Posts by Nicholas Myers

Sarah Anderson34 said:Question,

we had blood drawn for our son and the results were:
(K) Erythrocytes 4.90 x10e12/L 4.43 - 5.88
(K) RDW 13.3 % 11.6 - 14.3
(K) Hemoglobin 147 g/L 129 - 166
(K) Hematocrit 0.393 L/L 0.390 - 0.487
(K) MCV 80.2 fL 76.5 - 92.1
(K) MCH 30.0 pg 24.3 - 31.5
(K) MCHC 374 g/L 304 - 346 H
(K) Platelets 142 x10e9/L 178 - 420 L
(K) Reticulocytes 24 /10e3 Erc 4 - 19

Eosinophil gran. 0.6 % 0 - 9
Basophil gran. 1.6 % 0 - 3
Neutrophil gran. 25.9 % 34 - 69 L
Lymphocytes 61.5 % 19 - 52 H
Monocytes 10.4 % 5 - 13
MORPHOLOGY: Out of 100 differentiated leukocytes, 20 atypical lymphocytes were found.

Liver enzymes look great, everything else is fine—all within normal ranges.

Urine shows phosphate crystals and some bacteria.

Based on this, the doctor did an exam; nothing was swollen except for one lymph node, so he's sending him in for mono testing.

The follow-up blood work to check for mono is:

EBV VCA IgM positive 81.8
CMV IgG positive 149.0
All other EBV and CMV tests are negative.

To me, this looks like mono, but I'm not sure what exactly he already went through?

Thanks in advance for any insight.👍

Hello,

The lab results and serology align with an acute infection from the Epstein-Barr virus, which causes infectious mononucleosis. According to the data, the child previously had a cytomegalovirus infection, which also triggers mononucleosis syndrome. While there are clinical differences between these two viruses, they aren't always easy to distinguish in practice. With a CMV infection, you typically see a prolonged fever accompanied by liver and spleen enlargement, while sore throat and swollen lymph nodes are usually less prominent. Conversely, EBV infections often present with swollen lymph nodes, a sore throat combined with fever, fatigue, and frequently, an enlarged liver and spleen. Based on these findings, the child appears to be at the very onset of the infection, so the clinical picture may still develop (meaning symptoms could become more pronounced).

Amy Cox79 said:Dear Nicholas Myers, a few months ago I asked for recommendations regarding blood work—specifically, what a vegan diet should necessitate in terms of a routine checkup. I haven't run every single test due to costs, but I've done most of them. My physical also noted a slightly enlarged spleen. I'm in my late twenties. I would appreciate your perspective. Thank you.

https://ibb.co/d24P4JZ
https://ibb.co/6rgtrqN

Ma'am,

It's clear your diet isn't providing sufficient B12; the results speak for themselves. You'll need supplementation. Additionally, you should increase your intake of potassium-rich foods, as your levels are low, and B12 supplements can sometimes drive potassium even lower. I suggest checking your ferritin levels. Also, was your blood sugar tested while fasting?

bluepilot45 said:Hello,

Thanks for the reply.

In the meantime, I've had blood work done twice more.

The first time was on day three of taking Rexocef, Nov 19th. Results showed immediate improvement, suggesting the antibiotic was working (only white blood cell count was high at 10.23 (3.40-9.70) and CRP was 11.1 (0.0-5.0)): https://ibb.co/s635Kz4

The second time was four days after finishing the ten-day course of Rexocef 200, on Nov 30th. There were still some deviations: MPV 10.7 (6.8-10.4), WBC 10.7 (3.4-9.7), neutrophils 6.91 (2.06-6.49), and CRP 5.3 (https://ibb.co/5xTvz3c

Based on this last panel, my primary care physician thinks things are heading in the right direction—mainly because the CRP dropped—so she hasn't ordered a chest X-ray yet. She just gave me a referral for one more blood test in a few days; if the numbers look worse, she’ll prescribe another round of antibiotics.

