Posts by mellowviper24

Maria Fisher46 said:You should definitely redo the glucose test on an empty stomach.

The presence of a relatively high number of squamous epithelial cells suggests the sample might not have been ideal—perhaps it wasn't a midstream catch, or there was some contamination from skin or vaginal secretions. This theory is bolstered by the fact that you aren't showing any signs of a UTI and your urine culture came back sterile.

Personally, I always prefer to re-test borderline results, so I would recommend doing the same here. To ensure accuracy, one should be mindful of proper collection techniques, specifically aiming for that first morning midstream sample after cleaning the area.

I don't believe your MCV or Iron levels have anything to do with these urine findings.

Thanks so much for the response. I’ll go ahead and repeat the urinalysis and we’ll see where things stand.
For context, this first sample was taken in the middle of the day, so this time I'll follow the same protocol as the urine culture—using the first morning midstream catch.

Thanks again!

Maria Fisher46 said:Dear lady,

Based on these results:

a) neutrophilia—meaning an elevated neutrophil count. In this instance, the higher white blood cell count at the time of sampling was driven specifically by those neutrophils. There are numerous reasons why neutrophils might spike, with infections (primarily bacterial) being a common culprit. Regarding the link between asthma and leukocytosis: occasionally, asthma patients show elevated white cell counts, though this is typically due to increased eosinophils rather than neutrophils. Using inhaled corticosteroids shouldn't significantly alter your blood work. Given that you've seen elevated white cell counts across several different tests, it would be wise to look closely at the differential count to see exactly which cells are driving the total increase. Here, it is clearly the neutrophils;

b) elevated blood glucose—it is vital to confirm whether you were fasting at the time of the test;

c) abnormalities in the urinalysis—there are traces of red blood cells, white blood cells, and protein. It would be worth clarifying if you are experiencing any urinary tract infection symptoms, vaginal discharge, or gynecological issues. Additionally, a high number of squamous epithelial cells might suggest the sample wasn't collected perfectly.

d) low MCV—this refers to red blood cell volume, and your iron levels are also sitting right at the bottom limit. Sometimes, a drop in red cell volume serves as an early warning sign of iron deficiency. Ferritin generally provides a much more reliable picture of your actual iron stores than serum iron alone, as iron levels can fluctuate quite a bit throughout the day.

Thank you so much for the response.
Regarding the glucose—I wasn't fasting, so I will certainly have the test repeated.

As for the urine test, I went ahead and had a culture done after these results came back, but the culture was sterile. My doctor doesn't think the urinalysis is cause for concern, but I am still uneasy about the presence of red blood cells and white blood cells. Would it be a good idea to repeat the urinalysis?
If the results come back unchanged, what should my next step be? Should I schedule an abdominal or kidney ultrasound?
And does the low MCV and borderline iron level have any connection to the urine findings?

Thanks in advance for your help. 🙂

Following up on my previous post, I’m also including the urinalysis results here:
URINALYSIS
(U) leukocytes 25 /μl; + neg.
(U) nitrites neg. μmol/L neg.
(U) urobilinogen norm. μmol/L normal
(U) proteins 0.25 g/l; + g/L neg.
(U) pH 6.0 ( o ) 5.0 - 9.0
(U) erythrocytes 10 /μl; + neg.
(U) specific gravity 1.020 ( o ) 1.002 - 1.030
(U) ketones neg. mmol/L neg.
(U) Bilirubin 0 neg. μmol/L neg.
(U) glucose norm. mmol/L norm.
URINE SEDIMENT
(U) erythrocytes 3-5 0 - 2
(U) leukocytes 4-6 0 - 2
(U) casts /
(U) crystals /
(U) cells 20-30 squamous epithelial cells
(U) significant bacteria present
(U) heavy mucus presence

