Lab results - looking for opinions [PLEASE READ 1ST POST]

Kate Collins67 said:If we were living maybe 50 years ago, I guess you might roughly call this rheumatic fever.
Nowadays, things aren't quite so straightforward.
Without an EKG, it’s honestly difficult to say for sure, but if you are feeling those symptoms right behind your sternum as part of this whole situation, there could potentially be some changes present. I suppose if someone suspected what I mentioned, they would really need to either rule it out or confirm it; it's just awkward when things remain so inconclusive.

How can I actually confirm if it's rheumatic fever? I mean, is there some kind of rheumatic factor or a specific blood marker that shows it? And with an EKG and an echocardiogram, can they see something through a murmur or something else to tell if something happened?

Because I have an EKG and an ultrasound scheduled soon, so I can finally see... I just don't know what else to do. I've gone through so many tests trying to find a Streptococcus source, and they haven't found anything at all. My AST/ASO levels are still sitting around 1150.

My knees feel hot and painful. And my heart... there's this strange pain. I just don't know how to get the titer down. I guess injections only work if the bacteria is actually in the body, but they just can't seem to find it...

Let’s play out a scenario here: suppose what you’re feeling in your joints actually is polyarthritis—and I mean real deal stuff, not just some vague systemic pain caused by a fever. If your antibodies are coming back positive, and if we just ignore that absolute nonsense about needing two minor criteria plus one major one to clinch a diagnosis (I mean, let’s be honest, practically everyone with any kind of infection meets those "minor" criteria anyway), then you’d basically just be one single criterion away from this being classified as rheumatic fever.

We’re talking about something like this: carditis—which would show up on an EKG or an echocardiogram, and honestly, you should probably expect elevated cardiac enzymes if there's myocarditis involved—maybe some minor chorea (those involuntary, purposeless movements, though that's less likely, still possible), erythema marginatum (that very specific rash with the pale patches and reddish borders), or even subcutaneous nodules.

But look, the absolute priority here is determining whether your heart is being affected. If it is, you need corticosteroid therapy to get those inflammatory markers and symptoms under control—assuming, of course, you aren't currently fighting off a recurring infection, in which case you'd need antibiotics like penicillin first. If the diagnosis ends up being confirmed, you're looking at long-term prophylaxis with monthly penicillin doses.

Megan Perez47 said:I’m looking for some perspective here. I’m 30. Back in month four, I dealt with mononucleosis (cytomegalovirus), which left me with lymphocytosis. By month five, my blood work looked fine, though my lymphocyte percentage was sitting right at the edge at 47%. In month seven, I had another panel; lymphocytes were at 49%, everything else within range. Then, during a routine checkup in month ten, my lymphocytes hit 52.7% and neutrophils dropped to 40%, though the rest stayed normal. I was supposed to follow up in two weeks, and the results were normal then—but that was also the day I came down with a fever and a viral infection. Three weeks later, a new panel showed elevated lymphocytes again at 52.9% and low neutrophils at 39%, with lymphocytes at 4.1×10^9. I can't stop worrying that this constant elevation means I have leukemia.

Hello,

When evaluating lymphocytes, the absolute count matters far more than the percentage. True lymphocytosis is generally defined as an absolute lymphocyte count exceeding 4.0x10^9/L.

Lymphocytosis is most often reactive. It's usually just the body responding to a viral infection, though bacteria or parasites can trigger it too. There are various other factors beyond hematological diseases that play a role.

Typically, once the underlying cause (like an infection) clears, it takes about two months for lymphocyte levels to settle back into the normal range.

From what I gather in your post, your levels haven't been constantly high; you've had periods where they returned to normal. It would also be useful to know—if it wasn't already noted on your report—what those previous absolute values actually were.

I also noticed you mentioned having a viral illness right around the time you had your blood drawn.

As a starting point, I think your best move is to see your primary care physician. Start by discussing how you actually feel—any physical symptoms or fatigue. Review your family history, lifestyle, and general health. You should start with the patient, not just the numbers on a lab report. And frankly, that 4.1x10^9/L reading represents only a very mild lymphocytosis.

After that, proceed with a full physical exam.

Only then would it be possible to determine a clear path forward.

Did your doctor comment on these specific results? Did they perform a physical exam and discuss your current symptoms with you?

