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

restlessstag71 said:However, I still don't think this pain is just muscular. I've started digging into it, and it feels like it could be some form of arthritis. I have appointments with a physical medicine specialist and a rheumatologist in two weeks. Naturally, I’m impatient, so if anyone could reach out, I’d appreciate it.
I took photos of my results, but since I can't figure out how to upload them, I'll just type everything out.

Based on what you've shared, things are a bit vague: a) what specific symptoms are you experiencing beyond "lower back pain"? Isolated back pain isn't really a hallmark of systemic rheumatic diseases. b) What kind of arthritis are we talking about if there's no joint swelling? c) Who—specialty-wise, not by name—ordered these tests (the HLA typing, ANA, and ENA panel)? And d) How is it possible that these were ordered before more fundamental baseline tests, assuming there was actually suspicion of a systemic autoimmune issue?

Regarding the HLA typing, you do have HLA DRB1*01, which indicates a certain genetic predisposition toward rheumatoid arthritis, but that alone doesn't confirm anything.

An ANA test with a low titer is essentially meaningless unless there is strong clinical suspicion of an autoimmune disease.

Maria Fisher46 said:What you've said isn't entirely clear: a) what specific symptoms you actually have besides "lower back pain," because just mentioning that without other issues doesn't point toward systemic rheumatic disease, b) what kind of arthritis you suspect if there’s no joint swelling, c) who (not by name, but by specialty) ordered those tests (HLA typing, ANA, and ENA panel), and d) how it's possible those were done before more basic testing if there was actual suspicion of a systemic rheumatic disease?

By the way, your HLA typing shows you have HLA DRB1*01, which means there's a certain genetic predisposition for rheumatoid arthritis, but that alone doesn't mean anything.

ANA is positive at a low titer, and as such, it doesn't mean much unless there's a strong suspicion of an autoimmune disease.

Thanks for reaching out.
a) I'll try to keep my explanation of my symptoms brief. My lower back has been hurting for about 15 years now. For the first 10 years, it was just in the morning when I woke up, which wasn't a big deal. For the last 5 years, it's been worse in the mornings; I feel totally wrecked and need about half an hour to recover. I'd call it a feeling of stiffness. Also, for the past 3 years, my back has hurt badly after walking for about an hour. I gave birth three months ago, and now that one-hour limit has dropped to just 5 minutes of walking before the pain hits.
b) A friend told me that the pains I'm describing look like they could be some kind of arthritis. I'm always complaining to her about how everything feels inflamed in that lower back area.
c)&d) I had the immunology tests done because I was having trouble conceiving for a while. I was also diagnosed with thrombophilia. I haven't seen a rheumatologist yet. I have an appointment in two weeks with a physiatrist/rheumatologist at a major hospital in Chicago.

Since my friend mentioned potential arthritis issues, you know how it goes—you go online and start reading and reading, and I've already ruled out four different diseases, and now this one is left. And since I already did the HLA typing, I came across something saying HLA-B35 is linked to rheumatic diseases.

Also, my hand joints ache from time to time, but since it's nothing serious, I didn't pay much attention to it. And for some reason, my knee and right hip have been hurting for a few days now. So, naturally, I started thinking my issues might be rheumatic.
And then I realized that the ANA test could be positive, and boom—I've concluded I have undifferentiated spondylarthritis. Obviously, I need to talk to a doctor about all of this and get more tests done.

Sorry for the long post. And thanks for getting back to me.

Angela Moore63 said:No big deal, this could definitely be linked to your pregnancy. It's pretty common for women to experience increased joint, bone, and back pain after giving birth. No reason to panic... After this much time, CRP and ESR would still show inflammation if there was any present. Even if it turns out to be arthritis, it’s not the end of the world; plenty of people manage it just fine with regular exercise and a solid diet. I'd suggest taking calcium, magnesium, Omega 3, and Omega 6. Pineapple also has great anti-inflammatory properties. Obviously, that isn't a substitute for actual medical help, but it might help ease things. Just in case, check your urine pH levels too. Sometimes high pH can cause this kind of pain. You should definitely get tested for Waller-Rose and rheumatoid factor, and re-check your immunoglobulins, CRP, and sedimentation. Best of luck!

