Posts by Nicholas Myers

Paul Gray4 said:Could someone please explain what Se 3, MCV 98.8fL, and MCH 34.2ps mean? Are these results concerning anything?

You need to refer back to the introductory post and provide the necessary context—why was the blood drawn (symptoms, routine checkup, pregnancy?), age range (doesn't need to be exact, just "twenties" or "thirties" works), and the full set of results.

No, the deviations aren't significant.

Sarah Diaz27 said:Hi, I just got my results back regarding insulin resistance. My glucose and insulin levels both look normal, but what exactly does peripheral insulin sensitivity and pancreatic beta-cell activity mean in this context? Also, what is the ideal range for an insulin resistance index? Thanks in advance!

Glucose 5.8 mmol/L (Reference range: 4.2 to 6.0).
Insulin 10.0 mU/L (Reference range: 2.6 to 24.9)
Beta cell activity (HOMA calculator) 93.9%.
Peripheral insulin sensitivity (HOMA calculator) 64.4%
Insulin resistance index (HOMA calculator) 1.6

Dear Madam,

There is no universally accepted or agreed-upon "normal" range for HOMA-IR. You’ll find various ranges scattered throughout medical literature and different studies, but as a general rule of thumb, you can use 2.0 as the upper limit. Essentially, we start talking about insulin resistance once that index climbs north of 2.0.

Ideally, those index values would sit right around 1.

Beta cell activity in the pancreas indicates insulin production levels, whereas peripheral insulin sensitivity reflects how effectively that insulin actually works.

With insulin resistance, the body cranks up insulin production while its effectiveness drops off. It’s like revving an engine that won't catch; you get a higher initial reading from beta cell activity, but the peripheral sensitivity—how much the system actually responds—ends up being relatively low.

dustymaker642 said:I'm 19 weeks pregnant and just got my blood type results back today. Can someone explain what this actually means? Aside from the obvious fact that I'm B+.😁 Thanks.

ABO blood group: B

Rh(D) blood group: + (positive)

indirect antiglobulin test: negative

HBsAg: negative

Notes: No anti-erythrocyte antibodies were found in the plasma. Follow-up scheduled for the 34th week of pregnancy.

Ma'am,

everything here looks normal. They ran a test to check for antibodies that could cross the placenta and attack the baby's red blood cells, and yours came back negative—which is exactly what you want to see. You were also screened for Hepatitis B, and that result is clear. As for the blood type and Rh factor, you've already figured those out yourself.

Michelle Kelly4 said:I handed in my last stool culture sample on Thursday.
When can I expect the results, and what happens next?

By now, you should have received the results. If they are negative, your medical leave will end and you can return to work. However, if one of the samples comes back positive—meaning two consecutive samples aren't negative—you'll have to repeat the testing, and you won't be able to go back to work until everything is clear.

wiredotter12 said:Could someone please help me interpret these HLA tissue typing results:

HLA-A 2 3
HLA-C NT NT
HLA-B27 ND
Bw4/Bw6 NT NT
HLA-DR 11 13
DR51/DR52/DR53 52 ND
HLA-DQ 3 1
CDC & specificity:
B+T Ly, CDC, DTT – B Ly T Ly, CDC, DTT + B T Ly T Ly:
Note: M14

Thanks!

The fundamental logic behind this test is that certain HLA antigens appear more frequently in people with specific diseases than in healthy individuals. Essentially, having certain antigens is linked to a higher statistical risk of developing certain conditions. This doesn't mean that anyone carrying the antigen *will* get sick! Similarly, someone without the antigen can still develop the disease.

One thing that stands out is the HLA-B27, which can indicate an increased risk for things like reactive arthritis (about 40 times the risk of someone without it), uveitis (about 10 times the risk), ankylosing spondylitis (as much as 80 times the risk), and so on.

What strikes me most about this entire situation is the bluish tint in the extremities and lips. Based on what’s been described, it doesn't quite fit the profile of Raynaudov phenomenon. We need an actual clinical exam and further investigation to determine if we're looking at cyanosis. It would be wise to run an arterial blood gas test and an EKG—perhaps even a Holter monitor for both heart rhythm and blood pressure. Depending on the findings, a chest X-ray or pulmonary function tests might be necessary, along with a deeper dive into cardiology or pulmonology, though it's impossible to say for sure without a hands-on assessment. I'd strongly suggest you don't brush this off; bring it to the attention of your primary care physician immediately.

