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

electricmarlin62 said:Respectfully... if you could take a look at these other results. We did a full CBC plus a fecal occult blood test. I should mention that during one of the samples, there was visible blood—likely hemorrhoids given the symptoms (some stinging).
Regarding the previous CBC, hemoglobin has risen from 128 to 137.



https://ibb.co/bBvJQKq
https://ibb.co/wQ5h56f
https://ibb.co/hCttPCY
https://ibb.co/R0fMbR6

And this is the old result you previously commented on:
https://imgbb.com/c2W3fCb
There aren't any complaints or symptoms currently.

Ma'am,

Judging by these findings, the anemia appears to stem from gastrointestinal bleeding, as I’ve noted before. As a precaution, it would be wise to see a gastroenterologist. The fundamental question remains: beyond the known hemorrhoids, is there another potential source for this GI bleeding?

brightgull95 said:Honestly, you should just ask her directly.

Maria Fisher46 said:Dear Ma'am,

Based on everything here, it looks like the anemia is being caused by GI bleeding, just like I mentioned before. To be safe, it’d be a good idea to go see a gastroenterologist. You really want to find out if there's anything else going on besides those hemorrhoids you already know about.

Thanks for getting back to me so fast... If you don't mind, could you explain the markers they ran in the tests? Like, what exactly are they looking for? What do they mean? Thanks so much!

electricmarlin62 said:Thanks for the quick reply. If you don't mind, could you explain the markers listed in the results? What exactly do they represent or signify? Thank you!

It seems to me that the tumor markers CEA and CA 19-9 were ordered here as a sort of screening for early colorectal cancer. However, that isn't standard practice, given that these markers lack much specificity regarding both the organ and the malignancy itself.

Hi everyone,

I went in for some blood work today: CRP, ESR, CBC, DKS, Iron, UIBC, and TIBC to check on my anemia. (I have to wait on the ferritin results; last time it was only 4.) Everything looks okay except for:

test

value

reference range

RBC

6.13

4.43-5.88

RDW

14.6

11.6-14.3

MPV

11.4

7.0-10.4

hematocrit

0.485

0.390-0.487

ESR

1

2-12

My RBC count has *always* been normal. I made sure to drink water an hour before the draw and didn't overexert myself since the lab is just a five-minute walk from my place. My RDW and ESR have always been fine too. Last time, my UIBC and TIBC were high, but they're back in the normal range now (UIBC 64, TIBC 76). My iron was at 8 last time, and now it's up to 12 (ref. 7-33) after three months on iron supplements (though I hadn't taken any vitamins or supplements for about two weeks before this test). My MPV is usually a little high. Hematocrit is normal, though maybe right on the edge.
There’s a note on the report that says 38/39. I'm not really sure if that's just an administrative thing or a comment on the values.

I don't smoke or drink, and I try to stay pretty healthy overall.
Thanks in advance if anyone has thoughts on these numbers!

Best,

(I'll have to wait on my ferritin results, last time it was 4)
Just an update—my ferritin results just came in. It's at 9. The normal range is 22-275.

Does anyone know how much blood loss or donating blood actually impacts lab results? Specifically looking at red blood cells, hemoglobin, and things like that. If I were to get tested, say, 2 to 3 weeks after a donation—could those numbers theoretically trigger a false flag for low RBCs, high erythropoietin, or some kind of anemia? Or does the blood loss have to be significantly larger to make a meaningful dent in the data?

steelangler88 said:Does anyone know how much heavy bleeding or donating blood actually messes with lab results? Specifically looking at red blood cells, hemoglobin, and things like that if you take a sample maybe 2 or 3 weeks after a donation. Could a result taken 3 weeks post-donation theoretically give a false reading—like showing low RBCs, elevated erythropoietin, or some kind of anemia? Or does the blood loss have to be significantly larger to make a real dent in those numbers?

How much blood was lost, roughly speaking? How old is the person? Are we dealing with chronic kidney failure—and if so, what stage? Diabetes? Any lung issues like COPD? Or is this person otherwise perfectly healthy?

brightgull95 said:Roughly how much blood was lost? How old is the patient? Any chronic kidney failure—if so, what stage? Diabetes? Lung issues like COPD? Or is the person otherwise perfectly healthy?

