildup in your joints or kidneys—usually doesn't become an issue until you cross the 416 μmol/L threshold. For someone without symptoms, we generally don't start digging for underlying causes unless concentrations climb above 480 μmol/L.

On your end, if you're carrying any extra weight, working on gradual weight loss helps. You might also consider cutting back on meat—specifically organ meats—and limiting alcohol intake.

Maria Fisher46 said:Look, lady,

reference ranges aren't the same for adults and kids. Period. And even with kids, those numbers shift depending on how old they are. Regardless, a gamma-globulin level of 3.17 g/L for a baby this age is definitely on the low side. You’d usually see these kinds of numbers at the bottom edge of "normal" around the 4 to 6-month mark—that's when the mother's IBM starts breaking down and the baby is still playing catch-up trying to build their own IBM.

Since gamma-globulins cover all the bases—immunoglobulins G, A, M, and E, which are basically the antibodies that keep infections at bay—a low gamma-globulin count suggests low immunoglobulin levels. At this stage, we're likely looking at low IBM. It'd be smart to get an immunoelectrophoresis done or just get specific immunoglobulin levels checked for the kid.

I’m guessing this lab result was just a fluke, maybe caught during some routine workup for tics, and the kid isn't constantly getting sick—you know, dealing with nonstop bacterial sinus infections, ear infections, bronchitis, or pneumonia.

First off, thanks! Yeah, this was totally random. My baby isn't prone to getting sick; the only time she actually got ill was when she was about 2.5 months old with E. coli, which was the only time she ever needed antibiotics. She's healthy, energetic, and hitting all her milestones perfectly. Her nasal swabs and throat cultures have been fine too. I know you're just speculating, but could a result like this be caused by some underlying condition that hasn't shown symptoms yet, or is it just that her little system hasn't started cranking out gamma-globulins yet? Also, should I just stick with our pediatrician, or would it be better to see an immunologist? We haven't heard back from the pediatrician yet, and I just want to get ahead of this and do whatever needs to be done...

Adam Green5 said:Hi, my ALP dropped to 50, while the lab range is 60-142. I'm feeling constantly exhausted. Could this be related to my thyroid or liver?
Thanks

It’s unlikely that an alkaline phosphatase level of 50 U/L is the direct cause of your fatigue; that isn't a significant enough drop to be the smoking gun. However, it could still be a piece of the puzzle. Essentially, you need to figure out why you're feeling so drained. That starts with a thorough medical history and a full physical exam, as the potential culprits are numerous.

Dana Morales5 said:First off, thank you! Yes, this was an incidental finding. My baby isn't prone to infections; her only bout of illness was at 2.5 months old—E. coli—which was the only time she ever needed antibiotics. She’s healthy, energetic, and hitting all her developmental milestones perfectly. Her nasal swab and sinus tests came back normal, too. I realize this is speculation, but could a result like this stem from a previous illness, an asymptomatic condition, or perhaps just because her system hasn't fully ramped up gamma globulin production yet? Also, should we stick with our pediatrician, or is it worth seeing an immunologist? We haven't heard back from the pediatrician yet, and I want to stay ahead of this.

The immunoglobulin levels need to be established first. If the child shows no signs of frequent infections and growth/development remains on track, monitoring will likely be enough.

The lab results—including those immunoglobulin levels—and the child's diet should be reviewed by a pediatric immunologist to get the full picture.

Maria Fisher46 said:They’re checking everything—including immunoglobulin levels—and looking at diet too. To really wrap my head around this, I probably need to sit down with a pediatric immunologist.

Thanks a ton!

I'm 24 and I've noticed over the last week or so that my testicles have swollen up—and they feel pretty damn hard. It used to be that if I touched them, they’d practically slide right out of my hands and I couldn't get a good grip on them, but now they're way bigger, much firmer, and they don't move around nearly as easily
Is this enough of a reason to go see a GP right away, or should I just sit tight and wait?

Can someone make sense of this
HLA: A 24 (9), 32 (19); B 18, 44 (12) ; DR 12 (5)

hiddenviper said:Could someone please explain these results?
HLA: A 24 (9), 32 (19); B 18, 44 (12) ; DR 12 (5)

The logic here is simple: certain HLA antigens show up more frequently in people with specific diseases than in healthy populations.

Essentially, having certain antigens is linked to a slightly higher statistical risk. It isn't a guarantee of illness—having the antigen doesn't mean you will get sick, just as not having it doesn't mean you're immune.

