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

Alright, here’s the rest of the lab work.

Metabolites and Substrates

Urea 4.0 (2.8-8.3)
Creatinine 54 (49-90)
Total Bilirubin 9 (3-20)

Enzymes

AST 21 (8-30)
ALT 17 (10-36)
GGT 12 (9-35)
Alkaline Phosphatase 85 (64-153)
LDH 85 (div>

Hey everyone, could someone take a look at this bone marrow biopsy report? I'm wondering if anything stands out as concerning. It’s for a 66-year-old man who was sent in for the puncture due to thrombocytopenia—he's been dealing with that for about a year and a half to two years now. His CBC Panel is otherwise pretty normal, and he gets checked out every six months because his PSA levels have been elevated. Other than that, he isn't really complaining of anything else.
Here are the results from the image:

http://i61.tinypic.com/281ddlt.jpg

Sandra Brooks91 said:Could you weigh in on this one too?
THANKS

Sandra Brooks91 said:Wait, so my results aren't interesting enough? 🙂

Oh, they’re definitely interesting.
Just a heads-up, everything I’m saying comes with a massive disclaimer since I don't know why these tests were ordered in the first place—I haven't seen the full clinical picture or any medical history here.

Your cholesterol and triglycerides are through the roof.
It’s definitely something that needs more follow-up.
Honestly, there's a pretty slim chance that just cleaning up your diet and hitting the gym will be enough to bring these back down to earth; you might end up needing some medication to help things along (unless there’s an external factor at play that can be cut out completely))

Is it stress? Diet? Medications? (Maybe a long-term steroid use could explain the high fats and lower potassium?) Or perhaps it's just familial hypercholesterolemia?

Ferritin is a bit low; maybe tweak the diet slightly and then re-test in about 12 weeks.
Potassium is also running just a little low.

P.S. The serum was described as clear, so there's a very low chance this was just some lab error.

EDIT: And hey, even PCOS could be part of the reason behind these numbers.

Posting my dad's lab results here, he's 55.

He’s getting checked out because this cough just won't quit—it's been going on for a full year now. It gets really intense in the mornings, too.

I'm honestly pretty freaked out because there are 9 different things flagged above the normal range...



Would love some insight if anyone can help... thanks a million!

Could I get some input? Yesterday, I did my own cortisol blood draws at 8 AM, 6 PM, and 10 PM. At 8 AM, it was 790.8, while the lab range is 17 to 536. Then at 6 PM, it hit 244.3 (ref: 64 to 327), and by 10 PM, it was down to 81.27. Also, I'm a little worried about my ASTH—it was 19.74 at 8 AM (ref: 1.6 to 13.9), but dropped to 3.16 by 10 PM.

Emily Ortiz27 said:Nicholas Myers, sorry for the off-topic, but I can't accept PMs because my inbox is full 😉

Unfortunately, I have a mountain of unread messages and can't get to my inbox right now. Maybe over the weekend or whenever I find a spare moment.

Mark Anderson2 said:Hi. I’m looking for some help interpreting blood work I was ordered after being suspected of having arthritis:

Urea 310
ALP 116
leukocytes 9.08
Erythrocytes 4.28
Hgb 133
Hematocrit 0.372
MCV 87
MCH 28.7
MCHC 330
RDW 12.6
Platelets 303
MPV 7.4
ESR 34

My ALP is right at the edge of the reference range, which goes up to 119.
Also, my ESR is quite elevated.

Any help would be appreciated.

All in all, these results won't be the deciding factor in diagnosing or ruling out arthritis. Based solely on the numbers you've shared here, a diagnosis can neither be confirmed nor dismissed.

frozentinker992 said:I have a question regarding a low-dose dexamethasone test.

About a year and a half ago, I had a low-dose dex test due to high cortisol levels.
I’d take a 1mg tablet in the evening and test my cortisol the next morning.

The first time, cortisol dropped below 25, which is normal.

Then, a month ago, I did the test again; cortisol was around 190. My endocrinologist said the suppression wasn't sufficient and sent me to repeat the exact same test.

After a month, the result was normal—cortisol dropped below 25.

Now I'm wondering, can this cortisol suppression fluctuate due to an illness, or could it be a lab error or something else?

I hope someone knows. Thanks in advance.👍

With an overnight suppression test using 1 mg of dexamethasone, false positives and false negatives are possible. For instance, things like depression, certain medications, or acute illnesses can cause false positives—meaning the cortisol doesn't suppress enough.

You should discuss what happened and whether further diagnostics are needed with your endocrinologist, but just as a general guide, erroneous results are certainly possible with this test.