But I'm wondering: is she making the right call? Do you see the second set of results as an improvement over the first? Her logic rests on the lower CRP, which is nearly normal, but I'm concerned that both my white cell count and neutrophils ticked back up once I stopped the meds...

As for symptoms, I'm still coughing, though less frequently. It's worst in the morning, producing phlegm that shifted from yellow-green to green, and there's less of it now, if that matters clinically. No other symptoms.

Thanks in advance for your help. Best regards.

Hello,

It seems you are recovering despite the Rexocef rather than because of it. That isn't unusual; many causes of atypical lower respiratory infections are self-limiting. If your symptoms persist or you take a turn for the worse, I suggest following the previous advice.

coastalgull8 said:Hi there, could someone help me interpret the bottom section of these urinalysis results? The top part makes sense since they include clear reference ranges, but the bottom section is blank. It just lists "mucus - rare." Should that be negative?
Is this fine, or should I be worried?
Thanks in advance!

View on imgur

Hello,

The results look clean.

Donna Lopez79 said:Hello,
I had appointments scheduled in Washington, D.C. for November 29th and 30th.
I was looking forward to them immensely, but I eventually had to postpone everything because my daughter tested positive for COVID just three days before our trip.
The whole family had to go into quarantine.
Now it will be months before I can get another appointment with our specialists here.
At this point, I’ve lost the motivation to even see doctors locally; it feels like nothing more than constant blood draws. Part of me just wants to stop taking my Warfarin on my own and see what happens. I have this nagging feeling these pills are doing more harm than good.

I will check back in once I've completed my exams in Washington, D.C.

Ma'am,

do not stop taking your Warfarin without medical supervision!

Please update us when you can; I'll help however I'm able.

Kimberly Morris said:Female, 42 years old, recovered from Covid about 10 days ago.
Just got blood work back today. Looking for some insight on GGT and Vitamin D levels.

Photos attached below. Thanks in advance.

The GGT numbers aren't concerning right now; no immediate action needed there. Recheck the liver panel in four weeks (include bilirubin this time). Start some Vitamin D supplementation.

Kimberly Morris said:Dear Nicholas Myers,

I’m reaching out because you’ve been incredibly helpful, though if anyone else here has insight or can answer my questions, I’d certainly appreciate it.

I saw an immunologist who echoed your sentiments—my labs don't point toward lupus or RA. However, based on my HLA typing, the doctor mentioned a potential predisposition for inflammatory bowel disease. You previously brought up celiac disease.

The reality is, things are trending downward. I’m still out on medical leave, completely unable to function. It's constant fatigue, body aches, a fever that won't drop below 99°F, migraines, weakness, nausea... I also neglected to mention diarrhea accompanied by agonizing abdominal cramps—a dull, heavy pain that, honestly, is only comparable to labor pains.

I had blood work redone last week. My ESR is elevated (it should be 4 to 36; mine is 44), and my CRP is 8.5 (normal is
I would value your perspective. Thanks in advance.

The abdominal cramping and loose stools are new developments; I don't recall those in your previous updates. You absolutely need to get a stool analysis done—check for viruses, bacteria, parasites, and perhaps even C. difficile toxin. Following that, schedule three occult blood tests and a calprotectin test, then follow up with a gastroenterologist.

bluepilot45 said:My question: based on this, could I be fighting some kind of bacteria in my bronchi that Augmentin wasn't effective against (as my primary care physician suspects)? I'm worried about becoming a chronic bronchitis sufferer due to smoking. Also, there's this odd coincidence involving Covid in my family—though I haven't been vaccinated.

Do you recommend any further testing?

Apologies for the long post.

Thanks in advance for the help. Best regards!

The answer to your question is yes. It's entirely possible you're dealing with a microorganism, potentially one of those "atypical" pathogens. I'd suggest more investigation—a chest X-ray would be a start. A consultation with an infectious disease specialist to screen specifically for atypical organisms might also be wise; in that case, switching to a macrolide antibiotic would likely make sense.

Betty Collins45 said:Here are my results:

Could this be due to the Covid vaccine? I had my first dose just 7 days ago.