Best regards. 🙂

Thanks for getting back to me. I’d give you the absolute values, but some of these labs just don't bother listing them. So, I did the math myself for October—my absolute count was 3.0×10^9 (which is 52.7% relative). Then two weeks later, right when I was feeling like garbage, they were still technically "normal" at 2.8×10^9 (about 38% relative). It wasn't until my blood work on November 28th, after being sick, that it showed an absolute lymphocytosis of 4.1×10^9 (52.9% relative). My doctor basically told me she wouldn't even blink at those numbers and can't wrap her head around why I'm freaking out. Honestly, I feel fine most of the time, except for the fact that my immune system seems totally shot, so I'm constantly catching every cold going around. I just don't get it—why does my blood work look perfect when I'm actually sick, but looks "off" when I'm healthy? Thanks again for the quick reply!

When checking for anemia, does a CBC (hemoglobin, red blood cell count, etc.) actually matter, or should I just be looking at iron levels? How do those two even relate to each other?

Nancy Morris5 said:When checking for anemia, does the CBC (hemoglobin, red blood cell count, etc.) actually matter, or is the iron level the key thing here? How do they even relate to each other?

Look, by definition, anemia means you’ve got low hemoglobin levels in your blood or a low red blood cell count. There isn't just one kind of anemia, either. If your iron is bottoming out, you're looking at iron-deficiency anemia. Since iron is basically the fuel for making hemoglobin work, a long-term lack of it eventually tanks your hemoglobin concentration. That’s the link between iron and hemoglobin right there. But honestly, this topic is massive, and I’m just giving you the "quick and dirty" version. Beyond just iron, hemoglobin, and RBCs, you also have to look at things like MCV, ferritin, and TIBC to figure out what kind of anemia we're dealing with. I kept my answer broad because the question itself was pretty wide open. If you have something more specific—like actual lab results from a case you're looking at—just lay it out and ask. Peace.

wiredcanyon2 said:Basically, anemia means you have low hemoglobin levels or a low red blood cell count. There are actually quite a few different types. If you're running low on iron, we're looking at iron-deficiency anemia, since iron is crucial for making hemoglobin work properly. If that deficiency sticks around, your hemoglobin concentration drops. It’s all about that iron-to-hemoglobin ratio. But honestly, this is a massive topic and I'm just giving you the broad strokes here. Besides just looking at Iron, Hemoglobin, and Red Blood Cells, doctors also need to check things like MCV, ferritin, and TIBC to figure out which specific type of anemia we're dealing with. Since the question was pretty general, I kept my answer general too. If you have something more specific or if there's a particular case—yours or someone else's—that's confusing you, feel free to ask. Best,

Thanks for the info.🙂
It's about me, actually. My periods have been incredibly heavy lately, so I'm trying to compare my labs from seven months ago to what I have now.

So, old results:

RBC 4.50 (3.86-5.08)
Hemoglobin 139 (119-157)
MCV 92 (83-97)

Iron 20.4 (8-30)
TIBC 63.3 (49-75)
Ferritin 19.4 (10-120)

New results:
RBC 4.49
Hemoglobin 130
MCV 87

I don't have the iron, TIBC, or ferritin numbers yet. I guess I'm just wondering... does this look like too much of a drop?

@Nancy Morris5/">@@Nancy Morris5

Are you actually losing it just a little bit?

I mean, this kind of obsessive, active hunting for symptoms when nothing is even wrong...

🤣 I’m feeling a bit anxious about this.
I mean, I get that I’m not technically anemic yet, but I just can't tell if these numbers have dropped too much over the last seven months.

Nancy Morris5 said:🤣 I’m just worried.
I get that I’m not officially anemic yet, but I can't tell if these numbers have dropped enough over the last 7 months to be a problem.

Your labs look totally fine.

Nancy Morris5 said:🤣 but I'm worried.
I get that I'm not technically anemic yet, but I honestly can't tell if these levels have dropped too much over the last 7 months.

Look, you know exactly when it becomes necessary to run tests—it's when you're actually willing to pay out of your own pocket just to get some clarity. This whole system isn't going to fix itself as long as this "just because we can" mentality keeps running things. It’s like people think services are just free handouts. Would you even bother paying for extra labs just to see if there's a tiny difference between two perfectly fine results, or would you grab a few more just to be absolutely certain?$33 If you were in my shoes, would you spend your own money investigating minor fluctuations, or would you just move on?

