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

Maria Fisher46 said:Your ALT levels are slightly off, but nothing too crazy. One really important thing to consider is whether you've been taking any medications lately—I’m talking about everything from oral contraceptives to over-the-counter stuff like ibuprofen or other supplements. That could easily be the reason those liver enzymes are looking a bit elevated (unless, of course, there was a little too much celebrating at happy hour!).

Beyond that, have you been feeling anything unusual, like some discomfort, heaviness, or pain right under your right ribcage, or just generally off? And what prompted the blood work in the first place? Also, did they check your lipid panel, like your cholesterol and triglycerides?

Honestly, I don't think there's any reason to panic just yet. Definitely touch base with your doctor; they'll likely just want to run these tests again in a few weeks to see if things have leveled out.

Dear Mr. Gato, thank you so much! I haven't really felt any discomfort, but my gynecologist suggested I get some routine blood work done since it had been a while since my last checkup. I didn't have my lipids checked, just the things I mentioned before plus glucose and bilirubin (which were both totally fine). I haven't been on any medications, though I did just start taking some artichoke capsules on my doctor's recommendation.

I'll definitely make sure to repeat the tests in a little while, but until then, saludos and—hasta la victoria siempre! 🙂

Thanks for getting back to me so fast, I figured I’d just lay out my whole lab report here so maybe things will make more sense... basically, I'm 20, and I decided to go get some blood work done on my own because I had this massive exam two weeks ago, and the stress totally wrecked me—I dropped about 3 pounds in just a few days from pure nerves, and then lost another 2 pounds right after the test was over. Plus, my digestion has been acting up again for the last two days...
Here’s what all the numbers look like:

HEMATOLOGY
SE 7 ( 4-24)
erythrocyte 4.68 (3.86- 5.08)
hemoglobin 132 (119- 157)
hematocrit 0.409 (0.356-0.470)
MCV 87.4 (83.0- 97.2)
MCH 28.2 (27.4- 33.9)
MCHC 323 (320- 345)
RDW 14.4 (9.0- 15.0)
platelets 309 (158- 424)
MPV 12.8 (6.8- 10.4)
PDW 14.9 (9.0- 14.0)
P-LCR 49.0 (13.0- 45.0)
leukocytes 12.5 (3.4- 9.7)

Eo. gran. 0.01 (0.00- 0.43)
Ba. gran. 0.02 (0.00-0.06)
Neut. gran 9.00 (2.06- 6.49)
lymphocytes 2.85 (1.19- 3.35)
monocytes 0.60 (0.12-0.84)
Eo. gran % 0 (0-7)
Ba gran % 0 (0-1)
Neut. gran % 72 (44-72)
lymphocytes % 23 (20- 46)
monocytes % 5 (2-12)

BIOCHEMISTRY
Glucose 4.7 (4.2-6.0)
Cholesterol 5.60 (less than 5.0)
Triglycerides 1.07 (less than 1.7)
Urea 3.80 (2.8-8.3)
Creatinine 89 (63- 107)
Urate 181 (134-337)
Potassium 4.30 (3.9-5.1)
Sodium 142 (137-146)
Iron 10.50 (8-30)
UIBC 70.20 (26-59)
TIBC 80.70 (49-75)
bilirubin 9.10 (3-20)
AST 19 (8-30)
ALT 12 (10-36)
GGT 13 (9-35)

Thanks so much for being patient and helping me out😉

Good day 🙂
*Hematology results: my MCHC is elevated at 349 (normal range is 320-345)
*Coagulation
My PT is slightly up at 21.42 (normal is 14-21)
Blood Biochemistry
Elevated levels:
Total bilirubin 26.8 (normal is 3-20)
Direct bilirubin 5.2 (normal is 0-5)

Endocrine results—T3, T4, and TSH—are all within range
Immunology results—AST titer—is fine
Throat swab came back normal.

