Posts by Nicholas Myers

Emily Ortiz27 said:Thank you.
Yes, my TSH, prolactin, kidney function, and liver panels all came back normal.
So, nothing actually lines up. 😁

I’m waiting on a breast ultrasound, a gynecological exam, and an appointment with the endocrinologist. I’ll also try to get those other tests you mentioned done.

The discharge is still happening after more than a month. Is it normal to just leave it alone if the remaining tests and labs also turn out fine? I’m confused. 🤔

Occasionally, I let myself spiral into this uncomfortable anxiety. It’s because the dizziness—which was the whole reason I sought out these initial blood panels and TSH checks—is still there. Now that I’m worrying about everything, I’m noticing regular frontal headaches too. They aren't new, but I used to just blame them, along with the vertigo, on neck issues, dehydration, or PMS. Neither symptom is unbearable, though the dizziness is actually more unsettling than the headaches, especially when I'm not even moving. Sometimes I'll just be sitting there and feel this sudden pull to one side.

Yes, the results are quite baffling. As for the galactorrhea, idiopathic galactorrhea isn't rare—that's when no obvious cause surfaces even after a full workup. In those instances, treatment can be offered if the patient prefers it.

Emily Ortiz27 said:Hello, I'm back with more questions regarding my daughter. It feels like the issues never end.

My daughter (12 years old) dealt with a prolonged fever reaching 38.6°C for several weeks following a SARS-CoV-2 infection. We were referred to a post-viral clinic where she was seen by an immunologist.
There wasn't a specific diagnostic exam because her only complaints were occasional nausea and brief, passing bouts of mild headaches or stomach aches.
Since she's been menstruating for over a year now, those pains could theoretically be cycle-related, but given how long that fever persisted at such high levels, we didn't think it was just hormonal.
A battery of tests was ordered, but since the results haven't been finalized for five weeks, we still can't follow up with the doctor to get a definitive opinion.
So, while we wait for all the paperwork to come together, I’m asking if anyone sees anything concerning in these results.

Hello,

The labs show positive antinuclear antibodies at a significant titer of 1:640. These antibodies can appear in various systemic autoimmune diseases, but they are also found in about 3% of perfectly healthy individuals—and often follow different infections, including SARS-CoV-2. However, we also know that the SARS-CoV-2 virus itself can act as a trigger for autoimmune conditions, and these antibodies can sometimes surface years before clinical symptoms actually manifest.

All of this makes interpreting this single finding quite complicated. From what you've described, the girl isn't showing other major symptoms besides the extended fever, which adds another layer of complexity. Which specific results are you still waiting on? Were anti-ds DNA and antiphospholipid antibodies requested? Has a urinalysis been done—specifically checking the albumin-to-creatinine ratio? Was a serum protein electrophoresis performed? And has she had an abdominal ultrasound?

The only constant thread in this entire situation is the PPI usage. It might actually make sense to run a stool cytology test. As a next step, to rule out whether these diarrhea episodes are linked to the medication, you should discuss stopping the PPI with your gastroenterologist and then monitor how things progress. If the episodes stop, the mystery is solved.

darkmoose58 said:Looking for an expert opinion.
I'm 37. I’ve been dealing with Hashimoto for 15 years and vitiligo for three. Currently, I’m not on any medication. Back in June 2021, I received the SARS-CoV-2 vaccine and experienced a reaction in the form of arthritis. My ankles were the worst part—they actually swelled up—and my knees were painful, though without swelling. That lasted about a month; I managed it with nothing but Advil. Since then, I’ve felt fine. I get some minor knee discomfort when the weather shifts, but that happens less and less frequently. Overall, I feel good, though I haven't picked up my exercise routine again since it all happened.
I’m only seeing a rheumatologist because my doctor specifically ordered the referral. If I hadn't been scheduled like that, I wouldn't have even bothered showing up. I don't have any symptoms.
What I'm actually interested in is Ana.
Because of her, I was sent for further testing. Back in December 2021, my titer came back at 1:320 (ref That lab result from Breyer back in February '22—the ANA was So, I just got my latest lab results back from the hospital—the three-month follow-up from February—and here’s what they show:
The ANA results are somewhat vague. They show a speckled pattern, but there’s no specific titer listed—only a reference range of I'd appreciate some insight here. What do you all think?
We just received our HLA system results. Here they are:
HLA-A 2:-
HLA.B 18:51
HLA-C NT:NT
HLA-DRB1*01:14
HLA-DQB1
I'm looking for an interpretation.