Hello,

From the moment we receive a stool sample until the results are finalized, you're looking at a minimum of two days. To put it simply: if the sample comes back negative, we can usually have answers for you in about 48 hours. However, if we find something positive, the process takes longer—potentially up to five days total. You can expect all three sets of results within five days of submitting your final (third) sample, though they may arrive sooner.

Ashley Kern said:Small incident, big worry. A neighbor's dog bit me. I was riding my bike, passed a little too close to the dog, and it nipped my thigh. It didn't really bleed much—just three tiny red surface dots where the teeth hit. No deep wound, just marks. I washed it off with water and alcohol.

Now reading about rabies, I'm getting nervous. Apparently, even superficial scratches can be dangerous. Thoughts?

The right move here is to contact your local epidemiology department or a vaccination clinic. You can walk in any weekday; you don't need a referral or an appointment. These services are typically run through your local County Health Department.

They will go over the specifics of the bite with you and ask to see the dog's vaccination records. It would be helpful to have those ready if your neighbor is willing to share them. If the neighbor refuses, the authorities will request the records officially and notify the local vet to check the animal for rabies.

Additionally, stop by your primary care doctor. They need to examine the wound itself and determine if you require a tetanus shot.

Michelle Sullivan87 said:I get occasional cyanosis in my lips and limbs, and my legs often go numb.

Could you elaborate on what triggers the discoloration in your extremities and lips? For instance, does cold exposure, emotional stress, or physical exertion set it off?

Does paleness precede the blue tint? Any pain when your fingers or lips turn blue?

If you were to dip your hands into cold water, would they turn blue?

What is your general fitness level? How many flights of stairs can you climb before getting winded? Do you experience shortness of breath during specific activities?

Have you ever dealt with skin rashes, swollen or painful joints, or any unusual shaping of your finger joints?

Have your lower legs ever swelled up?

Regarding the tachycardia—what kind of heart rate are we talking about, and is this rapid rhythm constant or intermittent?

Any coughing?

Maria Reed75 said:34 years old, female, admitted with TIA symptoms (monitored for 24 hours; during that window, all the tests mentioned above were performed, including two CT scans and continuous Holter monitoring). Discharged without a definitive diagnosis.

A colleague already responded to your other thread regarding the ECG. That specific data point is critical in your situation, yet you haven't shared it here. Furthermore, several parameters from your testing lack actual results, making any meaningful commentary difficult.

redpuma26 said:I feel great and have zero symptoms, but these urine sediment results are worrying me. I don't know what they mean or what they might indicate.

Ma'am,

Your urine sediment shows quite a few casts. Hyaline casts aren't necessarily indicative of pathology, but fine granular casts can be—though they also appear in people with perfectly healthy kidneys, perhaps due to intense exercise or significant dehydration. It would be wise to repeat the urine sediment test after ensuring you are properly hydrated. I don't see whether urinary protein was checked in these results.

Linda Johnson66 said:I've never had issues with my iron levels before; they were always around 14-20. I've never seen them this low. What's going on?

You need to check ferritin to solve the mystery regarding your iron. Serum iron concentration fluctuates quite a bit—it depends on what you eat, and according to some data, even how you ate in the days leading up to the blood draw.

Once you have the ferritin numbers, you'll know exactly where your iron stores stand.

As for the rash, it's hard to say anything meaningful without an actual exam. I wouldn't say it's likely that the rash is tied to the iron levels.

Generally speaking, you shouldn't be testing iron while dealing with any kind of infection. You should wait until you've fully recovered before taking a sample for analysis.

Nicole Perez80 said:Hi,

Since last week, I've had swollen, painful lymph nodes under both armpits, frequent headaches, general weakness, and an unexplained weight loss of about 13 pounds over the last month and a half. Over the weekend, a rash appeared below both shins; it doesn't itch, but my legs are tender to the touch. Both ankles are swollen, making walking difficult. My fingers and hands are tingling.