I would appreciate your thoughts. Thank you. 🙂

If the full panel is required:
Hematology:
L 5.98
E 4.77
Hb 145
MCV 0.145
MCH 87

MCHC 349

T 220

Coagulation
PV 0.91
INR 1.06
APTV 30.9
Fibrinogen 2.1

PT 21.42

Fibrinolysis 2 hours and 10 minutes

Biochemistry
AST 24
ALT 19
GGT 20
Creatinine 71
Total bilirubin 26.8
Direct bilirubin 5.2
CRP 0.3

Endocrinology
T3 1.89
TSH 0.967
T4 96.4

Immunology
AST titer 140

I am 23 years old; I gave birth 11 months ago and am still breastfeeding.
The reason I sought out a hematologist was due to easy bruising—even from minor bumps, or sometimes for no apparent reason at all.

gentlecyclist2 said:Thanks for the quick reply. I figured I should just provide the full results to make things clearer. Basically, I'm 20, and I decided to get some blood work done on my own because I had a major exam two weeks ago. Between the nerves, I dropped about 3 lbs in a few days, then lost another 2 lbs after the exam. My digestive issues flared up again two days ago.
Here are my results:
(...)
Thanks for your patience and help.😉

Based on what you’ve added now, along with the lab work provided, I still can't give you a definitive answer. It’s best to base your next steps on a consultation with your primary care physician.

My previous assessment stands: this could be an infection, potentially paired with mild anemia since the iron levels are hovering near the lower limit (noting the elevated UIBC and TIBC), and cholesterol is slightly high and needs addressing. Regardless, seeing a doctor is unavoidable.

A physical exam is necessary to determine if there are signs of infection—and if so, where the source is and how to manage it. Given just these labs and the fact that you've lost weight and have digestive issues (which is a very broad symptom), I wouldn't dare attempt a diagnosis.

There is also the question of your gynecological health.

What I can say is that, given these results and your symptoms, you definitely have good reason to see a doctor. However, the deviations in these labs aren't massive; some values are only slightly outside the reference range. That’s why a clinical exam and how you actually feel are vital. We treat patients, not paper reports.

Unfortunately, I don't have any further advice to offer. 🤷 Perhaps one of the more seasoned colleagues here might have a more specific or insightful perspective.

Best regards and take care. 😉

I had a urine culture done around 3 weeks ago because the dipstick showed some blood in my urine (++) at the OBGYN. The culture results came back sterile. Yesterday, however, the dipstick showed high leukocytes (4+). My doctor didn't pay much attention to it since the culture was clear, but I’m wondering if this is normal or if it points toward an infection. Also, I'm 35 and pregnant, and my doctor is refusing to do a cervical swab, claiming there's no indication for it.
Mainly, I want to know what those elevated leukocytes in the urine actually signify, and would it make sense to get a CRP test? Would that show anything useful?

Thanks so much for all the help, and hey, sorry if I was being a total pain in the neck earlier... 😉

@ Nicholas Myers - please forgive my persistence, but I find myself needing one more small consultation. I am referring back to our previous correspondence (posts #1162 - #1166) regarding my blood work and the ongoing anemia.

So, I had my blood drawn again yesterday; my hemoglobin has climbed to 113, ferritin is steadily—if slowly—increasing, and my HCT has returned to the normal range. My MCV, MCH, and MCHC also show an upward trend, even if they remain slightly low, while my UIBS and TIBC look perfectly fine. As for my biochemistry panel, everything is within normal limits. And yes, you asked about my CRP last time; it’s sitting at a steady 0.2.

However, I did notice something curious: my leukocyte count was 7.4 during my last draw eight days ago, but today it jumped to 9.22. Just a month ago, it was at 6.2. Based on these numbers, could you perhaps offer any insight into why this uptick occurred, and should this rise be a cause for concern?

Given that those heart palpitations are still quite pronounced, I went ahead and had an EKG done, which came back normal. With my hemoglobin now up to 113, is it still considered normal to experience those occasional, stronger heart palpitations?