Thanks in advance for any insight you can offer. 🙂

It took me about a week to finally pull myself together after dealing with a nasty stomach flu, and I just had my blood work done today. Here are the results:
HEMATOLOGY
(vK) erythrocytes * 5.03 ( o) 10e12/L 3.86 - 5.08
(vK) hemoglobin * 131 ( o ) g/L female 119 - 157
(vK) hematocrit * 0.396 ( o ) 0.350 - 0.470
(vK) MCV * 78.7 < ( ) fL 83.0 - 97.0
(vK) MCH * 26.0 < ( ) pg 27.4 - 33.9
(vK) MCHC * 331 ( o ) g/L 320 - 345
(vK) distr. erythrocytes * 14.2 ( o) % 9.0 - 15.0
(vK) platelets * 388 ( o) 10e9/L 158 - 424
(vK) MPV * 9.9 ( o ) fL 6.8 - 10.4
(vK) leukocytes * 12.0 ( ) > 10e9/L 3.4 - 9.7
(vK) neutrophils * 74.1 ( ) > % 44.0 - 72.0
(vK) # 8.91 ( ) > 10e9/L 2.06 - 6.49
(vK) lymphocytes * 19.5 < ( ) % 20.0 - 46.0
(vK) # 2.34 ( o ) 10e9/L 1.19 - 3.35
(vK) monocytes * 5.5 ( o ) % 2.0-12.0
(vK) # 0.66 ( o ) 10e9/L 0.12 - 0.84
(vK) eosinophils * 0.7 (o ) % 0.0-7.0
(vK) # 0.08 (o ) 10e9/L 0.00 - 0.43
(vK) basophils * 0.2 (o ) % 0.0-1.0
(vK) # 0.03 ( o ) 10e9/L 0.00 - 0.06

ESR
(vK) ESR 14 ( o ) mm/h 4 - 24

BIOCHEMISTRY
(S) bilirubin * 7.0 ( o ) μmol/L 3.0 - 20.0
(S) glucose * 7.4 ( ) > mmol/L 4.4 - 6.4
(S) alkaline phosphatase * 74 ( o ) U/L 30 - 120
(S) AST * 20 ( o ) U/L 8 - 30
(S) ALT * 27 ( o ) U/L 10 - 36
(S) GGT * 31 ( o) U/L female 9 - 35
(S) potassium * 3.6 < ( ) mmol/L 3.9 - 5.1
(S) sodium * 140 ( o ) mmol/L 137 - 146
(S) calcium * 2.54 ( ) > mmol/L 2.14 - 2.53
(S) iron * 9 (o ) μmol/L 8 - 30

PROTEINS
(S) CRP * 0.9 (o ) mg/L 0.0 - 5.0

I've marked the values that fall outside the standard range in bold.
I typically get my blood drawn every six months, and I've noticed my white blood cell count has gradually climbed from around 8 to 12 over the last year. Looking at everything else, should I be concerned about this trend?

For context, I have asthma and use Advair as needed. I also deal with frequent corneal herpes outbreaks—usually twice a year, sometimes more—with the most recent one occurring about ten days ago. Aside from that, I don't have any other health issues.

Thanks in advance for your help with these numbers. 🙂

Thank you so much for such a prompt response!

So, here is how my complete blood count looks (values above the reference range are in bold):
RBC (EBR) (E) 4.69 ref. 3.86 to 5.08
HEMOGLOBIN (Hb) (EBR) (E) 133 g/L ref. 119 to 157
HEMATOCRIT (Hct) (EBR) (E) 0.394 L/L ref. 0.356 to 0.47
MCV (EBR) (E) 84.0 fL ref. 83 to 97.2
MCH (EBR) (E) 28.4 pg ref. 27.4 to 33.9
MCHC (EBR) (E) 338 g/L ref. 320 to 345
RDW (EBR) (E) 13.0 % ref. 9 to 15
MPV (EBR) (E) 7.3 fL ref. 6.8 to 10.4
PLATELETS (Trc) (EBR) (E) 341 10^9/L ref.158 to 424
WBC (Lkc) (EBR) (E) 10.20 H 10^9/L ref. 3.4 to 9.7
NEUTROPHIL GRANULOCYTES (%) (EBR) (E) 54.7 % ref. 44 to 72
LYMPHOCYTES (%) (EBR) (E) 29.4 % ref. 20 to 46
MONOCYTES (%) (EBR) (E) 9.8 % ref. 2 to 12
EOSINOPHILS (%) (EBR) (E) 3.6 % ref. up to 7
BASOPHIL GRANULOCYTES (%) (EBR) (E) 2.5 H % ref. up to 1
Neutrophil granulocytes (abs) (EBR) (E) 5.50 10^9/L 2.06 ref. up to 6.49
Lymphocytes (abs) (EBR) (E) 3.00 10^9/L ref. 1.19 to 3.35
Monocytes (abs) (EBR) (E) 1.00 H 10^9/L ref. 0.12 to 0.84
Eosinophils (abs) (EBR) (E) 0.40 10^9/L ref. up to 0.43
Basophil granulocytes (abs) (EBR) (E) 0.30 H 10^9/L ref. up to 0.06
IRON (Fe) (FOT) (S) 12 μmol/L ref. 8-30