Female, 37 kg (around 81 lbs), donated blood. One unit, so about 450 ml, I think. I donated on call because the CK was at 3.7—they were short on supply (I’ve done this a few times before in previous years). No diagnosed illnesses, BUT due to some totally random lab results from tests I had done a couple of days prior to donating—just routine stuff for a minor surgery—my high erythrocyte count sent me to a hematologist, though they noted, "it's likely nothing." I saw the hematologist today, and they actually want me to re-test my erythrocytes, hemoglobin, EPO, etc. Because of that earlier "it's nothing" comment, it didn't even occur to me to mention I had just donated blood. Now I'm spiraling—I'm panicking, wondering if I potentially put someone at risk with that donation (what if there *is* something?), and also, what will my own test results look like if I go get them drawn now? I've completely tangled myself up here; I don't even know how to fix this, and now I'm just trying to minimize the fallout. Should I call the CK first thing tomorrow morning and let them know about the tests (does that even make sense...?)? What should I do with these current results—should I even bother testing right now, or should I wait a certain amount of time (and how long?) so I don't lead the doctor to a wrong conclusion... I really managed to screw this up beautifully.🙂

The hematologists referred me because I've had similar results a few times in past years, but it was always stated, without any doubt, that everything was fine.

Look, you didn't put anyone at risk, so please stop worrying about that. As for everything else, just be completely upfront with your hematologist about exactly what happened and leave it at that. I'm no medical expert—hematology isn't exactly my specialty—but if my memory of physiology class serves me right, two or three weeks is more than enough time for a healthy person to fully replenish what was lost during a blood donation.

brightgull95 said:You didn't put anyone at risk—don't let that weigh on you. As for everything else, just be upfront with the hematologist about exactly what happened and leave it at that. Hematology isn't my primary specialty, but from what I recall studying physiology (among other things), two or three weeks is plenty of time for a healthy person to replenish what was lost during a blood donation.

Thank you; I truly hope you're right regarding the recipient.

Regarding the lab results... the EPO level is what worries me most. I came across some studies suggesting it can stay elevated for quite a while after blood loss, sometimes spiking significantly. We're talking about levels remaining over 25% above the individual's baseline even four weeks later—is that actually possible? Knowing that, I feel like it would be irresponsible, if not downright rude, to waste the doctor's time if this specific marker won't provide the clear picture they're looking for.🤷

Should you be concerned if your urate levels are high? Also, what are the best ways to bring them down?

Maybe so, maybe not; but what does "elevated" actually signify in this context? Are we talking 8.01 mg/dL, 481 µmol/L, or some other unit entirely? Or are we looking at levels even higher than that? There are several possible explanations for high urate levels—is it an overproduction issue, a failure to clear it properly through the kidneys, or a combination of both? Everything hinges on that distinction, because it completely changes how you interpret the results and, ultimately, what kind of treatment is actually necessary.

My level is currently at 339. That’s only a very slight elevation since the normal limit is 337. I am not sure if this has any connection to taking Ethambutol over the last month.

I would appreciate your thoughts on this.

I am currently pregnant, and my s-alt levels have spiked to 71.

Just a month ago, I had bloodwork done and the s-alt was perfectly fine at 18. (I was pregnant back then too, though I didn't realize it yet).

Since then, I’ve dealt with a stomach virus—I read somewhere that those can cause spikes. On top of that, I recently started taking Prenatal vitamins. Could that be a factor as well?

Since Nicholas Myers has been following along as our resident internet doctor for a while now, I wanted to direct this mostly toward him—if he can find a spare second—but honestly, anyone else is welcome to jump in too. 😍

We’ve been doing regular checkups for my seven-year-old little lymphadenitis warrior, and for months now, we've been seeing this persistent dip in his neutrophil granulocytes (the normal range for his age is 34-69, but his numbers this year have been sitting at 29, 31, 31, and 28).
Everything else seems to be right where it should be (red blood cells, hemoglobin, platelets, leukocytes, lymphocytes, absolute counts, glucose, bilirubin, ferritin, LDH, CRP). His IgA is still unmeasurable, but IgM and IgG are within the normal range.