Blood work (only abnormal values):
White Blood Cell Count 3.3 (3.4-9.7)
MCHC 356 (320-345)
RDW 12.2 (14.6-16.5)
MPV 10.5 (6.8-10.4)
Monocytes 12.8 (2-12)
Creatinine 60 (63-107)
Urate 127 (134-337)
ALT 8 (10-36)
CRP 8.1 ( HDL-C cholesterol 1.19 (>1.2)

Doctor's recommendation: Monitor and rest for 4 days.

I would appreciate your thoughts.

Hello,

The information provided isn't enough to give you a real answer. This could be an infectious issue followed by some sort of reactive joint inflammation, or it could simply be an underlying immunological or rheumatological condition. Keep monitoring your symptoms; if things worsen, you'll likely need more investigation (probably seeing a rheumatologist).

Michelle Kelly4 said:I’m looking for info on the stool culture procedure. How long does it take to get results, and when can I head back to work?
Thanks for the help everyone.

Unless public health officials at the CDC specify otherwise, you need to provide two or three* samples, spaced out by at least 24 hours. Basically, they won't accept two samples taken on the same day.

You can return to working with food once you have two consecutive negative results.

Salmonella shedding can be unpredictable—it might last a few days, several weeks, or even months. On average, though, people clear the carrier state in about three weeks, at which point they're usually cleared to go back to work.

Jessica Bailey39 said:I’d appreciate some insight on these lab results. Since I haven't been able to conceive, my doctor ordered a full panel covering reproductive hormones and thyroid function. Thanks.

Free testosterone 6.1 (range 0.2-14.2).
Testosterone at 1.9 (range 0.4-2.6).
Prolactin 209 (Range: 71-566)
DHEA-S 4.5 (0.6-7.2)
SHBG 61.7 (Reference range: 18.2–135.5)
FAI 3.1 (0.65-10.9)

Anti-TG 467 (Reference range < 60)
Anti-TPO is over 1300. Reference range is under 60.
TSH 5.59 (Range: 0.4-4.0)
fT4 14.4 (11.5-22.7)
fT3 5.48 (2.8-6.5)

To whom it may concern,

Based on these results, you’re looking at an autoimmune thyroid condition paired with subclinical hypothyroidism—meaning your TSH is elevated, even though your actual thyroid hormone levels are still sitting within the normal range. Both factors, the presence of antibodies and that elevated TSH, can potentially complicate things, affecting both conception and the course of pregnancy, particularly during the first trimester.

Consult an infertility specialist and an endocrinologist. It’s essential. For many dealing with subclinical hypothyroidism, medication isn't strictly necessary unless TSH climbs above 10. However, therapy can be used to lower TSH levels in certain cases—and women struggling with conception might find themselves as candidates for that approach.

You can find more information at the following links: Link No. 1 i Link No. 2.

If there isn't a pregnancy, you should definitely go through with more extensive testing beyond just these results. In your case, there could be other underlying factors at play here.

Greetings. 🙂

Emily Ortiz27 said:👋
I had bloodwork done due to a laundry list of symptoms. Redness, rashes, itching on my face, arms, and soles of my feet, frequent bowel movements—it was quite a collection of issues.
I had it removed. TSH. Which one was low? 0,04...and during the follow-up blood draw. 0,09
They ran out of reagents, so they couldn't process the T3, T4, or the antibodies. I'm waiting on the endocrinologist now; perhaps once I have their blessing, we can move forward.
Completed the CBC, differential, and serum biochemistry.
Most of my results came back perfectly normal, but a few were just a hair off. 😉 Outside the normal range: MPV. je 11,8 (6,8-10,4); Eosinophilic granulocytes. su 7,5 (0-7), a Neutrophil granulocytes. 41,5 (44-72).
Urine Glucose.Well, then. 4,0 (4,4-6,4), Urati 341 (134-337), a ALT 39 (10-36).

Could you explain this?

Dear Madam,

It's quite possible that a low TSH reading—and the hyperthyroidism that follows from it—could be responsible for at least some of the symptoms you're experiencing.

To make sense of eosinophil and neutrophil levels, you really need the total White Blood Cell Count.

A few other parameters are slightly off, though I don't think it's anything major. They'll just need some monitoring.

Best regards. 🙂

Jessica Baker69 said:But my iron levels are a bit high—even though they were totally normal (22) just a month and a half ago.
Now it’s at 33!