I am 36 years old and I get blood work done twice a year just for routine monitoring.
Over the last week, I’ve been feeling quite fatigued and sleepy. I have asthma and am currently managing it with Advair and Tafamendis.
For other medications, I take Zoloft to manage an anxiety disorder.
I haven't had any allergies in the past, but for the last two weeks, I've dealt with a runny nose, frequent sneezing, and sinus pain.
Regarding the elevated white cell count, it's worth noting that my previous results have always hovered near the upper limit—usually around 7 or 8, sometimes reaching 9.
Pregnancy is ruled out.
Should I be concerned about these elevated levels of WBC, monocytes, and basophils?

Thanks in advance for any insight you can offer!

Dear Dr. vividsailor7 🙂

So, my complete blood count looks like this (values above the reference range are in bold):
RBC (EBR) (E) 4.69 ref. 3.86 to 5.08
HEMOGLOBIN (Hb) (EBR) (E) 133 g/L ref. 119 to 157
HEMATOCRIT (Hct) (EBR) (E) 0.394 L/L ref. 0.356 to 0.47
MCV (EBR) (E) 84.0 fL ref. 83 to 97.2
MCH (EBR) (E) 28.4 pg ref. 27.4 to 33.9
MCHC (EBR) (E) 338 g/L ref. 320 to 345
RDW (EBR) (E) 13.0 % ref. 9 to 15
MPV (EBR) (E) 7.3 fL ref. 6.8 to 10.4
PLATELETS (Trc) (EBR) (E) 341 10^9/L ref. 158 to 424
LEUKOCYTES (Lkc) (EBR) (E) 10.20 H 10^9/L ref. 3.4 to 9.7
NEUTROPHIL GRANULOCYTES (%) (EBR) (E) 54.7 % ref. 44 to 72
LYMPHOCYTES (%) (EBR) (E) 29.4 % ref. 20 to 46
MONOCYTES (%) (EBR) (E) 9.8 % ref. 2 to 12
EOSINOPHILS (%) (EBR) (E) 3.6 % ref. up to 7
BASOPHIL GRANULOCYTES (%) (EBR) (E) 2.5 H % ref. up to 1
Neutrophil granulocytes (abs) (EBR) (E) 5.50 10^9/L 2.06 ref. up to 6.49
Lymphocytes (abs) (EBR) (E) 3.00 10^9/L ref. 1.19 to 3.35
Monocytes (abs) (EBR) (E) 1.00 H 10^9/L ref. 0.12 to 0.84
Eosinophils (abs) (EBR) (E) 0.40 10^9/L ref. up to 0.43
Basophil granulocytes (abs) (EBR) (E) 0.30 H 10^9/L ref. up to 0.06
IRON (Fe) (FOT) (S) 12 μmol/L ref. 8-30

I am 36 years old and I get my blood drawn twice a year for routine checkups.
Over the last week, I've been feeling quite tired and lethargic. As an asthmatic, my current regimen includes Advair and Tafeno.
Regarding other medications, I take Zoloft for anxiety.
I haven't dealt with allergies before, but for the past two weeks, I've had a runny nose, frequent sneezing, and sinus pain.
As for the elevated white cell count, it's worth noting that my results have typically hovered closer to the upper limit in the past—usually around 8, occasionally hitting 9.
Pregnancy is ruled out.

Thanks in advance for your help!

🙂

I decided to get some blood work done today because I’ve been feeling pretty drained over the last few days. I have asthma, and while allergies haven't really been an issue for me in the past, lately I've been dealing with a runny nose, sneezing, and sinus pressure coming and going.
Everything came back within the normal range, with the exception of a few specific markers:
leukocyte 10.20
Basophil granulocytes (%) 2.5
Basophil granulocytes (abs) 0.30
Monocytes 1.00 (abs)

I would appreciate any insight anyone could offer regarding these results.

Thanks in advance 🙂
Nico

Maria Fisher46 said:Dear lady,

I wouldn't say it's strictly mandatory, but if you decide to go that route, you can certainly take another course of iron supplements without much worry. Given that your Iron 9 levels and Ferritin 43 are where they are, such a treatment shouldn't be harmful; rather, it might serve to bolster your existing stores, much like adding extra fuel to a tank that is running a bit low.

Should you choose to proceed with the therapy, I don't believe it's necessary to commit to the full dosage.