Thanks for the advice, Jason James3. I'll definitely make sure to get all those tests done. I was also wondering about supplements—you mentioned calcium, magnesium, and Omegas. I know they're good, but do you have any specific brands you recommend? I have some Solgar Calcium, Magnesium, and Zinc on hand; would that work? And what about Omegas? Maybe Vitamin D too?

Just wanted to follow up on what I already wrote because I forgot this part, and it probably matters. When I had my baby, I had a C-section. We were on pain meds for three days, and honestly, I felt great. I didn't have any of these issues—none at all. Aside from the usual recovery from the surgery, which was nothing compared to this spinal stuff, I was fine. I was incredibly hyperactive (which is why I don't feel the pain right now) and happy, naively thinking all my back pain had just vanished along with the pregnancy. But after those three days were up, the disappointment hit me so hard I couldn't even function... 😢

restlessstag71 said:Thank you, Jason James3, for the advice; I will certainly pursue all the tests you mentioned. I have also been wondering if I should be taking calcium or magnesium—you mentioned Omega-3 as well, which I know is beneficial, but do you have any specific recommendations on brands? I currently have Solgar Calcium, Magnesium, and Zinc on hand; would those be suitable? And what about Omega-3? Perhaps Vitamin D as well?

I personally rely on BODY&FIT Essentials Omega-3 Fish Oil, Universal Naturals Calcium, Zinc, and Magnesium (plus Copper) mineral formula, Universal Naturals Vitamin B-Complex, and Optimum Vitamin C-1000mg gluten-free. Of course, there is no strict requirement to stick to a single manufacturer; it is perfectly sufficient to simply visit a reputable pharmacy in your local area. If I may offer some guidance, I suggest opting for calcium, magnesium, and zinc in capsule form rather than effervescent tablets, as the latter can sometimes be taxing on the liver. Vitamin D is certainly not a bad idea either, though one must exercise caution against overconsumption; regardless of how healthy a vitamin may be, excess is never beneficial. For my part, the Omega-3, B-Complex, and the various supplements I listed have provided significant relief. I would also wholeheartedly recommend incorporating royal jelly into your regimen, as it will likely alleviate some of your symptoms. Regarding the Omega capsules, they consist of fish oil, which has proven efficacy in managing rheumatic issues. Generally speaking, aim for more fish and fluids, and try to limit your intake of red meat. Personally, I am a firm believer that there is nothing that cannot be cured or, at the very least, halted if caught early enough. Adhere to a healthy diet as strictly as possible and engage in regular, moderate physical activity every day—even if that just means stretching. Many individuals suffering from arthritis shy away from exertion out of fear that they might further damage their aching joints, but that is a fundamental misconception; such inactivity leads to muscle weakness, whereas strengthening the muscles is essential so they can shoulder the primary load instead of the joints themselves. I truly hope your test results indicate that everything is fine. Stay positive; I am wishing you the very best of luck!

restlessstag71 said:Just to add one more thing to my previous points—I realized I forgot something that’s actually quite significant. When I had my baby via C-section, we were on pain management for three days straight, and honestly, I felt fantastic. I didn't experience any of those specific issues mentioned at all. Aside from the usual recovery from surgery, which was nothing compared to spinal issues, I was incredibly energetic—almost hyperactive—and just genuinely happy. I was naive enough to think all my back pain had vanished along with the pregnancy. But after three days passed, the disappointment hit me hard, and I just couldn't snap out of it... 😢