Just to be clear, everything else came back perfect: ESR, CRP, CBC, C3, C4, chest and heart X-rays, ACE, protein levels, IgA, IgG, and IgM.
Cryoglobulins? Not found. Monoclonal proteins via immunotyping? Normal. ANCA came back negative. Total complement activity sits at 99%, right in the middle of the 69-129 reference range. Serum protein electrophoresis shows nothing out of the ordinary. Everything looks clean.
Thanks in advance.

To whom it may concern,

Based on what you’ve laid out here, I don't see any actual indicators of inflammatory rheumatic disease. It isn't clear to me why hydroxychloroquine was even recommended in this case.

Regarding the ANA results, I won't bother commenting on anything from a private lab. In my view, the data coming out of Mayo Clinic is what actually matters.

Ana’s latest ANA results aren't quantified. It’s positive—the titer is over 1:100—but there's no specific number, so we're flying blind on the exact scale. Based on the AC-5 pattern, this isn't an automatic red flag; you see these kinds of results in healthy people from the general population all the time. Of course, in patients with autoimmune issues, it could point toward things like lupus, systemic scleroderma, overlap syndromes, or undefined collagen diseases. As for the anti-U1 RNP, I don't see much significance there, though given the rest of the picture, it probably warrants keeping a close eye on things moving forward.

Regarding your HLA profile, you have a predisposition for rheumatoid arthritis. Specifically, hla-drb1*01 is linked to an increased risk of seronegative rheumatoid arthritis in adults. If joint issues resurface, that’s where your focus should be. You also carry HLA-B51, which can be tied to another rheumatic condition, but in our clinical setting, it doesn't carry much weight for asymptomatic individuals. I wouldn't dwell on it right now.

All things considered, one could draw a conclusion—though I’ll add a massive disclaimer here since this forum isn't a substitute for seeing a doctor, reviewing full lab results, a complete medical history, or a physical exam. For now, I don't see any clear signs of active rheumatic disease, but you'll need regular monitoring. You definitely have certain predispositions that could lead to autoimmune issues down the road.

cosmicsurfer17 said:Hi there.

I've checked all my iron-related labs.
Everything looks normal, except my TIBC is a bit low.
The result was 43.7, while the reference range is 49-75.

I'm not sure if this is low enough to worry about or if it's just something doctors overlook.
Thanks.

There’s likely no cause for alarm, but it would be helpful if you listed all the values and the reason for the testing.

Emily Ortiz27 said:The cytology smear results show: right-side smears contain numerous polymorphonuclear phagocytes and secretions. Left-side smears show no cellular elements.

I have a breast ultrasound scheduled in about 20 days.
Is there anything else I should be doing?

Dear lady,

Looking at your lab work, nothing is quite clear. Your ferritin levels don't align with iron-deficiency anemia. On the flip side, a normal sedimentation rate doesn't point toward chronic inflammation, which might otherwise explain why your ferritin stays within the normal range. It might be wise to run a CBC with a differential and a CRP, though I'm not certain that will yield any new insights. Since you've already started iron supplements—which perhaps was premature before all test results were in (not that a short window would significantly alter ferritin, but it adds a layer of confusion to the data)—one could monitor how you respond to the iron to better determine if deficiency is indeed driving the anemia. It also wouldn't hurt to check reticulocyte counts and perform a peripheral blood smear.