I don't see anything alarming in these results. What specifically has you worried? If you’re looking at those values shifted to the left—the MCV and neutrophil count—I wouldn't lose sleep over them. I don't see a connection to the vaccination either.

mellowsailor34 said:Hi,
I need help interpreting these results: polyclonal increase in Immunoglobulin A. Elevated Beta globulins.

You really need to provide the full immunoglobulin panel and the complete serum protein electrophoresis report, along with the clinical reason for the testing. Just saying "confirming an autoimmune disease" is far too broad. It’s rare for these two specific findings alone to confirm an autoimmune condition. Typically, when dealing with autoimmune issues—especially systemic connective tissue diseases—you see hypergammaglobulinemia and elevated IgG more frequently.

ironsurfer10 said:Thank you for getting back to me. I just finished a 24-hour urine test, and it shows polyuria—2500ml (the normal range is 600–1600ml). As for my other completed labs, everything looks fine except for a few things:
Bicarbonate, capillary blood 25.4 (ref. 18 to 23)
Oxygen saturation 99 (ref. 95-98).
Should I be concerned about these results for now?

One can't draw conclusions from isolated values like this; we really need to see the full acid-base status report. Also, that urine volume needs to be weighed against total fluid intake.

Emily Ortiz27 said:(image)
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Our routine checkup. An 8-year-old with lymphadenopathy...

The CBC results are within reference ranges, except for 1% atypical lymphocytes. Markers are normal, immunoglobulins are unchanged (IgA is below detectable limits, others are normal, IgE is elevated)
Cytology shows slightly low lymphocytes, but no atypical cells. Is the descriptive part at the bottom of the report okay? What does it indicate?

I still can't wrap my head around how a child can have enlarged, reactive lymph nodes for 4 or 5 years without an underlying cause for such reactivity. How common is this?
Every bit of medical literature or internet research we've done suggests any node larger than 1 cm warrants investigation, yet here we have old and new ones that just won't shrink back to normal size...
On top of that, besides the areas where the old nodes are visible, there are new "lumps" appearing on the head (behind the ear, under the hairline).
I realize they can't biopsy every single one—none look suspicious—but there are so many of them.

Is it overkill to do these ultrasounds once a year? Some doctors clearly find it a nuisance when we show up "constantly" if the child isn't showing obvious symptoms. We brought them in for an ultrasound 14 months after the last scan because new lumps appeared, and we specifically asked to check the old, known areas as well.

Ma'am,

Up to 90% of children aged 4 to 8 have palpable lymph nodes in their necks. From what I can see, none exceed 2 cm and there are no signs of malignancy. The child has an immune disorder, so they aren't entirely healthy. The root cause of this immune issue hasn't been fully clarified (ALPS has been ruled out, though, as I've mentioned before, there is a group of so-called ALPS-like disorders—conditions that mimic ALPS but lack its characteristic findings. Only genetic testing might pinpoint the exact cause there). The cytology doesn't show anything unusual; hypochromia simply means the erythrocytes are somewhat paler, which could suggest lower hemoglobin content, but a blood count would confirm whether that's actually the case. All in all, the results are satisfactory. They aren't perfectly normal, but given the circumstances (considering the immune disorder), they are acceptable. You should discuss the need for genetic diagnostics for immune dysregulation disorders with a hematologist or immunologist. I believe I've touched on this in another thread you posted in. I don't see any other way to potentially uncover the underlying cause, though even genetic analysis can sometimes be uninformative (in fact, finding a specific genetic disorder is less common than you'd think).

Grace Murphy27 said:Looking for some perspective here. I went in for blood work because I've been dealing with constant dizziness for about 10 days now. Most of the results came back relatively normal, except for a few outliers:
Fe- 36, 2 (range 8-30)
UIBC- 23,5 (26-59)
RDW - 13,0 (14,6-16,5)
Eosinophil % - 8,3 (0-7)
My doctor says everything looks fine.
Should I be concerned about the high iron levels?
I have no idea where the excess is coming from—I barely even eat meat. No drinking, no smoking either.
Could this be linked to the dizziness?
Thanks

You really ought to get a ferritin level checked as well.