Kimberly Cooper68 said:I’d love some input if possible. Yesterday I drew my own cortisol levels at 8 AM, 6 PM, and 10 PM. At 8 AM, it was 790.8 (ref range is 17 to 536). At 6 PM, it was 244.3 (ref range is 64 to 327), and at 10 PM, it was 81.27. Also, I'm a bit worried about my ACTH at 8 AM—it hit 19.74 when the ref range is 1.6 to 13.9, though by 10 PM it dropped to 3.16.

My bad, typo there—not ASTH, meant ACTH.

redcyclist7 said:So... I'm a bit confused. I just had bloodwork done, and my Hematocrit came back low.

The result shows Hematocrit at 0.338L, while the normal range starts at 0.356.

And my iron is 20.🤔

Some people say low Hematocrit can signal bleeding... but everything else in my CBC Panel looks fine. What’s actually wrong here?

We really need to see the rest of those results, too. It would also help to know why you were sent for these specific tests in the first place.

Sarah Rodriguez68 said:I have a question as well. I had blood and urine tests because of some ovarian inflammation.
What worried me was finding ketones in my urine. I know that can be a sign of diabetes—my dad is diabetic—but my glucose was 4.6, which is normal. About six months ago, for entirely different reasons, I took an OGTT test; my fasting level was fine, but ninety minutes after the glucose drink, it was 3.6 (below normal).
Could there be a connection? Should I be looking into more testing? I'm feeling a little anxious about it.

It would be helpful if you could share the full report so we can see what we're dealing with. For instance, ketones in urine can show up if someone is simply fasting.

Sandra Brooks91 said:Are my results not interesting enough?🙂

To provide any meaningful feedback, we need context: why were these tests ordered, are you experiencing symptoms, and were you fasting?

Nancy Martinez70 said:I got my urine results back and Urobilinogen is 1. The report says the reference interval is 1, which implies my result is normal. But I've been reading online and everyone seems to say it should be zero?

As mentioned before, providing just one outlier value isn't enough for an interpretation. We need the full picture: the reason for the tests and the other related values.

Jessica Reyes42 said:I just got my blood and urine results back.
Erc. 4.67 (3.86-5.08)
Hgb 146 (119-157)
Hematocrit 0.446 (0.356-0.470)
MCV 95.5 (83.0-97.2)
MCH 31.3 (27.4-33.9)
MCHC 327 (320-345)
RDW-CV 15.1 H (9.0-15.0)
White Blood Cells 7.1 (3.4-9.7)
Neutrophils 50.40 (44-72)
4 Lymphocytes 39.10 (20-46)
Mid cells (MID) 10.50 (2-19)
Platelets 232 (158-424)

Urinalysis looks clean.

I am 56 years old.

The elevated RDW-CV has me worried.
Can someone tell me how these look?
I should mention I was dealing with some digestive issues (diarrhea) the day I had my blood drawn.
Thanks in advance!

Everything you listed appears normal; I don't see any reason for concern. That RDW is fine—a tiny deviation like that is essentially negligible.

velvetmoose9 said:They really are.
Everything I’ve noted comes with a massive disclaimer: I don't know why these tests were ordered, nor do I have access to the clinical picture or medical history.

Cholesterol and triglycerides are aggressively high.
This definitely requires further follow-up.
There is a slim chance that diet and exercise alone will normalize these levels; you might actually need pharmacological support for a while (unless there is an avoidable risk factor at play)

Stress? Diet? Medications (perhaps long-term corticosteroid use—high fat and low potassium)? Familial hypercholesterolemia?

Ferritin is slightly low; adjust the diet and retest in about 12 weeks.
Potassium is marginally low.

P.S. The serum was described as clear, so there is a very low probability of "lab error."

EDIT: And PCOS could also be the culprit here.

Thanks for the response. My cholesterol is clearly hereditary and exacerbated by stress; it climbs by about 1 point every eighteen months. No statins yet, diet is fine, non-smoker, etc... the only issue is zero exercise, though I'm not overweight (168 cm, 60 kg).

I'm not sure what you mean by "risk factor"—how does one eliminate a risk factor?

I took corticosteroids twice this year on short courses of less than a week at low doses for tinnitus... once 8 months ago and before that, 5 months ago.

What is PCOS?

Could this low ferritin be causing physical fatigue? For instance, waking up feeling physically exhausted despite getting enough sleep... plus, I have quite heavy periods, and my last lab results showed lower hemoglobin and potassium too... that was about a year ago.
How should I adjust my diet to boost ferritin? I don't eat meat. I eat everything else, and it's very healthy—lots of vegetables, like broccoli almost every day, beets, etc.

