Kate Collins67 said:Look, now that you're bringing up those heavy periods—if you're bleeding heavily right now, that might actually be the explanation for your D-dimer levels. It really could be.
Alright, I need to go settle this once and for all. I’ve been digging through some data lately, and I keep seeing these people claiming that D-dimer levels don't actually spike during menstrual bleeding... seriously? I really need to take a much closer look at this—maybe even pick a gynecologist's brain to get the actual facts. Is anyone else seeing this nonsense?
Then you've got this other crowd claiming that levels can spike during a heavy period—so now you’re supposed to just be a mind reader? Good luck with that.
Look, Rocaltrol is just the active form of Vitamin D. If you’re only taking that and nothing else, then you aren't getting any calcium—and let's be real, you clearly aren't getting nearly enough from your diet, plus you probably aren't soaking up much sun throughout the year, if at all. So, you'll likely need to supplement some calcium with a separate medication. And now that you mention those heavy periods—if you're bleeding heavily right now, that could very well explain the D-dimer levels.
As for clinical signs, we're talking about what I mentioned earlier: swelling in one leg, maybe even both, swelling in one arm, shortness of breath, or heart palpitations that just won't quit on their own...
Are you taking any kind of calcium supplement at all?
Look, D-dimer tests are one of those things where you always end up tripping over your own feet because you don't actually know what you're trying to prove by ordering them. In theory, it means there’s some clotting happening somewhere while simultaneously breaking down—but if there aren't any actual clinical signs of clots... well, then what are we even doing?
Generally speaking, hormonal contraceptives are linked to an increased risk of clotting, but I don't really follow OB-GYN patients, so I don't typically bother looking at D-dimer levels unless someone shows up with swollen limbs or starts complaining about shortness of breath.
Betty Hall said:I had my cortisol checked about 20 days ago—my cycles have been all over the place, too.
My ovarian hormones aren't right either; LH and FSH are inverted and high, plus Testosterone, Androstenedione, and 17-OH progesterone were all elevated when tested on day 5 of my cycle. Everything else seems normal.
My cortisol came back at 1047, while the standard range is roughly 180 to 670.
I did the morning cortisol test, but before that, I’d smoked two cigarettes and had a little bit of juice...
Because my doctor told me I didn't need to be fasting!
So, I went ahead and repeated both the morning and afternoon cortisol tests. It should take about 15 days for the results to roll in.
I've been reading online that stress can cause cortisol to spike... I'm wondering if stress alone can push it that high? Though, honestly, I don't feel like I've been under massive amounts of pressure.
Look, you really need to pin this down more precisely: you need serum cortisol at 8 AM and 4 PM, a 24-hour urine cortisol test, sodium and potassium levels in the serum, and you definitely need ACTH alongside that morning cortisol, not to mention glucose.
If things are still looking fuzzy, you'll need to do a dexamethasone suppression test.
If hypercortisolism actually shows up—then we're talking ultrasound and CT scans of the adrenal glands. And most likely, you'll end up needing a brain MRI too (if nothing turns up on the adrenals).
The next steps depend entirely on what those results show.
Just type "Cushing syndrome" into Google Cushing and see if you recognize any of the symptoms they list—you know, stuff like purple stretch marks, a buffalo hump, moon face, or hypertension...
And who knows? In the end, it might turn out to be nothing at all.
Look, if you’re at the point where you think you might need blood pressure medication, the least you can do is actually find out if your pressure is even high in the first place.
restlesscobra9 said:I get hit with something similar—except it isn't nausea, it's more like this lightheadedness. Like my head is suddenly flushing with heat. It feels almost identical to when my blood pressure spikes.🤷 So, what's actually going on here?
Well, it’s highly likely your blood pressure is spiking—honestly, just go test it under stress, it's not that hard to verify. Though, you really ought to shell out some cash for a decent digital monitor if you want to actually map out the connection between your BP and these symptoms. Seriously. You might need to dial back the intense workouts and start keeping a tighter grip on those numbers. And look, let's be real—there are serious heart conditions out there that could cause this exact kind of trouble, and you aren't going to diagnose those through an online forum.
At the end of the day, the most basic question is always about your overall fitness level, and that's something everyone has to judge for themselves...
So, nausea triggered by intense physical activity while dealing with asthma... wait, I just realized this post is actually from last year. My bad.
The real question you need to ask yourself is: are you feeling that wheezing in your chest while you're working out? Because if you are, there’s your answer right there. You're hitting hypoxia, which leads to lactic acidosis, and suddenly you're dealing with all those symptoms you mentioned—only for them to vanish once you finally sit down to rest. If that’s what’s happening, the fix is simple: get your asthma under better control and start using your Ventolin preventatively before you even think about pushing yourself physically.
I have to stress again—this advice only applies if that is indeed the root cause of your issues. But honestly? If I were in your shoes, I’d seriously consider scaling back the intensity or even walking away from competitive sports altogether.
Either way, go see a pulmonologist. Sit them down, explain exactly what's happening with these symptoms, and see what the professional verdict is.
Lymphoma—lymph nodes—hematologists. In the US, we usually see lymphomas and leukemias handled by hematologists rather than oncologists, though I can't help but wonder if there's a push to eventually shift all of that over to the oncology side of things.