My apologies for the repeated questions, and thank you in advance for your time. 🙂

Hi there. I'm looking for some advice...
I received my blood and urine test results yesterday, and they look like this:

Urinalysis (Physical/Chemical)
proteins +/- (0/neg)
ketones +/- (0/neg)
color: yellow
appearance: cloudy

Enzymes
AST 32 (8-30)
ALP 53 (54-119)
epithelial cells - plenty
round epithelial cells - rare
bacteria - some
mucus - some

Hematology
RDW 12.5 (14.6 - 16.5)
MPV 10.7 (6.8 - 10.4)
lymphocytes 16 (20-46)
monocytes 14 (2-12)

Basically, they told me they would call if anything was wrong, but I didn't hear from them. When I went to pick up the results, my doctor mentioned he was a bit concerned about these enzyme levels, asked if I was taking any medications, and suggested I should probably get retested in about a month.
For context, I'm an athlete. I take dietary supplements, mostly vitamins and minerals, and for the last few days, I've been taking Advil for muscle aches. I've also been under a lot of stress lately, so I suppose I don't know if all of that might be affecting the results.
Should I go ahead and redo everything, or is there really nothing to worry about?
Thanks

I’m not really sure which thread this belongs in, but this one seems like the best spot for it... so, anyway. Can you actually tell if something is off with T-lymphocytes—like, if they're running way too low—just from a standard CBC? And could that be enough to signal that someone needs more testing right away? Basically, can a basic blood panel show that your immune system is basically in a coma?...

redpilot37 said:I did a urine culture about three weeks ago because my OBGYN saw blood on the dipstick. The culture came back sterile. Yesterday, the dipstick showed leukocytes ++++ (4 pluses). My doctor didn't worry since the culture was clean. I'm wondering if this is a normal finding or if it points to an infection. Also, I'm 35 and pregnant, and my doctor refuses to do a cervical swab, saying there's no indication for it. I'm mainly interested in what those high leukocytes in the urine mean, and if there's any point in getting a CRP test—would the results actually tell us anything?
Zanimaju me prvenstveno ovi poviseni leukociti u urinu(sto oznacavaju) i imali smisla da radim CRP-odnosno-bi li ono sto pokazao?

Went to a private lab today and got a CRP done... normal is up to 5.0, and mine was 4.8.
Given that result, what does it mean? Thanks.

Amy Lewis66 said:Good day. 🙂
Hematology report update: I’ve seen an increase in my MCHC—it's sitting at 349 now (normal range is 320-345).
Coagulation.
TV is up to 21.42. Normal range is 14–21.
Blood chemistry results.
It’s up.
Bilirubin is at 26.8 (normal range is 3–20).
Bilirubin 5.2 (normal range is 0–5).

(...)

I'm 23. I gave birth 11 months ago and I'm still breastfeeding.
The reason I went to see the hematologist was because of how easily I was bruising—even from the slightest bump, and sometimes without any impact at all.

Given the symptoms you've described, you really ought to have a specialist in hematology review these results.

When a patient complains of spontaneous bleeding—specifically skin hemorrhages triggered by even minor trauma—the diagnostic path isn't a straight line. If we’re looking at small, pinpoint spots, the initial suspicion usually lands on platelet disorders. This becomes especially likely if there's also mucosal involvement, like frequent nosebleeds. However, once you start seeing larger bruises, the conversation shifts toward coagulation disorders. Then you have to factor in vasculopathies—damage to the blood vessels themselves. It’s a layered puzzle; it's never as simple as it looks on the surface.

A low platelet count often triggers these kinds of symptoms, but yours are within the standard range. Even when the count itself looks fine, platelet function can still be impaired, which might explain spontaneous bleeding. Beyond issues specifically tied to platelets, however, there are other underlying conditions to consider—things your hematologist will likely investigate.

It’s interesting. So far, the coagulation tests have mostly come back normal. There is just this tiny deviation in the thrombin time (TT), and honestly, I’m not even sure if the fibrinolysis results fall within the standard reference range.

It seems to me—though a hematologist might have a completely different take, and their expertise far outweighs my own limited perspective—that the tests you’ve run won't actually pinpoint why there's a hemorrhagic diathesis. In other words, we're looking at a tendency toward bleeding that hasn't been explained yet. Based on what a specialist would likely think, expect more testing to be necessary to clear up the uncertainty.

Regarding liver function markers, bilirubin is also marginally elevated, though it's still up. The liver enzymes are within normal range, which is definitely a positive sign.

What’s going on with these values? MCV 0.145 and MCH 87? Did you transcribe the lab results correctly? I'm asking because standard ranges usually sit around MCV 86–100 fL and MCH 27–34 pg.