To my colleagues,

I have already addressed this point elsewhere:

Nicholas Myers said:Hello,

Densitometry T-scores can vary between the lumbar region and the hip region. In this instance, there isn't a significant discrepancy because, according to the scan, both the lumbar and hip regions fall into the same category: osteopenia (a T-score between -1.0 and -2.5). However, even if the T-score is higher than -2.5 (meaning less negative), we can still discuss osteoporosis if an atraumatic spinal fracture occurs. There are many reasons why T-scores fluctuate between the hips and the lumbar spine, but such variation is quite common, provided the differences between regions don't jump across entirely different diagnostic categories (for example, a normal T-score in one area and a pathological one in another).

So, the answer is yes.

wearyviper15 said:Hi, I’d appreciate some insight on my daughter's blood work. Hemoglobin is 8.5g, CRP is 1.7, she had a fever around 38-39°C a couple of days ago, and she's been coughing heavily for 2 or 3 days. Her MPV and monocytes are elevated...

Thanks so much

https://ibb.co/jkkchyW

Hello,

Based on these results, there isn't currently evidence suggesting a bacterial infection that would necessitate antibiotics. Of course, any final decision rests entirely on the physical clinical examination. These deviations aren't significant.

ironsurfer10 said:Hi, can someone briefly explain why I might have such a high percentage of dysmorphic erythrocytes in my urine? Back in June they were at 55%, and now they've jumped to 86%.
The CT urogram was normal, and the urine culture came back clear too. Currently waiting on blood work (ANA/ENA and other immunological markers).

I'm not experiencing any symptoms, other than the fact that there's a constant, high count of erythrocytes in my routine urine tests.

I hadn't given it much thought until now, but seeing these numbers is starting to worry me.

Sent from my Samsung Galaxy

Ma'am,

Dysmorphic erythrocytes are red blood cells with irregular, notched membranes. Their presence typically points toward the upper urinary tract—specifically, the kidneys.

Essentially, this testing aims to pinpoint where bleeding in the urinary system is originating. If the source is the upper tract, you deal with a nephrologist; if it's the lower tract, you see a urologist. That’s the simplified version.

To make an accurate classification, we look for the ratio of dysmorphic versus smooth erythrocytes. If dysmorphic cells exceed 70% or 80%, the bleeding is coming from the upper urinary tract. Conversely, if smooth cells make up more than 70-80%, the issue lies in the lower tract.

In your case, it likely indicates bleeding from the kidneys. Since your CT urogram was clear, it suggests a glomerular origin, specifically a glomerulopathy. This falls under nephrology, though a urologist might still be brought in for a cystoscopy depending on your clinical history and subsequent findings.

If you haven't already—though I assume you have given how long this has been going on—you'll need a 24-hour protein test (protein-to-creatinine ratio), urea, creatinine, eGFR, standard lab panels, and the immunological screening already suggested to you: ANA, ENA, C3, C4, CH50, etc. Once those results are in, consult a nephrologist. They will decide whether a kidney biopsy is necessary or if continued monitoring is sufficient.

Nancy Williams2 said:I'm looking for some help interpreting my labs. For over a year now, my eosinophil levels have been elevated and steadily climbing. They're currently at 16, while the limit is 7. My neutrophils are low too.
Segmented neutrophils: 30 (limit 44)
Eosinophils: 16.1 (limit 7)
Basophils: 1.1 (limit 1)
Segmented neutrophils: 1.86 (limit 2.06)
Eosinophils: 1 (limit 0.43)(10^9/L)
Basophils: 0.07 (limit 0.06) (10^9/L)

Everything else in my CBC looks normal.
Earlier this year, I dealt with an H. pylori infection in my stomach, which I believe I cleared after three attempts. I've also had two separate bouts of bladder inflammation and E. coli infections within three months, both treated with antibiotics.
Is it possible these bacteria are causing the high eosinophils? I've been reading things on Google and starting to panic...
Thanks in advance for any insight.