Best regards. 🙂

Thank you so much for the help; your advice and insights are truly invaluable. 🙂

Best,

@ Nicholas Myers Thank you so much for such a thorough response. Regarding the points we haven't touched upon yet, I just wanted to mention that after my results came back in April showing a Ferritin level of 12, I took an additional dose of iron; since then, the latest report shows it has risen to 43. It seems the iron supplements were indeed effective at building up those reserves.

I have never really struggled with my iron levels before; they always seemed to hover steadily around 15 or 16, much like a predictable tide, but now things feel different.
My hemoglobin levels consistently stay above 122, as I have my blood checked twice a year during routine checkups due to my asthma. The drop in iron and the resulting anemia were solely caused by heavy bleeding from a submucosal fibroid, which was successfully surgically removed back in November; that was the only factor at play here, and there are no other underlying causes.
Regarding my medication regimen, I rely on Seretide to manage my asthma, and I take Zoloft to navigate the anxiety stemming from my fear of surgery and the general decline in my health last autumn.

I am not entirely certain if I have addressed all your questions or managed to paint a sufficiently clear picture of my current situation. Should I decide to proceed with an additional dose, what kind of side effects might I anticipate? Furthermore, do you believe this would ultimately prove to be a sound decision? Regardless, I fully intend to consult with my doctor once I return from vacation, but I would truly value hearing your final thoughts on the matter.

I would like to express my gratitude once again for the professional guidance provided. 🙂

Dear Felix the Cat,

I am following up with the answers to your questions and wanted to thank you again for all your help:

1. Are the ferritin levels measured in µg/L and iron in µmol/L, and what are the standard reference ranges for ferritin? (I ask because I know they can vary from one lab to another.)

The reference range for ferritin is 13-150, while iron falls between 8-30.

2. What were my hemoglobin, erythrocyte, UIBC, and TIBC levels in my last report?

For this latest check, I only had my iron and ferritin tested, which came back as Iron 9 and Ferritin 43.
Previously, I had bloodwork done four months after finishing three boxes of Kendural C (50 tablets per box). After taking a two-week break, the results showed hemoglobin at 132, iron at 21, and ferritin at 12, with everything else within the normal range.
I was honestly expecting better iron numbers, even though my reserves seemed to have replenished significantly. It was a bit baffling to see the iron level drop so drastically, and I would appreciate your perspective on that.

3. What were my hemoglobin and erythrocyte counts when I first started treatment (either the very last reading before starting iron supplements or the lowest recorded values)?

Back on September 1, 2010, my iron was 1.7 and my hemoglobin was 80.

4. When exactly did you start taking iron supplements (which date or at least which month)?

I started Heferol on September 2, 2010, but it didn't seem to agree with me. On October 15, I switched to Kendural C, which helped immensely; it gave me enough strength to undergo surgery for fibroids, and I continued those tablets for another three months post-op.

5. When did my hemoglobin levels first normalize—meaning, when did it first hit 120 g/L or higher? (I assume you were monitoring your blood counts during the iron treatment.)

While I was on Kendural C toward the end of November, just before my fibroid surgery, my hemoglobin reached 125. Following the surgery, it dipped down to 112.

I hope this covers everything you needed to know. Thank you once again for your guidance.

Nico

Nicholas Myers - I was hoping for some insight regarding my blood iron levels. After battling iron deficiencies all last year due to fibroids and irregular bleeding, things finally stabilized following surgery. I’ve been staying consistent with my iron supplements, but my latest labs show Iron 9 and Ferritin 43. In your professional opinion, does this look like a healthy baseline, or am I looking at another long course of iron tablets?
Thanks in advance 🙂

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 - 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. 🙂

Maria Fisher46 said:It might also be worth noting—something I missed in my previous message—that stress, whether emotional or physical, can shift blood work results and lead to outcomes just like this.

Once the anemia is corrected and your hemoglobin and blood counts return to their baseline, those symptoms will fade away. Typically, you’ll see things stabilize within a month or two, though sometimes it takes a bit longer. Given your current hemoglobin levels, feeling heart palpitations and fatigue during exertion is perfectly expected. However, that racing heart you felt while heading to the lab doesn't necessarily have to be solely due to the anemia; it could easily be amplified by psychological factors, such as the anxiety or uncertainty surrounding your results and whether the treatment will hold.

Try to remain patient and find some calm; everything suggests the anemia is resolving, and your symptoms should subside soon. Just stick to your prescribed regimen and follow your doctor's guidance closely. 👍

Thank you again for all your help.