Two weeks ago, I started taking a prenatal vitamin and some Omega-3s, and as of yesterday, I added royal jelly to the mix... Could any of that be the culprit?
I need help here!

Hello,

You're taking a supplement that contains iron, so naturally, that's going to impact your iron concentration. To get an accurate reading, you really shouldn't take any iron supplements within ten days of having blood drawn.

Regarding the cough, I mentioned previously that you need a full workup. A chest X-ray and a standard blood count aren't enough to pin down the cause of a cough.

Best regards. 🙂

Donna Campbell said:Prothrombin time 1,0, ref: 2,0 - 3,5
granulocytes: 76 ref: 32 - 68
lymphocytes: 18 ref: 20 - 46
creatinine: 62 ref: 63 - 107

If possible, could someone explain the values falling outside the reference range? Should I be concerned?

(my next OB-GYN appointment is scheduled for next week)

Hello,

Your results look normal; there is no cause for concern.

Specifically, an INR range of 2.0-3.5 applies to patients on anticoagulant therapy ("blood thinners"). For anyone not taking such medication, an INR around 1.0 is perfectly standard. Your result is completely fine.

Creatinine levels are typically lower during pregnancy, so you shouldn't worry about that either—the provided interval is meant for non-pregnant women.

As for the granulocytes and lymphocytes: while the percentages deviate slightly, the absolute counts are normal and the CRP is stable, so everything is fine. A slight increase in white blood cells is common during pregnancy due to estrogen influence. In cases of DIC, you might see a rise in neutrophil or granulocyte percentages (as seen in your labs) along with a slight eosinophil increase. However, one must consider clinical symptoms and CRP when looking for infection during pregnancy. If an infection were suspected, we would take a thorough patient history and check the CRP, which has already been done here. Since the CRP is normal and the absolute neutrophil and lymphocyte counts are within range, this is an expected finding.

Be sure to consult with your OB-GYN.

Best regards. 🙂

rustyskipper512 said:Bumping this. Right before I moved abroad, I got my first two doses of the Hepatitis B vaccine. However, since I couldn't make it back to the States in time, I missed the third shot. It’s been two years now. Do I need to restart the whole series from scratch, or can I just get that third dose? Or should I just leave it alone?

Hello,

The medical consensus is pretty clear: to be fully protected, you need all three doses of the Hepatitis B vaccine (though some recent studies suggest certain groups might find coverage with just two). That said, your immunity won't suffer if you deviate from the standard schedule—meaning, if the gap between shots ends up longer than planned. As long as the interval isn't too short, a longer delay won't compromise your protection; you'll end up just as shielded as if you'd followed the timeline perfectly.

There is no need to start over from the beginning. You simply need to get that third, missed dose whenever you can.

If you stop at only two doses, there is a chance your protection will be incomplete.

Check in with a local health official or contact the clinic where you received those first two shots.

Best regards. 🙂

cosmiclynx12 said:My gynecological swabs came back clear, so that's one less thing to worry about.

To me, this doesn't look like gout. Based on the symptoms and history provided, it feels more like reactive arthritis, much like what the colleague suggested.

It would be wise to run tests for chlamydia and mycoplasma—but specifically via a urethral swab or urine sample.

Have you dealt with any eye issues, like conjunctivitis, or perhaps some diarrhea recently?

I’ve been away for a bit, so I’m circling back to answer the questions left hanging.

rapidcyclist9 said:My five-year-old son just got his serology results back from a lumbar puncture. I'm wondering what these values indicate;

EBV VCA IgG positive 121
EBNA IgG positive 67
CMV IgG positive 0.8
Rubella IgG positive 14
Measles IgG positive 617

Thanks.🙂.

Ma'am,

CSF results are essentially useless without a corresponding serum panel. There are several other parameters involved that need to be factored into specific formulas before any real conclusions can be drawn.

Maria Nguyen93 said:I did an OGTT because my fertility specialist requested it ahead of my scheduled IVF treatment. Otherwise, I have no health issues.

In my view, that OGTT looks normal, though the blood sugar at the 120-minute mark is relatively low. There isn't a universal consensus on a minimum threshold for blood sugar at 120 minutes; different guidelines suggest a lower limit ranging roughly from 3.4 to 3.9 mmol/l.