The specific HLA markers in your report aren't "smoking guns" for any particular autoimmune condition, though almost any HLA can be tied to some elevated risk if you look hard enough.

One could mention that HLA-DR5 carries a slightly higher association with Hashimoto, which might be relevant to you, but I suspect the doctors weren't screening for that specifically. They were likely looking for something else entirely.

Context matters. If this is for a child, the interpretation shifts. Without knowing which disease group is being investigated or why the typing was ordered in the first place, any answer is somewhat incomplete.

bluewalker9 said:I'm 24. Over the last week, I've noticed my testicles have increased in size and feel significantly firmer. Previously, they were quite loose and easy to move, but now they feel larger, much harder, and don't shift easily.
Should I see a GP about this, or just wait it out?

What does this have to do with lab results? If you're noticing physical changes like this, don't sit around waiting. Go see a doctor for an exam immediately.

Hey everyone,

Can someone take a look at these results and let me know if I should be heading to a specialist for more testing? It’s for a guy in his mid-thirties who stays pretty active—mostly running. These labs came back during a routine physical. His resting heart rate is sitting at about 40 bpm. He was diagnosed with hypothyroidism two years ago and is currently managing it with Euthyrox 25 mcg along with 100 mcg of selenium. No steroid use or crazy supplements here. Diet-wise, he's pretty dialed in—lots of complex carbs, low-fat cottage cheese, veggies, fruit, nuts, and honey. Lately, he's actually been cutting back on meat and fats.

Do you think this is just what happens when you're an athlete, or could we be looking at something more serious?

https://ibb.co/KXv7Xbx

Karen Alvarez40 said:To whom it may concern,

Could someone review these results and suggest where to go for follow-up if necessary? This is for a male in his mid-thirties, an active runner. The tests were part of a routine physical. Resting heart rate is 40 bpm. Diagnosed with hypothyroidism two years ago; currently on Euthyrox 25 mcg and 100 mcg of selenium. No steroids or supplements used. Diet is fairly disciplined—complex carbs, low-fat cottage cheese, vegetables, fruit, nuts, honey. Recently cut back on meat and fats.

Is this just a byproduct of high athletic activity, or should we be looking at something more serious?

https://ibb.co/KXv7Xbx

Ma'am,

The individual in these results definitely needs further investigation. Thyroid hormone levels need re-checking. You’ll need to supplement those tests by checking CRP, running a urinalysis if one hasn't been done, and determining LDH, CK, ferritin, TIBC, and UIBC. An occult blood test (stool sample) three times is advisable, along with an abdominal and renal ultrasound. Most importantly, however, a thorough clinical examination and a detailed consultation are required to identify any subtle symptoms that might have been overlooked.

A man in this age group, particularly an athlete, shouldn't be showing signs of anemia. There is also an elevated ESR (sedimentation rate), which could stem from anemia, or conversely, the anemia could be a symptom of an underlying condition driving the inflammation. Additionally, there is a mild liver lesion present (does the patient consume alcohol?).

There are many variables here. My view: start with a solid clinical exam and an in-depth discussion with a doctor before deciding on the next steps.

Hi there,

Thanks for getting back to me so fast.
As far as alcohol goes, he doesn't really touch it—maybe a tiny bit of red wine maybe twice a year at most.
He stays away from soda too, but he drinks tons of water and tea, and occasionally takes some magnesium supplements.

We actually had a urine test done, but I totally forgot to snap a photo of it: https://ibb.co/ZXNX8zW

His thyroid was checked back in June along with an internal medicine workup, and everything looked steady (TSH: 3.39 mU/L 0.38-5.33, fT3 4.4 pmol/L 3.2-6.2 and fT4 9.1 pmol/L 8.0-16.3).

Early last year, he had an abdominal ultrasound: the liver looks normal in size and structure, though they did spot a small 20mm hemangioma. The gallbladder showed no issues in the lumen and the walls look fine. Pancreas is normal size and texture. No dilation found in the bile ducts. Kidneys look good—normal size and thickness, and no signs of kidney stones. Adrenal glands look clear. No ascites or aortic aneurysms detected. Spleen looks normal. Bladder is full and shows no abnormalities.

Basically, even then, after his physical, they sent him off for more testing, but it turned out to be a total nothingburger. The final word was that it was just from working out. Still, we’re pretty worried and really want to get to the bottom of this, but we're stuck on where to go next.
When you mention a clinical exam and a deep-dive conversation, which specialist are you thinking of? An internist, a GI doctor, or someone else entirely?

Thanks again.