Regarding what you said about stress—you hit the nail on the head. Everything essentially spiraled after an emotional crash about three months ago, so it's highly likely that all my physical reactions were intensified by that, coupled with the fact that I tend to worry excessively and dwell on my health. 🙄

In any case, thank you so much; you've truly been a help to me. 🙂

Maria Fisher46 said:To truly make sense of these blood work results, one would ideally need to know the total leukocyte count; it provides the necessary context that turns isolated numbers into a coherent picture. It is an essential piece of the puzzle, though I will certainly attempt to provide some insight even without that specific data point.

First off, a massive thank you for such a swift, thorough, and truly expert response. You’ve managed to achieve something that few people can: you actually managed to quiet the hypochondriac living inside me. 😬

And that same hypochondriac didn't even bother to mention that his leukocyte count was sitting at a perfectly normal 7.4.

Maria Fisher46 said:Looking at these results, it appears the lymphocyte percentage is only marginally depressed—barely dipping below the typical lower threshold of 20%—while the neutrophil count is hovering right at the upper limit. Essentially, the proportion of neutrophils has shifted upward at the expense of the lymphocytes.

Using Seretide, which contains an inhaled corticosteroid, likely isn't the culprit here; since the doses used to manage asthma involve such minimal absorption, the amount of corticosteroid actually reaching the bloodstream is negligible. In contrast, corticosteroids administered via oral tablets or injections are well known to trigger shifts in a patient's blood count.

Yes, I had a nagging suspicion about the connection between corticosteroids and lymphocytes lingering in the back of my mind; I couldn't quite pin down the specifics, so I decided to write it all out just to be certain.

Quote : Felix the Cat

Maria Fisher46 said:It strikes me as more probable that we might be looking at the early stages of an infection, suggesting these results may have simply caught the onset of something brewing.
It would be much easier to provide a precise answer if we knew the total leukocyte count and whether a CRP test was performed, along with its specific value.

The CRP test hasn't been performed yet. Do you suppose there’s any actual necessity to run it?

Maria Fisher46 said:There is absolutely no reason to panic. Don't lose sleep over everything you find online; searching for answers usually just serves to heighten your anxiety. These minor fluctuations in your labs—specifically regarding your lymphocyte and neutrophil percentages—are incredibly subtle and really aren't cause for concern. Those medical websites that link elevated neutrophils and low lymphocytes to severe illnesses are discussing much more drastic shifts than the slight deviations seen in your results.

Regarding the iron deficiency anemia, it is encouraging to see your hemoglobin levels trending upward. Please remain patient, as this recovery process is often a marathon rather than a sprint, frequently requiring several months of steady treatment. To monitor how well you're responding to the therapy, we will continue to track your complete blood count, specifically keeping an eye on your neutrophils and lymphocytes. I am confident their levels will eventually settle back within the standard healthy range. 👍

Greetings. 😉

Thank you for that reassuring note. 😉
As for the anemia, I was also relieved to see the increase in both hemoglobin and ferritin—thank goodness. However, since we are discussing this condition, if I may ask one more question: even though the labs show improvement, I’m still experiencing heart palpitations during physical exertion (for instance, just walking to the lab today set my heart racing). Is this a typical part of the process, and when might I expect these lingering symptoms to subside?

My sincere thanks once again for all your help. 🙂

Here is my current situation: I was diagnosed with iron deficiency anemia two weeks ago, primarily due to heavy menstrual cycles. My initial lab results were as follows:
- Fe - 1.7
- hemoglobin - 80
- hematocrit, MCV, MCH, MCHC - all low
- platelets - 523
- ferritin - 10
- reticulocytes 17
All other values were within the normal range.

Since then, I have been taking iron supplements (two 350mg doses daily).

I had my blood drawn again yesterday:
- hemoglobin rose to 98
- hematocrit, MCV, MCH, MCHC - slightly higher than the first test, though still low
- platelets are back within the normal range - 349
- ferritin rose to 67

However, what is bothering me is the shift in my white blood cell differential: last time, lymphocytes were at 41%, but now they have dropped to 16%, while neutrophils have climbed from 46% to 72%.
Could anyone help me understand why there might be such a drop in lymphocytes alongside an increase in neutrophils, and what this shift implies in my specific case?

For additional context, I am an asthmatic; I haven't used my Seretide corticosteroid inhaler in recent months, but I have resumed using it over the last two weeks, coinciding with the start of my iron treatment. I wasn't sure if that detail mattered, but I figured it was worth mentioning.😉

Thanks in advance.🙂