Given the symptoms you've described, this inquiry falls outside my specific medical expertise. In this instance, I’ll defer to a hematologist to evaluate the situation and determine the next steps. Further consultations with a hematology specialist will be necessary.

Greetings. Wishing you all the best. 😉

redpilot37 said:I had a urine culture done about 3 weeks ago because the dipstick at my OB/GYN showed blood in my urine++. The culture came back sterile. Yesterday, the dipstick showed leukocytes++++ (4 pluses). My OB/GYN didn't worry about it since the culture was sterile... I'm wondering if this is a normal finding or if it points to an infection. Also, I'm 35 and pregnant, and my doctor refuses to do a cervical swab, claiming there's no indication. I'm primarily interested in these elevated white blood cells in the urine (what they signify) and whether it makes sense to run a CRP test—would that show anything?
Zanimaju me prvenavno ovi poviseni leukociti u urinu(sto oznacavaju) i imali smisla da radim CRP-odnosno-bi li ono sto pokazao.

Hello,

You’ve raised some very specific questions. Here are my thoughts:

1. While leukocytes were found in the recent urine sample, from what I gather, other indicators of infection (like proteins, nitrites, or potentially erythrocytes) weren't mentioned. It is entirely possible, then, that these leukocytes are originating from the vaginal area rather than the urinary tract itself. This makes determining the level of vaginal cleanliness quite critical.

It is possible to find leukocytes, or even bacteria under a microscope, without an actual urinary tract infection being present; instead, it could simply be contamination of the sample. A urine culture is certainly a more reliable metric than a simple dipstick test.

Given that your last urine culture (if I understood correctly) was sterile three weeks ago, yet these leukocyte findings are bothering you, you might consider re-checking the urine. Starting with a dipstick is an option, provided extreme care is taken during collection to avoid contamination from vaginal secretions or skin contact. Since this can be done quickly and easily at a primary care physician's office or your OB/GYN, I see no reason why a quick dipstick re-check wouldn't be worthwhile.

Please discuss your concerns and any potential next steps with your gynecologist or primary care provider.

2. Regarding CRP, generally speaking, infections in the lower urinary tract (urethra and bladder) shouldn't cause a significant rise in CRP, unlike infections in the upper urinary tract. Therefore, a CRP test likely won't help confirm or rule out a lower urinary tract infection.

Best regards. 😉

gentlecyclist2 said:Thanks for the help, and sorry for the intrusion.😉

Sorry I couldn't be of more assistance. 😢

That’s the whole point of this forum—exchanging advice and perspectives, isn't it? 😉

There's no need for apologies. 😉

Best regards and all the best.👍

mellowviper24 said:@ Felix the Cat - sorry to bother you again, but I’d appreciate one more quick consultation. I’m referring back to our previous exchange (posts #1162 - #1166) regarding my blood work and anemia issues.

So, I had my blood drawn again yesterday. Hemoglobin has climbed to 113, ferritin is steadily—if slowly—rising, and HCT is back within the normal range. MCV, MCH, and MCHC are also trending upward, even if they remain low, while UIBS and TIBC look fine. As for the biochemistry panel, everything is normal. And yes, you asked about CRP last time; it's steady at 0.2.

However, I did notice something. My leukocyte count was 7.4 during my last draw eight days ago, but today it hit 9.22. A month ago, it was 6.2. Based on these numbers, can you give me any insight into why the leukocytes jumped, and is this increase something to worry about?

Since the heart palpitations are still quite pronounced, I had an EKG done—results were normal. Now that my hemoglobin has risen to 113, is it still normal to experience these occasional, somewhat stronger palpitations?

Apologies for the nagging, and thanks in advance for your reply. 🙂

It seems to me you've been thoroughly evaluated, and everything appears to be on the right track. 👍

CRP is calm, and we know how sensitive that inflammatory marker can be. Your leukocytes are well within the reference range. Don't let those minor fluctuations cause you any stress. The most important metric in all of this is how you actually feel. 🙂

Regarding the palpitations, I believe the exam and the EKG you completed are sufficient. Those occasional flutters might now be more closely linked to stress or anxiety rather than the anemia itself.