Karen Alvarez40 said:Hello,

Thanks for the quick reply.
The patient doesn't drink alcohol—maybe a glass of red wine twice a year during the holidays.
No soda either, just plenty of water and tea, with occasional magnesium supplements.

We had a urinalysis done, though I forgot to snap a photo: https://ibb.co/ZXNX8zW

A thyroid checkup was completed back in June along with an internal medicine assessment: everything remained stable (TSH: 3.39 mU/L 0.38-5.33, fT3 4.4 pmol/L 3.2-6.2, and fT4 9.1 pmol/L 8.0-16.3).

Early last year, an abdominal ultrasound was performed: liver size and parenchyma are normal, showing a focal lesion—a roughly 20 mm hemangioma. Gallbladder shows no pathology in the lumen; walls are normal. Pancreas is normal in size and texture. No dilation in the intrahepatic or main bile ducts. Kidneys show normal size and thickness; no signs of nephroliths or congestion. Adrenal glands appear clear. No ascites or abdominal aortic aneurysms detected. Spleen is normal. Bladder is full with no visible abnormalities.

Back then, after the physical, they were sent for more testing, but it turned out to be nothing. The conclusion was that it was just from athletic exertion. Still, we’re concerned and want to find the root cause, but we aren't sure where to start.
When you mention a clinical exam and a detailed consultation, which specialist are you referring to? An internist, a gastroenterologist, or someone else?

Thanks again.

Generally speaking, beyond the thyroid hormone levels and urinalysis already completed, my previous advice stands. It would also be wise to repeat the abdominal ultrasound; if that hemangioma was first spotted a year ago, we need to confirm it hasn't grown, though typically these stay stable.

Given these additional findings, I would recommend seeing an internist.

Of course, there is context missing here that can't be captured on a forum, such as past medical history. For instance, has this person dealt with anemia before? How long has it been known, and is the current level a steady state or a change?

But fundamentally, an internal medicine consultation seems necessary.

Maria Fisher46 said:I remember those numbers. Doesn't change what I said before.

Look, I get it, you’re looking at an automated CBC with a differential here, and they're still working on the peripheral blood smear. But like I’ve already pointed out in one of my earlier posts, you really have to lean on the microscopic review, especially when the machine starts flagging deviations. Everything else I said stands.

Hey everyone, it's been two months since the last round of tests, so it was time for a follow-up.

The automated blood count looks totally normal, within range and everything, but the cytological smear noted 1% plasma cells.
The follow-up didn't show any major shifts; those enlarged, swollen lymph nodes in the neck, abdomen, and armpits are still there...
We're just waiting on our appointment with the hematologist, but in the meantime, I want to be prepared in case there's anything specific I should be asking about.

Maria Fisher46 said:Look, generally speaking, besides checking those thyroid hormone levels and doing the urinalysis—which are already done—my previous advice still stands. Also, if that hemangioma was first spotted on an abdominal MRI over a year ago, you really ought to get another scan just to make sure it hasn't grown. Usually, they stay the same size, but it's better to be safe.

Given everything else that showed up in the tests, I’d strongly suggest seeing an internist.

Of course, there's a lot we can't see through a forum post, like what the past medical records actually look like. For example, does this person have a history of anemia? How long has it been going on? Is the level steady, or is it dropping? We just don't know.

But yeah, bottom line: an internal medicine specialist needs to take a look.

Thanks a ton.
Can you recommend a good hospital in Washington, D.C. with solid internists?

Emily Ortiz27 said:It’s been two months since the last round of tests, so it’s time for a follow-up.

The CBC shows everything within the standard reference ranges, though the cytology smear noted 1% plasma cells.
The MRI showed no significant changes; those enlarged lymph nodes in the neck, abdomen, and armpits are still there.
We’re waiting on an appointment with the hematologist, but in the meantime, I want to be prepared with any necessary questions.

Ma'am,

Nothing much to add at the moment. Those plasma cells shouldn't technically be in peripheral blood, but they remain present in small numbers. In this context, it seems to be the "new normal." You asked earlier if you should pursue additional private testing. My answer remains no. However, my previous suggestion regarding future genetic analysis—specifically a gene panel for ALPS and ALPS-like disorders including FAS, FASLG, CASP10, NRAS, KRAS, CASP8, PRKCD, and STAT3—still stands.

Karen Alvarez40 said:Thank you very much.
Can you recommend a hospital in Washington, D.C. with good internists?

Every hospital has its share of excellent and mediocre internists. My advice would be to book with whoever can see you the soonest.