I was just sitting here thinking—they ran those serology tests for Bartonella and Toxoplasma for you through the outpatient clinic, right? But what if you're just stuck waiting on those results for another week or two? Have you actually seen the findings yet? Because, look, if they aren't already written down in your chart, it means you're going to have to call them up and track them down. If you already have the results in hand, then just ignore me.
Regarding the toxoplasmosis results—it’s negative. If you want to get really deep into the weeds and start over-theorizing, you could argue that the result might just be caught in the "early stages," but honestly? That feels like pure speculation at this point, and frankly, that's not even my specialty.
Now, about the Listeria: looking at the medical literature, serology—which is basically what they did here—isn't actually an objective way to prove a Listeria infection. Whether or not this is standard routine practice here in the States is something you’d really need to clear up with an infectious disease specialist. But strictly speaking, a 1:160 titer means that "one unit of your sample" was diluted with 160 units of some reagent (I don't know exactly which substance they used), and at that level of dilution, those specific antibodies weren't detected. Even if they were, you'd typically need to see them show up at a higher dilution, like 1:320, to even consider calling it a borderline or positive result.
To put it in plain English—layman's terms, if you will—it’s like throwing one gram of sand into a small glass of water and trying to find it, and then throwing that same gram into a massive swimming pool and trying to find it. If you can still spot it in the swimming pool (a 1:100 ratio, say), then there was probably much more than just one gram in there to begin with.
So, finding antibodies at a higher dilution indicates a stronger presence, which allows you to indirectly infer the "existence and intensity of an infection"—or, conversely, suggests that the immune response isn't quite hitting the mark.
I hope I haven't missed anything major.
At the end of the day, the most important thing is whether you’re actually feeling sick—was this testing done because you have symptoms, or was it just some routine screening?
wanderingcobra76 said:MRI is definitely better if you're looking at soft tissue, but when it comes to bone structures? CT wins hands down.
Look, I used to think exactly the same way, but honestly—it’s not that simple: Magnetic resonance imaging (MRI) might be brought in for an evaluation specifically when those first bone scans don't give you any clear answers [3, 4]. Because MRI has such incredibly high soft tissue resolution, it actually lets you see the medullary cavity of the bone—which is where most bone marrow (BM) originates—way more clearly than any X-ray-based tech could. We're talking about radiography or CT, both of which just lack that kind of soft tissue detail. In fact, studies have shown that MRI can pick up much more BM than radiography, CT, or bone scans (BS) [10, 11], even if it does cost a bit more out of pocket.
Wait, hold on—isn't a doctor's note from the ER enough? You know, one where it actually says something like "th: Novocain 500 mg, 1 tab twice a day"? Or do they seriously insist on that tiny little scrap of white paper they call a private prescription?
I know plenty of cases where GPs messed up and wrote down a slightly higher dose—like, just a tiny bit off, what's the big deal, right? 😁 But then the ladies at the pharmacy 😁 catch the mistake, tell the patient, call the doctor, and fix the dosage. So, honestly, sometimes those clerks 😬 are actually saving lives.
Though, being a doctor, you probably already know all this and you're just being difficult now. 😁
Look, I’m not saying *I* get confused, but it’s obvious that regular people do. It’s beyond me why you find that so hard to wrap your head around.
swiftbear86 said:Regarding the whole topic of pain medication, I came across this one line: "the pharmacist at the drugstore told me...
It really makes you wonder—why is there this perception that we’re just retail clerks?
I mean, look—you’re standing there behind the counter, right? You're basically running a sales pitch every single second you're on the clock. It’s easy enough to lose your footing when you're constantly being pushed to move product... honestly, anyone could get tripped up in that situation.
If there’s a metastasis sitting right where a bone density scan was performed—and if that bone is already pretty badly damaged—you might actually catch it. But that’s a huge "if." It only works if the lesion is specifically located in the exact spots the densitometry is actually "mapping." Otherwise? Even a standard X-ray often isn't enough to spot bone metastases.
But honestly, why even overthink it like that? If there is any suspicion at all regarding metastases, you don't play guessing games. You get a standard X-ray of the painful area first, and then you move straight to an MRI.
Generally speaking, you’ve got two ways to play this. First, you can have your primary care doctor refer you to an immunologist and just follow whatever path they decide is best. The second option—and honestly, if you start running a fever again without any obvious explanation—is to just head straight to the ER at a major university hospital like Mayo Clinic. If you do that, you absolutely have to make sure you mention the butterfly rash and those swollen lymph nodes you dealt with earlier. With any luck, they’ll end up admitting you to the rheumatology or clinical immunology ward, and then you can finally get some answers. Because look, if they can rule out an autoimmune disorder, you can finally stop stressing about it.
While you're stuck waiting for all those appointments to happen, if I were in your doctor's shoes, I wouldn't be sitting around. I'd be ordering a serum protein electrophoresis, immunoelectrophoresis, repeating a CBC, checking fibrinogen, urine analysis, 24-hour urine protein, lupus anticoagulant, anticardiolipin antibodies, and C3 and C4 levels right now.
If you run another fever and can't get hold of an immunologist immediately, you should at least get your C3, C4, and total complement levels checked alongside your routine labs.
Now, look—you could be looking at some insignificant proteinuria caused by just having a fever. It might not even be a big deal. Why don't you have your primary care physician run a follow-up urine test while you're actually feeling okay? If they do find protein in there, then—and only then—will you need to go through the whole ordeal of a 24-hour urine protein collection to get the full picture.
Honestly, those lab results from 2011? They don't tell us anything useful at all.