Hello,

Bacteria are rarely linked to eosinophilia. If memory serves, medical literature only describes one single case where an H. pylori infection coincided with eosinophilia, and even then, it was accompanied by thrombocytopenia. It's highly unlikely that either of the infections you mentioned would be the culprit here.

Generally speaking, the absolute count of eosinophils matters much more than the percentage. When assessing the severity of eosinophilia, we always look at the absolute number rather than the ratio. Your absolute count is 1000 x 10^9/L, which points toward mild eosinophilia. Common causes for counts in this range include allergic conditions (allergic rhinitis, asthma, atopic dermatitis, eosinophilic esophagitis, drug allergies) or certain parasitic infections. Therefore, I suspect your follow-up should focus on those two areas—ruling out parasites (testing for tissue-dwelling parasites via serology would be wise) and investigating potential allergies.

The eosinophilic leukemias and other "scary" diagnoses you encounter on Google typically present with much higher eosinophil values.

Standard clinical guidelines usually suggest beginning a workup once the eosinophil count exceeds 1.5 x 10^9/L without a known cause, persisting for longer than a month.

Donna Lopez79 said:Respectfully, I’m writing again because I feel like I’ve hit a wall. My lab results haven't changed much; the only thing that actually made an impact was the B complex. Back in July, during a talk with a neurologist at the hospital, they explained that given the dissections and my blood work, Warfarin is the best course of action. They still suspect some underlying issues, so I have to redo the blood work early next year.

On Tuesday, my vision went blurry, followed by a headache. I took a pill, slept it off, and felt fine. Then Wednesday rolled around, the symptoms returned, and I headed to the ER. The neurologist basically brushed me off since they already had access to my previous records.
The CT scan was clear, color Doppler was normal, and the MRI of my head and neck showed nothing new—no new dissections. However, my blood pressure was incredibly low, and my INR spiked. My iron is also low, so I’m on treatment for that.
That blurred vision and headache even happened while I was in the hospital.
I was hooked up to monitors for blood pressure, oxygen, and likely heart rate the whole time.

So, I told the neurologist that since I’ve been without a definitive diagnosis for two years, maybe it would be wise to get a second opinion at a different clinic. They took offense. They pointed out that the team from two years ago isn't the current team, and if necessary, they would contact another facility for a consultation. But honestly, it's like trying to teach an old dog new tricks.
Now, my discharge papers read:
Migraine headache
Carotid and vertebral dissections (2019)
High-risk coagulation on Warfarin
Anemia
Antiphospholipid Syndrome
Possible Tachycardia

No Vasculitis!
They’re recommending I see the same rheumatologist again, but that doctor already told me I wasn't their patient.

I’ve been home since Friday. I have this nagging feeling that I’m going to start bleeding from my ears and nose.

Later this month, I am definitely heading to Washington, D.C. for a private consultation.
Because what's happening here is becoming a bit of a joke.

Dear lady,

Based on what you've described and what is noted in your new discharge summary, your symptoms are being interpreted as migraine attacks. Those can be extremely severe and can certainly mimic the presentation of a stroke. I'm not sure if any other immunological tests were repeated besides the antiphospholipid antibodies. Based on the imaging, there are no signs of vasculitis, which is what I suspected previously; it's probably for the best that the diagnosis was ruled out, as it only adds confusion to the case.

I hope the Warfarin dosage stabilizes soon; patients often struggle until those expected therapeutic INR levels are reached.

In my view, your priority should be finding a solid neurologist. While a rheumatologist is important, they are secondary in this specific context. However, given the conflicting rheumatological diagnoses you've faced, seeing a specialist wouldn't be a bad idea.

Please keep us posted on what happens in Washington, D.C.!

Good luck!