So, this low potassium persists even though I eat bananas regularly?😁
Thanks!

Maria Fisher46 said:To provide any useful feedback on these labs, I need context: why were these specific tests ordered? Is the patient experiencing symptoms, and was the blood drawn while fasting?

Follow-up—about a year ago, hemoglobin and potassium were low, and cholesterol was classic high at 10...
Yes, fasting. Age 33, if that matters...
Aside from the follow-up, the patient is feeling pretty exhausted and highly stressed (dealing with tinnitus and anxiety). Nothing else significant to report.

Thanks a ton for getting back to me so fast 🙂 Now I can actually get some sleep without tossing and turning all night 🙂

Maria Fisher46 said:It would be quite helpful if you could share the actual lab results so we can get a clear picture of what exactly is going on. For instance, seeing positive ketones in urine can happen simply from fasting.

It’s hard to argue that it's due to starvation when I've actually gained three pounds over the last three months. 😵

Alright, I’m not entirely sure if I should transcribe the entire report here—if you all think it would be helpful, just let me know and I’ll get right on it. For now, here is what was pulled from my labs:
Hematology lab results.Red blood cell count, hemoglobin, hematocrit, MCV, MCH, MCHC, platelet count, white blood cell count, neutrophil granulocytes, lymphocytes, mid-range cells, and erythrocyte sedimentation rate—all part of the standard CBC Panel. Everything is within the reference range.
General biochemical screenings.Here is a breakdown of my recent lab results: glucose, urea, creatinine, eGFR, sodium, potassium, chloride, total calcium, total magnesium, inorganic phosphates, CK, total Bilirubin, urate, AST, ALT, ALP, GGT, alpha-amylase, LD, iron, UIBC and TIBC, ferritin, cholesterol, triglycerides, total proteins, albumin, globulins, and CRP. Everything is within the reference range except for:
Sodium levels sitting at 135—when the standard reference range starts at 137—can certainly be a point of concern when you're looking at lab results. It’s just enough to fall outside the normal window to make you wonder what’s going on beneath the surface.
My latest labs came back, and I noticed my ALP is sitting at 52, which falls just below the standard reference range of 54–119. It’s a minor deviation, but certainly worth noting.

Urine:
Appearance: slightly cloudy.
Color: yellow
Specific gravity: 1.020 (normal range: 1.002–1.030).
pH level: 6.0 (Normal range: 5.0-9.0)
Leukocyte esterase, protein, Bilirubin, nitrites, and RBC/Hgb all came back negative.
Glucose and Urobilinogen levels both came back within the normal range.
Ketones ++ (negative)
Microscopic sediment analysis: a few squamous epithelial cells were noted.

Thanks!
If it would be helpful, I can type out my entire blood work report.

I would also appreciate some insight regarding my husband's recent lab results. He is 35 years old and a regular blood donor, but he went in specifically to check his ferritin levels, which have always tended to run low.
He had the exact same panel done as I did, with the exception of a urinalysis.
For clarity, I will only list the values that fall outside the standard reference ranges.

ALP 54 (60-142)
Alpha-amylase 150 (23-91)
Iron 10 (11-32)
UIBC and TIBC 55 (25-54)
Ferritin 14 (20-300)

Given these numbers, would he be cleared to donate blood? (I am assuming the answer is no.) Additionally, what might a spike in alpha-amylase suggest, and are there further tests you would recommend following this up?

Thanks!

Megan Gray said:Could someone please take a look at this bone marrow biopsy result? A 66-year-old male was referred for a biopsy due to thrombocytopenia lasting about a year and a half to two years. His blood work is otherwise normal, though he’s monitored every six months because of elevated PSA. No other symptoms.
The results via the image link:

http://i61.tinypic.com/281ddlt.jpg

The results aren't clean. Monoclonal cells were found in the bone marrow, and those shouldn't be there. This person needs a more detailed follow-up with a Hematology specialist. There is a possibility of a malignancy, but I don't specialize in Hematology, so I can't say for certain.

Kimberly Cooper68 said:I’d appreciate some feedback if possible. Yesterday, I drew my own cortisol levels at 8 a.m., 6 p.m., and 10 p.m. At 8 a.m., it was 790.8 (ref range 17–536); at 6 p.m., it was 244.3 (ref range 64–327); and at 10 p.m., it was 81.27. I'm also concerned about the ACTH at 8 a.m., which was 19.74 (ref range 1.6–13.9), while the ACTH at 10 p.m. was 3.16.