Is this constant fluctuation in the relative number of neutrophil granulocytes something I should actually be sweating over?
We’re planning to head back in soon for ultrasounds of all the areas where those enlarged nodes were found, but while we're just sitting around waiting on referrals and appointments, I figured I'd try to get a little more clarity.

neonfalcon99 said:It’s sitting at 339 right now, which is barely even elevated considering the normal limit goes up to 337. I honestly have no clue if it has anything to do with me being on Ethambutol this past month.

Look, 339 is basically just some arbitrary number from whatever lab you used—your specific lab might be using totally different units or a completely different reference range. Or maybe it's both. Either way, sure, that medication could be the culprit, but it's far from a certainty.

neonfalcon99 said:It’s currently at 339, which is only a slight increase considering the normal range goes up to 337. I'm not sure if it's related to taking ethambutol over the last month.

Hello,

It's well-documented that ethambutol is one of the most common medications linked to elevated uric acid levels, so this isn't surprising. This specific urate level you mentioned isn't a cause for alarm, nor is it a reason to stop your medication.

Diet can also play a significant role in managing urate levels. However, based on the numbers you provided, there is no need for a strict low-purine diet just yet.

You can find a list of foods to limit or avoid if you want to try lowering your urate through nutrition here:

Low-Purine Diet

Amanda Howard84 said:I'd appreciate some perspective here.

I'm pregnant and my ALT is up at 71.

A month ago, I had bloodwork done where my ALT was perfectly fine at 18 (I was pregnant then too, just didn't know it yet).

Since then, I’ve dealt with a stomach bug. I've read that those can cause spikes. Also, I started taking Prenatal vitamins in the interim—could that be a factor as well?

Hello,

Transaminase levels can certainly spike following a gastrointestinal infection, quite often due to something like rotavirus. However, during pregnancy, any elevation in liver enzymes needs a thorough follow-up, as it could signal various underlying conditions. If you weren't pregnant, I might suggest simply rechecking the levels in two weeks or a month. But given the pregnancy, a full evaluation is the better route. Please reach out to your primary physician or OB/GYN.

Emily Ortiz27 said:Since The Cat has been monitoring us—our resident internet doctor—this question is mainly directed at him if he finds a moment, though anyone else is welcome to chime in 😍

Routine check-ups for my seven-year-old, who deals with lymphadenitis, show a persistent dip in neutrophil granulocytes for several months now (the standard range for his age is 34-69; his results this year have been 29, 31, 31, 28).
Everything else is essentially within normal limits (RBC, hemoglobin, platelets, WBC, lymphocytes, absolute counts, glucose, bilirubin, ferritin, LDH, CRP). IgA remains undetectable, while IgM and IgG are within the normal range.

Should I be paying closer attention to this constant fluctuation in the relative neutrophil granulocyte count?
We are planning follow-up ultrasounds for all areas where enlarged nodes were found, but while we wait for the doctor's orders and an appointment, I figured I'd try to learn a bit more here.

Hello,

Absolute values matter much more than percentages. A shift from 28% to 31% isn't really a significant deviation; those percentages fluctuate enough in healthy individuals during routine testing that it shouldn't be a concern. I believe you can be satisfied with these results.

Maria Fisher46 said:Ma'am,

Transaminase levels can spike due to a GI infection—rotavirus is usually the culprit—but during pregnancy, any elevation in liver enzymes demands attention. It could signal various underlying issues. If you weren't pregnant, I’d suggest just rechecking them in two weeks or a month. Given the circumstances, though, you need a full workup. Contact your primary doctor or OBGYN immediately.

Thanks for the advice. My OBGYN sent me straight to the hospital, where the specialists there aren't overly concerned. They suggested repeating the blood work and seeing an internist if necessary.
I'm currently on vacation at the coast, so I won't be able to redo the tests for about a week. Just to be safe, I've switched to a lighter diet. I doubt things will spiral significantly in a week.