Quote: Felix the Cat

Jessica Sanders60 said:Much appreciated for the response.
I’ve had two Pap smears within the last year, along with ultrasounds, and everything came back clear. I also went in for an ultrasound specifically regarding some microhematuria, and that was all fine too. In my seventh month, I underwent a colonoscopy, and once again, everything looks good.
My leukocyte levels have always been elevated, and no hematologist has really made sense of this latest lab result yet. I’m planning to seek a second opinion. Honestly, I'm pretty shaken up by this. Just one question regarding the microhematuria—is it possible that could be caused by physical strain? I'm breastfeeding, and we're doing quite long treks every day, including hauling the baby up to the third floor on foot.
It seems to me that rather than focusing strictly on polycythemia, you should just get a full blood panel done and schedule an appointment with a hematologist.

Jessica Sanders60 said:Another important point: I'm on Siofor, and I’ve actually been losing weight—down about 9 pounds in three months since I started taking it. I haven't even gone on a diet, but my appetite has definitely dropped. Does that have anything to do with it?

Dear Madam,

We see cases where microhematuria pops up following intense physical exertion. Generally, that should clear out within 48 to 72 hours after you stop pushing yourself. If it doesn't resolve in that window, further investigation is necessary.

Regarding hematology workups, my advice is to follow through with the tests I previously outlined. You should also make sure to repeat the CBC in two to four weeks. Once you have those results in hand, it would be wise to consult a hematologist—especially if your leukocyte, hemoglobin, or hematocrit levels continue to climb.

Regarding weight loss, the cases mentioned involving metformin treatment show that body weight typically drops gradually—usually over a one to two-year period—averaging about 3 to 6 pounds in that timeframe. While weight loss can stem from poorly managed diabetes, there are plenty of other underlying factors at play here that definitely warrant a closer look.

Jessica Sanders60 said:Thanks a lot for the response.
Let me provide a bit more context regarding why I went ahead with all those tests.
A year ago, I had a C-section that turned into a complete nightmare. Complications escalated so quickly that I ended up back in surgery to deal with three abscesses that were right on the edge of sepsis. During that procedure, they actually had to remove my appendix; apparently, an E. coli infection in my urinary tract was the culprit. They left the wound open for seven days, managed with a drain and a catheter. Things stabilized after that, but then my blood sugar spiked again—something I first dealt with during my pregnancy when I was relying on Fragmin and insulin. These days, I'm managing it with Glucophage. Looking back, I did a urine test during my seventh month of pregnancy because of those sugar issues, and the results showed 15 erythrocytes, 4 leukocytes, 15-20 squamous epithelial cells, and some amorphous salts.
A week after repeating the test, I’m seeing the same results: 8 erythrocytes, 6 leukocytes, and 10 platelets/epithelial cells. Is it actually possible to mess up a urine sample three times in a row, or do these numbers actually point to something? My abdominal and urinary tract ultrasounds both came back completely normal. Now, since one urine culture turned out sterile, my doctor is sending me for cytology.
Looking at the blood work posted above, my results are pretty much always in this same ballpark. My white cell count has been elevated since I was a kid; occasionally my red cell count and hematocrit run a bit high, though my hematocrit has never actually crossed the upper limit. My hemoglobin has stayed within the normal range—it’s never been this high before, nor has it ever breached the threshold. Do you think a glucose reading sitting right at the upper limit is a cause for concern? Now that the levels have settled back into the normal range, I just happened to have a particularly heavy period. That brings me to the question weighing on me: does this microhematuria indicate something dangerous? Should I go for urine cytology? Or perhaps a urine culture? Could this be a kidney stone or some grit that doesn't show up on an ultrasound and isn't causing pain? Honestly, I'm scared—maybe a bit of a hypochondriac, too. Is it possible these blood parameters point to a kidney or bladder infection that hasn't started showing symptoms yet?
Much appreciated.

Jessica Sanders60 said:Just one more question regarding the peripheral blood smear: why the request? What exactly are you suspicious of?

To whom it may concern,

You should probably schedule a gynecological exam to rule out a vaginal infection or any other gynecological issues that might be triggering these results. Squamous epithelium is present in the vaginal canal as well.