This is a common experience for many women. To give you an example, my aunt has dealt with chronic back pain her entire life, starting as early as her mid-teens; there are times when she tells me she can barely even turn over in bed, and other times the pain radiates into her arms, fingers, and legs. Her condition definitely took a turn for the worse after childbirth, though that isn't surprising by any stretch of the imagination. For a while, she wore this magnetic bracelet that she swears saved her, providing years of relief. Now, the pain flares up occasionally, but she's forty now, works all day both professionally and at home, and manages a thirteen-year-old without letting it stop her. If I can dig up more specifics about that bracelet, I’ll let you know. There's no harm in trying something new. You might even consider visiting a local herbalist you trust to find some natural, plant-based teas for rheumatic issues. I actually know an older woman who was told she’d never walk again, yet ten years later, she’s out running while I’m just struggling to walk. For now, please follow the advice from the earlier comment and do your own research. There are plenty of paths and solutions out there that might either resolve this for you or, at the very least, make life significantly easier!

Maria Fisher46 said:It’s pretty clear you’re dealing with a much more complex disorder here, which isn't really something we can untangle just through an online forum. However, if there hasn't been any meaningful improvement after such a prolonged course of appropriate antibiotic treatment, then the diagnosis of Lyme disease itself needs a serious second look. We also need to re-evaluate whether continuing this specific antibiotic regimen is actually the right move; if it hasn't worked by now, it’s unlikely to suddenly start working, and honestly, pushing forward could potentially do more harm than good.

Regarding that discrepancy between the EnGene results and the MR findings, I should clarify that while EnGene can point toward the existence of nerve damage, it lacks the capacity to pinpoint the actual cause behind that damage. On the flip side, an MR can visualize certain lesions or issues, but it certainly won't catch everything.

Thanks so much for the response!

Well... there *are* improvements, technically. My joints don't ache anymore, except when the weather shifts. That burning sensation in my forearms is almost entirely gone, too. My infectious disease specialist finally managed to bring back some reflexes—like a patellar reflex on the right side—though the left side is still sluggish or non-existent. So, things are moving in the right direction, but I'm still stuck with these finger vibrations, hand weakness, and a whole laundry list of other symptoms... 🙂 I have a neurology appointment coming up on March 5th, and I'm wondering if I should proactively ask for specific tests? I know they probably won't just volunteer them without me prompting them... I was thinking about suggesting a B12 panel and a general vitamin check... Any advice?

Can someone help me make sense of these endoscopy results:

Reason for procedure: persistent coughing paired with post-nasal drip... this happens every winter.... constant drainage both internally and externally, plus the coughing.

1. Diagnosis: chronic gastritis. The samples consist of four small tissue fragments, roughly 2mm in diameter, which histologically represent gastric mucosa covered by columnar epithelium. Within the lamina propria, alongside glands showing some reactive changes, there is moderate mononuclear cell infiltration. Giemsa staining showed no evidence of H. pylori colonization in these samples.
>>6>> 2. Diagnosis: gastric hyperplastic polyp. Samples include three small tissue pieces, 1-3 mm in diameter, representing gastric mucosa with polypoid formations. These have granular surfaces covered by tall columnar epithelium with increased mucus production; the sparse connective stroma contains glands lined by the same epithelial type. It isn't possible to determine the relationship of the formation to the base from this specific sample.

Nasal CT findings: high neutrophil count and a small number of eosinophils.

Last year, I was diagnosed with an allergy to birch and hazelnut pollen. I had some immunological tests done last week; my ECP is elevated at 76.2, though my IgE levels are within the normal range. Do these results suggest a risk of developing asthma?

Megan Jones27 said:Here is my CBC report from two months postpartum... I had it done because of low iron during my pregnancy and because I’ve been feeling pretty weak over the last couple of months. This lab work is from two weeks ago; my doctor told me over the phone that everything looks fine, but now that I actually have the results in front of me, I noticed a few values are slightly high or low. Otherwise, my iron is at 19 (normal range is 8–30), which seems okay...

What I'm struggling with is...