So, just try to relax. 😉

Best regards. 👋

Grace Robinson12 said:I'm not quite sure which thread this belongs in, but this seems like the right spot. So, can a standard CBC actually show if there’s an issue with T4 lymphocytes—like if they're too low—and trigger further testing based on that? Basically, can a routine blood panel suggest that someone's immune system is essentially in a coma?

First, you have to actually suspect an impaired or weakened immune response. That suspicion should stem from the patient's specific symptoms combined with a clinical exam. Only then do you order the targeted tests to clear things up.

Standard screenings, such as a complete blood count (CBC) or an ESR (sedimentation rate), might hint at immune issues—for instance, a low lymphocyte count could point toward compromised cellular immunity—but those results alone aren't enough to confirm or rule out an actual immunodeficiency.

To answer your question directly: Are CD4 and CD8 lymphocyte counts part of a routine blood panel? The answer is NO.

Bottom line: If there is a suspicion of an immune disorder, a battery of tests is required to confirm or debunk it. A single CBC result isn't a diagnostic tool on its own.

Best, 😉

Nicole Edwards22 said:Hey! Looking for some advice...
I got my blood and urine results back yesterday, and here’s how they look:

Urine - physical/chemical exam
proteins +/- (0/neg)
ketones +/- (0/neg)
color yellow
appearance cloudy

Enzymes
AST 32 (8-30)
ALP 53 (54-119)
squamous epithelium - plenty
round cells - rare
bacteria - some
mucus - some

Laboratory hematology
RDW 12.5 (14.6 - 16.5 )
MPV 10.7 (6.8 - 10.4 )
lymphocytes 16 (20-46)
monocytes 14 (2- 12)

Basically, they told me they'd call if anything was wrong, but they didn't. When I went to pick up the results, my doctor mentioned he was a bit concerned about these enzymes, asked if I was taking any meds, and said I should probably get retested in about a month...
I'm an athlete, so I take supplements—mostly vitamins and minerals. Also, for the last few days, I've been taking Advil because of muscle aches. Plus, I've been under a massive amount of stress lately, so I'm wondering if all that could be affecting the results....
Should I redo everything, or is there really nothing to worry about?
Thanks

Jeremy Alvarez33,

Could you please retype the entire set of results? It looks like the urine physical-chemical findings are getting mixed up with the "enzymes," so we have a little AST and ALP mixed with epithelial cells, and it gets confusing.

Regarding those "enzymes worrying the doctor"—you only listed AST and ALP, and their values don't look particularly alarming to me. Please double-check and transcribe the WHOLE report accurately (take a look at Alexandra's posts from a few threads back; she formatted hers exactly the way it should be done).

Maria Fisher46 said:It appears to me that your diagnostic workup has been thorough, and from what I can see, everything seems to be in good order. 👍

CRP remains steady, which is significant given how sensitive an inflammatory marker it can be. Your leukocyte count is sitting squarely within the normal range, so please don't let those minor fluctuations cause you any undue concern. Ultimately, the most vital metric in this entire process is that you are feeling well. 🙂

Regarding those heart palpitations, I suspect the physical exam and ECG you’ve already completed should be sufficient to provide clarity. It occurs to me that these occasional flutters might actually be more closely tied to recent psychological stressors than to your anemia.

So, just take it easy. 😉

Warmest greetings to you. 👋

I truly appreciate your prompt and calming response. 🙂

I shall attempt to follow your advice and find some semblance of relaxation. 😉

Thanks again, and all the best. 🙂

@Nicholas Myers:

thanks for getting back to me 🙂

Maria Fisher46 said:Hi there,

You’ve asked some very specific questions. Here are my thoughts:

1. Your last urine sample showed leukocytes, but from what I can tell, other infection markers weren't mentioned (like proteins, nitrites, or potentially red blood cells). It’s entirely possible those leukocytes came from vaginal contamination rather than the urinary tract itself. Because of that, determining how clean the sample actually was is vital.

It's quite common to find leukocytes or even bacteria (under a microscope) in urine when there isn't an actual urinary tract infection, but rather just "contamination" during collection. A urine culture is always more reliable than a quick dipstick test.