I’m of the opinion that a urine culture definitely needs to be part of the picture here. From what I gather in your notes, only one culture was performed, even though three separate samples were taken for the biochemistry and sediment analysis. I also noticed that the heavy presence of squamous epithelium shows up only in that last sample. To me, that suggests the specimen might not be clean—likely due to contamination or vaginal shedding.

If you're dealing with persistent microhematuria, running three cytology panels is the right move to pinpoint whether that bleeding is coming from the upper or lower urinary tract. However, if those samples are consistently showing a high concentration of squamous epithelial cells, I’d definitely look beyond the urinary system and consider gynecological causes as well.

I’d suggest considering a peripheral blood smear, given the rise in white blood cell count. If I understood correctly, your leukocytes were around 12 and have now climbed past 13 x 10*9/L. According to standard medical guidelines, that’s a threshold where we should dig deeper—not just to rule out underlying issues, but to confirm if this is simply your body's baseline, perhaps influenced by smoking. Since both the hemoglobin and hematocrit concentrations have risen, we're looking at changes in two different cell lines. A smear would allow us to examine the morphology of those elevated neutrophils. Certain structural changes in neutrophils can sometimes point toward a low-grade, lingering infection. Naturally, we'd also be scanning for any atypical or suspicious cells that might suggest malignancy, especially since two cell lines are showing shifts. Beyond that, I’d recommend protein electrophoresis and immunoglobulin testing for the same reasons; they can help identify chronic inflammation or other systemic processes.

That’s my take. Of course, if a hematologist actually reviewed this specific CBC—with the WBC at 13.9 x 10*9/L, Hgb at 153 g/L, and Htc at 0.458—and decided there was no need for follow-up, then that's a different story. I should clarify that I'm speaking specifically about this exact result, not just something "similar," and I can't account for how these numbers trend compared to your previous labs since I don't have access to your full history.

Jessica Sanders60 said:RBC 5.27.
Hemoglobin 153
Hematocrit 0.458
MCV 86.9
MCH 29.0
MCHC 334
RDW 13
MPV 10.9
Platelet 270
Leukocytes 13.9
Neutrophils 65.9
Lymphocytes 21.7
Monocytes 9.4
Eosinophils 2.5
Basophils 0.5
Neutrophils 8.64
Lymphocytes 2.84
Monocytes 1.23
Eosinophils 0.33
Basophils 0.06
ESR 2

Total Bilirubin 28
Glucose 6.9
Standard Creatinine 55
Urate 236
Urea 4.3
Iron 28
Everything else looks fine
The RBC, leukocytes, bilirubin, monocytes, neutrophils, and slightly the RBC are elevated here.
It's difficult to transcribe the entire report. I have been getting regular blood work done, and this is the latest one where the hematocrit was normal. My hemoglobin always hovers at the upper limit. My leukocyte count has stayed around 12 my whole life.

Urinalysis results
leukocyte Esteaz 25
erythrocyte hemoglobin 150
leukocyte 8
erythrocyte 10
Squamous epithelial cells: mass
Bacteria: plenty
I’ve had urinalysis done three times over the last three months, and it looked like this every single time. I urinate frequently, but there is no pain, and the urine culture back in the seventh month was sterile.

Ma'am,

Regarding the changes in the blood work: leukocytosis due to neutrophils, along with borderline high hemoglobin and hematocrit levels, can be seen in smokers. Smoking is often cited as one of the most frequent reasons for this specific constellation of blood markers. Since the leukocyte count is above 12 x 10^9/L, I would suggest monitoring the CBC and reacting if the numbers continue to climb. Recheck the CBC in four weeks. It wouldn't hurt to also check CRP, if you haven't already, along with LDH and serum protein/immunoglobulin electrophoresis. I think a peripheral blood smear would also be a good idea.

As for the urinalysis, the presence of many squamous epithelial cells could suggest the sample wasn't collected properly—perhaps due to insufficient cleaning before collection, contact with the skin during the process, or potentially a vaginal infection or contamination.