Neutrophil granulocytes: 38.4 (44 - 72), slightly low...
Lymphocytes: 50.7 (20 - 46), slightly elevated...
Platelets: 152 (normal range 158 - 424)... slightly low.

To add to what I mentioned earlier, I just found out today that I have CIN II again. Since I'm breastfeeding, they only prescribed vaginal medication for now, so my next checkup isn't until May...

Lately, I’ve been dealing with some nagging lower back pain that seems to radiate toward my front. It feels like there might be a connection between this discomfort and my digestion or bathroom habits. I've also noticed a bit of blood on the paper when I have a major bowel movement—perhaps internal hemorrhoids? On top of that, for the last two months, I've had occasional itching all over my body, mostly concentrated on my face and head. It usually shows up in the same few spots on my face, looking almost like mosquito bites...

I am not certain if everything I have mentioned is relevant, but perhaps it might help determine whether this is a genuine issue or...

Thank you.

Maria Fisher46 said:The values you've listed show some slight irregularities, though I don't believe they are directly linked to the symptoms you're experiencing. Furthermore, I doubt there is any connection to the HPV either. However, seeing blood on the toilet paper shouldn't be overlooked, regardless of your age...

Here is another set of results after a month... (as of today/Tuesday)...

Still the same old story...

Neutrophil granulocytes: 34.0 L (44-72)...
Lymphocytes: 53.5 H (20-46)...

It appears the numbers have shifted again since the last check...

I happened to have some bloodwork done this past Friday—my gynecologist actually sent me in for it. Everything came back perfectly fine on her end after the exam and ultrasound, but looking at the results from just a few days ago, there is a really noticeable difference...

Here are a few lab results for comparison (the first one is from a few days before delivery when everything was perfectly normal)...

From left to right—the older finding versus the more recent one...

12.11.2014. / 15.01.2015. / 13.02.2015. / 17.02.2015.

White blood cell counts: 8.3 / 6.5 / 6.8 / 5.5...
Eosinophilic granulocytes: 0.7 / nothing / 3.1 / 6.4...
Basophils: 0.2 / nothing / 0.1 / 0.2...
Neutrophil granulocytes: 61.3 / 38.4 / 36.1 / 34.0...
Lymphocytes: 29.7 / 50.7 / 54.2 / 53.5...
Monocytes: 8.1 / nothing / 6.5 / 5.9...

The lower back and abdominal pains are still persisting... Sometimes they flare up, other times they subside, usually accompanied by a general sense of weakness during the episodes. For the last few days, I've been experiencing loose stools with some small black specks present. There is also discomfort during bowel movements, along with constant stomach rumbling...

Occasional itching on the scalp, face, and other areas...

I have started taking Fuzzy Plus probiotics...

My primary care physician says my results are normal—though I have my doubts—but she did write me some referrals for stool tests to check for bacteria and parasites, along with an imaging scan for my spine since I deal with scoliosis...

I am looking into scheduling a color Doppler abdominal ultrasound. In my experience, wait times for that here can stretch on for months—if they even offer it at all—so I will likely just book a private appointment with Dr. Bajic Tarle. I might also follow up with some additional blood work through a hematologist.

I would appreciate any thoughts or advice you might have... Thank you.

I should probably mention a few more symptoms... I've been dealing with an itchy scalp, mostly at the back, and on my face too (it used to flare up under my chin and on my neck as well)... It feels like tiny mosquito bites popping up. Sometimes it happens on my arms, too. Lately, I've even felt some stinging sensations under my armpits. 🤔

Could this be viral, immunological, an allergy, or perhaps parasites...?

I suppose I'll just have to wait and see what the upcoming lab results reveal.

Maria Fisher46 said:What you wrote isn't really clear: a) what specific symptoms you actually had besides "lower back pain," because just having that without other issues isn't a hallmark of systemic rheumatic diseases, b) what kind of arthritis you're suspecting if there's no joint swelling, c) who (not by name, but by medical specialty) referred you for these tests (HLA typing, ANA, and ENA panel), and d) how it's possible these tests were done before other basic screenings if there was suspicion of a systemic rheumatic disease?