Based on the cytology report, it looks like galactorrhea, given the milky content. However, since your prolactin levels are normal and your menstrual cycles are regular, hyperprolactinemia seems unlikely. Most clinical guidelines would stop here, given that the prolactin level is fine. I agree that a breast ultrasound is the next logical step. If I recall correctly, you've already had your thyroid hormones checked, so that shouldn't be the culprit behind the galactorrhea either.

vividcrane24 said:Hello,

My swab results just came back. Chlamydia Mycoplasma/Ureaplasma are negative, but Streptococcus agalactiae (BHS-B) showed up in both the mycological and bacteriological tests. View on imgur
Does this shed any light on the symptoms I mentioned earlier?
I have an appointment with the urologist next week regardless...

It’s hard to say if Streptococcus agalactiae is actually linked to your symptoms. Often, it's just colonization—about 30% of women carry it in their gut or reproductive system. Treatment is usually reserved for specific circumstances, such as pregnancy. Your gynecologist, who ordered the test, should be the one to make that call.

Emily Ortiz27 said:I just started taking an iron supplement (two days ago), and I still need to go get my ferritin levels checked. Will that interfere with the results? Should I stop taking it for a bit, or is a one-day break enough?
I realize two days isn't exactly going to move the needle when treatment usually lasts 6 to 12 weeks, but I’d rather ask than mess up the data.

The window of time you've been on the iron supplement is too short to skew the results. It shouldn't be an issue.

Are there specific inflammatory markers being tracked during the diarrhea episodes? Was a stool cytology performed? Did they take a duodenal biopsy? Also, can you pinpoint any connection between these symptoms and certain foods?

Amy Cruz8 said:I took photos of all three pages. The first one is at the link.
Aside from being under the weather last week and the week before, I'm not on any medication. I took some DayQuil and one effervescent Vitamin C aspirin tablet, though I can't recall if I took the aspirin the day before the tests or the day after.
Otherwise, my results look fine, except my iron levels haven't budged above 6 since I gave birth back in 2018.
I don't remember exactly when my last full CBC was done. Maybe a year ago.

Ma'am,

Based on the new data you provided in your previous post, that slight, currently non-significant thrombocytopenia appears to be nothing more than a "trace" left behind by a recent viral infection. It doesn't require any intervention right now. Just repeat the CBC in 2 to 3 weeks.

Regarding the iron, we need to determine your ferritin concentration. If ferritin is below 30 ug/L, we're looking at iron deficiency without anemia. In that case, I’d recommend dietary adjustments—incorporating meat, poultry, or fish at least five days a week, along with legumes and leafy greens—plus iron supplements and periodic checks of your hemoglobin and ferritin. If that's the situation, you can ignore the raw iron concentration value itself.

Once the ferritin results come in, consult with your primary care physician. If it is low, they will need to investigate the underlying cause and take appropriate steps.

Amy Cruz8 said:I’m looking for some insight—basically, an interpretation of my blood work. We went in for a routine checkup and a few markers came back just below the threshold.
Glucose 4.2 (lower limit 4.4)
HDL cholesterol 1.1 (lower limit 1.2)
Iron 6 (lower limit 8)
MCHC 319 (lower limit 320)
Platelets 148 (lower limit 158)
Everything else looks fine. I'm 36 years old, weighing 134 lbs at 5'6".
Should I be worried?
My iron levels have been like this since I gave birth in 2018. I always assumed it was because I had to undergo a D&C after delivery due to heavy bleeding.
Thanks in advance.

Hello,

If possible, please transcribe the results from all tests performed.

Are you currently taking any medications?

Do you recall what your previous blood counts were like—specifically, when was the last time you had them checked?

Emily Ortiz27 said:To whom it may concern,
I’ll add a bit more context to my question. I'm looking for an interpretation: is there a potential link between these specific lab results and my situation, and what should my next steps be?

Dear Madam,

Given the symptoms that surfaced later, it would be wise to check serum protein and albumin levels, along with a one-time urine albumin-to-creatinine ratio.

Regarding further steps for managing galactorrhea, we first need to confirm that this is indeed milk discharge from the breast. If it turns out to be true lactation—provided prolactin levels are normal and menstrual cycles remain regular—the risk of a pituitary adenoma being the underlying cause is low. That said, expanding the endocrine workup would be a prudent move.

A glucose reading of 4.1 mmol/L doesn't qualify as hypoglycemia. It shouldn't be linked to the symptoms you're experiencing.