What was the reason for running this test?

Sandra Brooks91 said:Routine checkup—a year ago, hemoglobin and potassium were low, and cholesterol was classic high at 10...
Yes, taken fasting. Age 33, if that matters...
Aside from the checkup, I've been pretty tired and stressed (tinnitus, anxiety), but nothing else specific.

In my view, that's enough reason to pursue a broader investigation, as my colleague already suggested. These lipid panel numbers are unacceptably high; you should probably start therapy. Low ferritin means you've depleted your iron stores and are bordering on anemia. This might be linked to heavy periods. However, since the hemoglobin levels are still within the normal range, it likely isn't the primary cause of the fatigue, even though some people believe iron deficiency alone triggers exhaustion.

If your primary care physician is stumped, I suggest asking for a referral to an Internist.

Mark Stewart2 said:I'm posting my father's lab results. He's 55.

I’m starting the search because of this cough. It's been hanging on for a year now. In the mornings, it gets particularly intense.

It worries me that nine of these values are sitting above the threshold.

View on imgur

I’d appreciate some input... thanks a lot.

Unfortunately, these results won't help us pin down the cause of your father's cough. While a few parameters deviate from the norm, they aren't significant enough to point toward a specific diagnosis. I'd assume he’s heading to see a pulmonologist next.

Sarah Rodriguez68 said:Hard to blame it on hunger when I've actually put on six pounds over the last three months. 😵

I’m not talking about long-term dieting or calorie restriction over the last few months. I mean fasting immediately before having blood drawn. I suggest you get the tests redone. If the results come back clean, then there shouldn't be any reason to worry.

Sarah Rodriguez68 said:I’d also appreciate some insight regarding my husband's lab results. He's 35 and a regular blood donor, but he went in for a checkup because his ferritin levels are consistently low.
He had the exact same panel drawn as I did, just without the urinalysis.
I'll list only the values that fall outside the standard reference ranges.

ALP 54 (60-142)
Alpha-amylase 150 (23-91)
Iron 10 (11-32)
UIBC 55 (25-54)
Ferritin 14 (20-300)

With these numbers, would he be cleared to donate blood? (I assume not.) Also, what might that elevated alpha-amylase indicate—is further testing necessary?

Thanks!

Is your husband experiencing any symptoms? What prompted the blood work in the first place? It would also be helpful to know his CBC results. A 35-year-old man shouldn't be losing iron like this; we need to figure out the cause. What does his diet look like?

Sarah Rodriguez68 said:I would also appreciate some insight regarding my husband's blood work. He’s 35 and a regular blood donor, so he was checking his ferritin levels, which tend to run low.
He had the exact same panel done as I did, just without the urinalysis.
I'll list only the values that fall outside the standard reference range.

ALP 54 (60-142)
Alpha-amylase 150 (23-91)
iron 10 (11-32)
UIBC 55 (25-54)
ferritin 14 (20-300)

Given these results, is he cleared to donate blood? (I assume not.) Also, what might that elevated alpha-amylase indicate, and should he pursue further testing?

Thanks!

Low serum iron paired with low ferritin suggests poor iron absorption. Combined with the elevated alpha-amylase...

(High amylase concentrations in the serum or urine can signal inflammation in the pancreas or various parts of the digestive tract—like the esophagus, stomach, duodenum, or small intestine)
...it could point toward hypochlorhydria.

Does he deal with heartburn, a dry throat, or similar symptoms?

rapidranger79 said:I can't go into all the specifics, but the lab results came back this afternoon... there isn't much else to say. Iron levels are Fe 9, UIBC 24, TIBC 33, ferritin 252... they prescribed Ferrilit in high doses. Another internist thinks the Ferrilit is unnecessary, or even harmful.

With iron levels like that and relatively high ferritin (if you're female, it's borderline if you're male), you really need to look at the MCV. If those values are elevated, testing for B12 should be the next step. I'd suspect megaloblastic anemia. Are you taking anything like Controloc or Nexium, Grandma?

Hey there!
So, I've been dealing with constant bladder infections for about two years now. I finally went in for some tests this morning: ultrasound, urine analysis, culture, and CRP.

Here’s what I got back:
Bloodwork: slightly elevated basophils (1.4)
Urine: WBC 1-3, RBC 1-3 fresh, plenty of squamous epithelium, lots of bacteria, some mucus, slight protein turbidity, ketones positive
CRP: 0.1

Can anyone make sense of these results?