Since your last urine culture—if I understood correctly—was sterile three weeks ago, but this recent leukocyte finding is bothering you, you could start by re-checking the urine with a test strip. Just be extremely careful with how you collect the sample to avoid mixing it with vaginal discharge or skin contact. Since this is a quick and easy thing to do at your primary care doctor or gynecologist's office, there's really no reason not to double-check with a test strip first.

Definitely talk through these concerns and any next steps with your gynecologist or primary care physician.

2. Regarding CRP, infections in the lower urinary tract (the urethra and bladder) generally shouldn't cause a significant rise in CRP, unlike upper urinary tract infections. So, a CRP test won't really help confirm or rule out a lower urinary tract issue.

Best regards. 😉

Thanks for the reply... I will definitely head back to the lab to check my urine again. For context, on the day I had that urine culture three weeks ago, I also had a routine urinalysis which showed:

cloudy
proteins at 0.15 g/L (trace)
leukocyte esterase 70 (1+)
Leukocytes 7-8
quite a few squamous epithelial cells
some bacteria and amorphous urates...

...And then the culture came back sterile, yet during a routine checkup with my gynecologist, the test strip showed 4+ leukocytes in the urine.
Then I had my CRP checked yesterday, and it came back at 4.8...

Could you please tell me more about what these urine results mean? I read somewhere that leukocyte esterase indicates inflammation, essentially acting as a marker for it...
Also, one more question about the proteins being 0.15 g/L...
The urine wasn't my first morning sample... so I'm wondering—isn't that a slightly high amount of protein for urine that had only been sitting in the bladder for an hour?
I also read that proteinuria is diagnosed if daily values exceed 0.15 g/L...
Additionally, my blood pressure was recorded at 130/90 one day... then normal at 110/70 the next... but I was told to keep monitoring it. Does any of this mean anything to you?

Thanks for the help and the response.🙂

Here is everything. If something is missing from the list, it wasn't on the report or the field was left blank....

Urinalysis, chemical
Test-trak Spec.
Specific gravity 1.030 (1.002-1.030)
pH 5.0 (5.0-9.0)
leukocytes neg. (0/neg.)
nitrites neg. (0/neg.)
proteins +/- (0/neg)
glucose neg. (neg.)
ketones +/- (0/neg)
urobilinogen 1+ (norm)
bilirubin neg. (0/neg)
Erc/Hb neg. (0.neg)
color yellow (light yellow)
appearance cloudy (clear)

Metabolites and substrates
Total bilirubin 16.2 (3-20)
Glucose 5.0 (4.2-6.0)
Urea 2.9 (2.8-8.3)
Creatinine 85 (63- 107)

Enzymes
AST 32 (8-30)
ALT 21 (10-36)
GGT 21 (9-35)
ALP 53 (54-119)

Electrolytes
Potassium 3.9 (3.9-5.1)
Sodium 138 (137-146)

Trace elements
Fe 9.7 (8-30)
UIBC 36.8 (26-59)

Urinalysis, microscopic sediment exam
leukocytes 0-2 ((0-2 (x400))
erythrocytes 0-2 ((0-2 (x400))
squamous epithelium many ((0-1(x400))
transitional epithelium rare ((0 (x100))
bacteria some
mucus some

Laboratory hematology
ESR 7 (4-24)
erythrocytes 4.49 (3.86- 5.08)
hemoglobin 138 (119- 157)
hematocrit 0.404 (0.356-0.470)
MCV 90.0 (83.0- 97.2)
MCH 30.7 (27.4- 33.9)
MCHC 342 (320- 345)
platelets 259 (158- 424)
RDW 12.5 (14.6- 16.5)
MPV 10.7 (6.8- 10.4)
PDW 13.2 (ref interval not listed)
leukocytes 9.0 (3.4- 9.7)

WHITE BLOOD CELL DIFFERENTIAL
Eosinophils 2 (0-7)
Neutrophils 68 (44-72)
lymphocytes 16 (20-46)
monocytes 14 (2-12)

I guess nothing looks bad to me either 🙂, though my doctor did stick a bug in my ear...