Everything else depends on the lab results we're still waiting for.

Was a random biopsy performed during the colonoscopy?

Emily Ortiz27 said:https://i.ibb.co/CwfYprg/provjera-nalaza.jpg

Hi there.
Could these results explain frequent dizzy spells?
Female, 41 years old, slightly overweight (5'6"/167 lbs) currently working on weight loss through a high vegetable, meat, and fish diet—essentially LCHF. Physically quite active.
Non-smoker, though I drink on weekends, sometimes more frequently.
My hemoglobin and iron levels don't look critically low, and while my cholesterol is outside the standard range, it doesn't seem alarming to me. Should I be concerned about this or anything else?
I'll definitely be starting an iron supplement again.
Thanks.

There is mild anemia present, which could certainly cause dizziness, though whether it's the actual cause of your vertigo remains to be seen. The real question is determining what is driving the anemia itself. As for the lipid panel, the values are elevated, but they aren't a cause for immediate alarm; however, it would be wise to manage them by adjusting lifestyle habits.

Betty Collins45 said:Still waiting on the urine culture. Is there anything concerning about this urinalysis result?
http://uploads.tapatalk-cdn.com/202...c533e88e8a.jpg

The results look normal.

Kimberly Morris said:I'm uploading my results here. I’d appreciate any feedback—do you think I actually needed further imaging, like a brain CT or maybe even an X-ray of the cervical spine?

To reiterate: radiological follow-up—specifically a CT, or ideally a brain MRI with angiography—is definitely indicated in my view.

vividcrane24 said:You're right; since my Pap smear came back clean, all that's left are the cervical swabs. I managed to snag some appointments for follow-up hematology and urology work, so hopefully, I'll have some actual answers regarding these symptoms soon.

👍

While I wait, I'm curious about how neutropenia linked to Hashimoto is typically handled (assuming other causes are ruled out)?
It strikes me as odd that an endocrinology specialist told me he wouldn't link elevated lymphocytes and low neutrophils to thyroid dysfunction.
On the other hand, one study suggests that a low white blood cell count is observed in patients with autoimmune diseases (i.e., chronic thyroiditis), and that this possibility might even extend to untreated hypertensive patients.

If other causes are ruled out, neutropenia as part of an autoimmune condition like Hashimoto’s thyroiditis is quite plausible.

The endocrinologist you mentioned seems to be contradicting both clinical experience and scientific literature—for instance: https://pubmed.ncbi.nlm.nih.gov/26061308/

Given that we are looking at mild neutropenia without an increased susceptibility to infections, if a link to autoimmune thyroid disease is confirmed, treatment isn't necessary.

Harold Garcia60 said:Thank you. For the last three months, I've been diving deep—reading journals, scientific papers, patient stories, watching YouTube videos. It’s been an intense education on this condition. Because you clearly have a much deeper grasp of this than most doctors we've encountered, I would be grateful if you could answer a few questions. We are still waiting on the genetic results; we sent the samples to a lab in Newcastle Upon Tyne back in early December.

If the condition is well-managed, does that reduce the risk of complications, or is the probability still the same? What specific complications are you aware of? As you mentioned, there is a possibility of sensorineural hearing loss due to Enlarged Vestibular Aqueduct (EVA). To be honest, that is our greatest fear, and it's something we are struggling to accept. Since the deafness is driven by specific gene mutations, my question is: is there any hope? Any chance of a cure, whether natural or "official," to prevent it?

Additionally, nephrocalcinosis has developed in both kidneys. I'm attaching photos. Is it possible to cure or completely remove nephrocalcinosis through any means?

https://ibb.co/K207ZkS
https://ibb.co/2WN5Ng1

Forgive the many questions, but processing this diagnosis for our son has been overwhelming.

Dear Sir,

Since it is quite late, I may have overlooked some of your inquiries. I will provide brief answers for now and perhaps expand on them later.

Regarding treatment: based on current medical knowledge, nothing available can slow down, delay, or prevent hearing loss if it is genetically determined. Nothing has proven effective yet. At this stage, the only options remain hearing aids or a cochlear implant if the hearing loss progresses.