Anyway, looking at the HLA typing, you have HLA drb1*01, which means you have a certain genetic predisposition for rheumatoid arthritis, but that doesn't mean anything on its own.

The ANA is positive at a low titer, and as such, it doesn't mean anything unless there's strong suspicion of an autoimmune disease.

If you have a moment, I'd like to ask you one more question.

I did some digging and found that HLA drb1*01 is linked to asthma, and I deal with major allergy issues and the onset of asthma.
Regarding that ANA result—you said it was positive at a low titer. Is it possible that could be due to allergies or asthma?
Of course, I'll look into everything regarding arthritis. I don't see my doctor until next week, so I'm messaging you because I can't wait, and I'm honestly terrified. Plus, I've been constantly anxious about these back pains for three months now. First it was a herniated disc, then spinal stenosis, then the sacroiliac joint, and now the thought of arthritis on top of these allergies... gosh.

Thanks if you can find the time to reply.

Is a total cholesterol of 4.9 too high (div>

I just had my hormone panel done, and honestly, everything looks like it’s within the normal range. But then I noticed this "D4" note tucked away in the comments section at the bottom. Does anyone actually know what that signifies? Thanks.

Can someone please help me out? I’ve already laid out my back issues in previous posts. I just got some lab results back today, and here is what they show:

SE 8 (4-24)
CRP 0.4 (0.1-5)
RF Urate 227 (134-337)

I was leaning toward arthritis, but my RF came back at div>

restlessstag71 said:I went ahead and got that HLA typing done as well. I came across some information suggesting that HLA-B35 is linked to rheumatoid diseases.

The HLA-B35 marker is linked to a specific form of enteropathic arthritis—often referred to as Type 1. It manifests as joint inflammation in patients dealing with inflammatory bowel diseases, such as ulcerative colitis or Crohn’s disease, along with other intestinal conditions.

If you're dealing with those specific symptoms, the fact that we haven't confirmed an HLA-B27 status is a much bigger deal. It changes the whole equation.

Then I realized my ANA test could come back positive, which led me straight to the conclusion that I’m dealing with undifferentiated spondyloarthritis. Naturally, I need to sit down with my doctor to hash all this out and schedule some follow-up testing.

ANA is relevant when looking at systemic connective tissue diseases, not undifferentiated spondyloarthropathy. This finding doesn't really support that specific diagnosis.

restlessstag71 said:If you have a moment, I’d appreciate it if you could answer one more quick question for me.

I was doing some digging and stumbled upon a link between HLA drb1*01 and asthma. Given my history of severe allergies and the recent onset of asthma symptoms, this feels like a significant connection.

HLA drb1*01 shows up more frequently in people dealing with asthma and high serum IgE levels. But when you look at joint issues, it’s tied to rheumatoid arthritis—essentially acting as a marker for an increased risk of developing the disease.

Regarding that ANA result—you mentioned it came back positive at a low titer. Could that be linked to allergies or asthma?

The data indicates that patients suffering from asthma show a higher incidence of ANA compared to healthy individuals.

restlessstag71 said:Can someone please help me make sense of this? I’ve detailed my back issues in previous posts, but I finally went in for some testing today. Here are the results:

SE 8 (4-24)
CRP is at 0.4. Normal range is 0.1 to 5.0. Low, steady.
RF Urea: 227 (Range: 134–337)

I’ve been looking into arthritis. My RF came back at div>

Inflammatory markers look normal, and the RF is negative. Based on the symptoms you described, those results don't really point toward rheumatoid arthritis. That said, even if we were considering RA, a negative RF doesn't rule it out—about 20% of patients are seronegative.

Your symptoms are quite varied. Some of what you’ve noted could align with various rheumatic conditions. However, I noticed you’re approaching this in reverse order: instead of seeing a rheumatologist first and then getting targeted testing, you're running subspecialty tests and trying to piece together a diagnosis from the data.