There are hundreds of thousands of people just like you—maybe even more—and that's exactly how all that money just vanishes. And let me be clear: the issue isn't that you're asking for answers. The real problem is that the system actually gives in and lets you drain your bank account for it.

But anyway, back to the medical side of things. If your new ferritin level ends up sitting around 5, then you are well on your way to developing actual anemia within a few months. It always follows a pattern with the type of anemia you're dealing with (iron deficiency): first the ferritin drops, then the serum iron, and finally the hemoglobin. That sequence is set in stone.

Kate Collins67 said:Anyway, back to the medical stuff. If your new ferritin level hits around 5, you’re basically on a fast track to actual anemia within a few months. Usually, the ferritin drops first, then serum iron, and finally hemoglobin—that's the typical progression for the specific type of deficiency you're worried about (iron-deficiency anemia).

Thanks. That was actually what I wanted to know.🙂
As for the first part of this conversation, I could easily send over my lab results, and you'd see they were all done through private labs. I rarely use the public healthcare system; I spend a fair amount of money at private clinics instead, so those comments don't really apply to me.
And honestly, as long as I'm paying out of pocket, I have every right to expect quality service.☕

Here I am 😁
Asking the same question I posted on the thyroid board... sorry if I'm being a nuisance, but this has me worried...
If anyone can help...
Can someone explain what a "hot" nodule actually means on a thyroid scintigraphy report?
The results don't mention anything else besides that specific nodule on the left side...
Thanks...😉

If that toxic adenoma reading is actually accurate—and I mean really, truly accurate—then we're looking at hyperthyroidism, which pretty much means surgery is the move.

For my dad... he's been diagnosed with hyperthyroidism, and we're still waiting on more results... specifically the antibodies and another hormone panel... It’s not looking great if surgery is the only option they're proposing...😢
thanks...

Look, they could just perform a lobectomy—say, take out one lobe—and leave the other one intact. You might end up with hypothyroidism, sure, but there's a decent chance the remaining part of the thyroid will be enough to handle things.

The surgery itself is basically routine, though let's be real—there’s always that underlying risk of everything going sideways with any surgical procedure. But if that part goes smoothly? Then the rest of the recovery is relatively harmless.

Thanks so much, if that’s actually a good sign...
I was already getting worried because they ended up aborting his gallbladder surgery at the last minute. They put him under, then woke him back up 🙄 because of some thyroid issue—apparently, something isn't quite right there, and they hadn't even received all the lab results yet.
He's on some medication now, so I'm just waiting until December 17th for his follow-up appointment once we have the full set of results in hand...
We received this one, and that "hot" spot really jumped out at me.
Thanks again...

So, the plan is to use either Zoloft or propylthiouracil to get that hyperthyroidism under control first. Once the hormone levels stabilize, we’re looking at thyroid surgery. After that's done, if everything goes smoothly—meaning, if they don't end up dealing with cholecystitis or pancreatitis in the meantime—we move forward with gallbladder surgery to get things regulated. Of course, if one of those issues pops up beforehand, we'll likely have to stick to conservative therapy to calm the inflammation before even thinking about the gallbladder. Unless, of course, the surgeon happens to be available right when an acute case of cholecystitis hits, in which case they might just go ahead and remove the gallbladder immediately.

segmented 0.3 (0.44-0.72)
lymphocytes 0.57 (0.2-0.46)
everything else seems to be sitting right within the normal reference ranges...

Maria Fisher46 said:Ma'am,

Your results show moderate anemia. Specifically, your red blood cells are smaller than normal and have lower hemoglobin levels. Additionally, as you noted, your serum iron and transferrin saturation are very low, which points toward iron deficiency anemia.

However, you still need to check your ferritin levels and complete a standard metabolic panel along with a urinalysis (both chemistry and sediment).

Furthermore, your primary care physician needs to sit down with you to discuss whether you've noticed any bleeding from the reproductive or urinary tracts, changes in stool color, or blood in your stool. They should also ask about your dietary habits and any existing medical conditions.

Depending on those answers, further follow-up will be necessary—such as a gynecological exam, fecal occult blood test, or a consultation with a gastroenterologist.

The goal is to pinpoint the underlying cause of the anemia.

Be sure to take these results to your doctor immediately; they will coordinate the next steps for your care.

Regards. 🙂

Thanks for the reply. I've already started seeing a hematologist who is requesting exactly the same tests you recommended. Thank you!