As for the nephrocalcinosis, therapy might slightly reduce it, but expecting a total reversal is unrealistic. Based on what we know today, complete removal isn't possible. However, treatment can prevent further progression, help preserve kidney function, allow for normal growth and development, prevent bone density loss, and lower the risk of kidney stones.

The known complications associated with this condition include: growth and developmental delays, rickets, osteomalacia, nephrocalcinosis, kidney stones, impaired renal function leading up to chronic kidney failure, kidney cysts, dental enamel issues, hemolytic anemia, and hearing loss in cases involving distal renal tubular acidosis. I may have missed something else given the late hour.

Therapy can be used to manage the issues I listed above.

vividcrane24 said:Hello,

I just got my urine culture results back, and they show an evident presence of "Enterococcus faecalis."

View on imgur

Could someone interpret this and suggest a direction for treatment? (As I mentioned in a few previous posts), I've dealt with a long-standing, frequent urge to urinate accompanied by pressure or inflammation in my lower abdomen/pelvis. To reiterate, I was previously prescribed Ninur or Norfloxacin for cystitis, but there was no improvement following those treatments.
Is it possible to link my neutropenia to these urinary issues?
I would appreciate your perspective..

To the requester,

I am not convinced that an E. faecalis count of 10^3 CFU/ml is linked to the symptoms you are describing.

It seems unlikely that your urinary issues are directly tied to your mild neutropenia.

Unless something else emerges from other microbiological tests (you mentioned swabs earlier?), my suggestion would be to seek a gynecological and urological evaluation. There are specialists in urogynecology specifically; I'd recommend starting there to resolve this.

Frankly, I doubt a single course of an antibiotic sensitive to the E. faecalis found in this culture will fix chronic issues that have persisted for years.

Hannah Stewart27 said:Sir,

Thank you. I'll try to push for the ANA and ENA panels, though everything is still a bit of a question mark right now—including how malabsorption actually works if that ends up being the diagnosis.

Regarding Vitamin D, yes, the units were identical. Three months ago, it was at 69.5 nmol/L; now it's dropped to 14.7 nmol/L (target range 75-100).

The protein electrophoresis results, in both % and g/L, are as follows:

12/23/2021:
Albumin - 61.5% (52-68)
Alpha 1 globulins 2.7% (2-5)
Alpha 2 globulins 7.8% (7-11)
Beta globulins 7.6% (9-14)
Gamma globulins 20.4% (12-20)
Albumin 45.5 g/L (35-49)
Alpha 1 globulins 2.0 g/L (1-4)
Alpha 2 globulins 5.8 g/L (4-11)
Beta globulins 5.6 g/L (6-10)
Gamma globulins 15.1 g/L (8-14)
Albumin/Globulin 1.60 1

02/10/2022:
Albumin - 68.0% (52-68)
Alpha 1 globulins 2.4% (2-5)
Alpha 2 globulins 6.5% (7-11)
Beta globulins 4.9% (9-14)
Gamma globulins 18.2% (12-20)
Albumin 48.3 g/L (35-49)
Alpha 1 globulins 1.7 g/L (1-4)
Alpha 2 globulins 4.6 g/L (4-11)
Beta globulins 3.5 g/L (6-10)
Gamma globulins 12.9 g/L (8-14)
Albumin/Globulin 2.13 1

I appreciate all the information provided so far.

Looking at these side-by-side—which is why presenting full sets for comparison is always better—the drop in beta globulins stands out as significant. The Vitamin D level has also plummeted, though we have to consider that it’s winter here in the States; less sunlight likely played a role in that decline.

"Malabsorption" isn't really a diagnosis in itself. It's more of a descriptive term for a condition that can stem from a massive variety of underlying causes. This makes it notoriously difficult to pin down or treat effectively.

That said, I might have missed a detail earlier—I can't recall the very beginning of your history—but typically, patients dealing with malabsorption or malabsorption syndrome present with prominent symptoms like chronic diarrhea, weight loss, or anemia. There could be others, but I don't recall the exact specifics of how your situation first began...