To diagnose a rheumatic disease, a patient has to meet specific clinical criteria. Lab work is just one piece of that puzzle; without a proper physical examination, a diagnosis is impossible.

If we ran every possible immunological and rheumatological test on everyone in this room, many of us would show at least one positive result. That wouldn't mean we all have autoimmune diseases.

The lab results you've obtained must always be interpreted alongside the actual clinical picture.

Michael Rodriguez37 said:I just got my hormone panel back, and everything looks like it's within the normal range. However, there's a "D4" listed under the notes and comments at the end. Does anyone know what that refers to? Thanks.

I'm not entirely sure what those "D comments" or "DZ comments" signify; they show up on lab reports quite frequently. It seems likely they are internal notations meant for laboratory staff rather than anything relevant to clinical interpretation. As physicians, we aren't typically trained on these specific shorthand codes, so it would be best to check directly with the lab technicians.

Lawrence Anderson19 said:Last year, I was diagnosed with allergies to birch and hazelnut pollen. I had some immunology tests done last week; my ECP is elevated at 76.2, though my IgE is within the normal range. Could these results point toward the development of asthma?

Eosinophilic cationic protein (ECP) serves as an indicator of allergic mechanisms and can certainly be elevated during allergic reactions. Measuring ECP levels can help identify allergic inflammation within the respiratory system, among other things. That said, an elevated ECP level alone is not sufficient to establish a diagnosis of asthma.

Thomas Jones4 said:Is a total cholesterol of 4.9 (div>

The number is acceptable. Generally speaking, lower total cholesterol levels are more favorable for younger people.

Megan Jones27 said:Adding a few more symptoms to the list... Itching on the scalp, mostly at the back, and on my face (sometimes under the chin or on the neck). It feels like tiny mosquito bites popping up. Occasionally on my arms, too. Recently, I've also had some stinging sensations under my armpits.🤔

Could it be viral, immunological, an allergy, or parasites...?

I'll have to wait and see what the next round of tests reveals.

Wait for the processed results. If everything comes back negative, it might be worth consulting a gastroenterologist. The CBC isn't perfectly clean, but it doesn't deviate enough to require emergency intervention.

Leukocytes 9.7 10^9/L (ref. 3.4 to 9.7)
Erythrocytes 4.08 10^12/L
Hemoglobin 132 g/L 119 to 157
Hematocrit 0.393 L/L 0.356 to 0.47
MCV 96.0 fL 83 to 97.2
MCH 32.4 pg 27.4 to 33.9
MCHC 337 g/L 320 to 345
RDW 12.9 % 9 to 15
Platelets 294 10^9/L 158 to 424
MPV - mean platelet volume 8.8 fL 6.8 to 10.4
Leukocyte differential - light microscopy
Test Result Unit Reference Interval
Segmented neutrophils 46 % 44 to 72
Band neutrophils 0 % up to 2
Lymphocytes 47 % 20 to 46
Monocytes 5 % 2 to 12
Eosinophils 2 %

So, here’s the thing. I have a history of my blood work flipping on me—my lymphocyte percentage hits 47% sometimes, even though for the last few years it’s always stayed under 35%. This looks like absolute lymphocytosis to me. I'm dealing with insane stress right now and haven't slept a wink. Hey, dear doctors, could that be what's causing this?🙂

A quick question for the group.

RBC: 3.38 (3.86–5.08)
Hematocrit: 0.311 (0.356–0.470)
MCH: 37.5 (27.4–33.9)
MCHC: 408 (320–345)
RDW: 19.1% (9–15%)
UIBC: 68 (26–59)
TIBC: 80 (49–75)

Most of these values are sitting outside the standard reference ranges—either too high or too low—but since

Hemoglobin: 127 (119–157)
Iron: 13 (8–30)

I suppose everything might actually be fine. Does anyone else think that's the case?