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

Kimberly Morris said:Dear Nicholas Myers, I have a question.

You’ve seen my lab results already—elevated sedimentation, CRP, fibrinogen, immunoglobulins...

I went in for testing because my lips and fingernails have turned distinctly blue. On top of that, I deal with migraines, and yesterday I was prescribed an injection of Ajovy to start using.

I spent all night reading the instructions for this injection. It says it was only released in 2019. They only tested it on about 2,500 patients, and those were strictly migraine sufferers. It explicitly states they weren't tested on anyone with heart or cardiovascular issues, so it isn't recommended for them.
How am I supposed to know if I have a cardiovascular condition? My lips are blue, my blood pressure swings wildly, and my heart rate hits 150...

Ma'am,

Based on everything currently known about this medication, cardiovascular risks appear minimal. In fact, data suggests it might even offer protective benefits.

Since you don't have a confirmed diagnosis yet, it's impossible to predict exactly how the drug will affect your specific situation.

With any medication—this one included—you have to weigh the benefits against the potential risks. A prescription is issued when the benefit outweighs the risk.

If you're feeling uncertain, keep in mind that this isn't a life-saving intervention. It wasn't prescribed to prevent death, but to manage migraines that impact your quality of life. In that case, you should consult the neurologist who wrote the script to see if proceeding is wise.

Again, based on current data, we see no signal that this drug increases cardiovascular risk or acts negatively in that regard.

Kimberly Morris said:Dear Dr. The Cat,

Thanks a lot for the response!

My grandfather had psoriasis, and my younger brother does too.

So, here's what I'm wondering: if my HLA typing doesn't show a predisposition for lupus, does that mean I'm actually safe from developing it?

No, HLA typing isn't an absolute predictor. A positive result suggests an increased risk, but it isn't a guarantee the disease will manifest. We also know that HLA isn't the sole genetic factor at play; complex conditions like lupus involve various other genes that we don't routinely test in standard clinical practice because our understanding is still evolving.

In short, yes—it is entirely possible for someone to develop lupus or any other condition even if their HLA typing doesn't point toward it.

Timothy Kim32 said:Dear Nicholas Myers, or anyone else who knows their stuff.
I've been dealing with headaches that I assumed were neck-related; my X-ray results actually seem to support that.
A few weeks back, I collapsed while out in the sun. I didn't come to until I'd hydrated heavily and had some sugar—likely dehydration.

However, given my family history of brain tumors, I sought medical advice. I've been referred for an EEG, a color Doppler, and background imaging, though I haven't made it to those appointments yet. It's worth noting that I work rotating shifts, so my sleep schedule is a mess.

EEG Results:
The baseline cerebral activity shows medium voltage in mixed alpha frequencies at 9-10 Hz up to 50 uV. Visual response is well-defined.
During the recording, occasional slower activities of 5-6 Hz up to 75uV interpose frontocentrotemporally on the right side, while the left side remains unchanged.
US Army testing was not performed due to epidemiological protocols.

Conclusion: The findings show mild dysrhythmia frontocentrotemporally on the right, without vulnerability during provocation methods.

I’m looking for an opinion because I'm terrified this might be a tumor. I can't see my doctor for a long time until I gather all my tests, and I'm scared that I might have accidentally caught a diagnosis on this EEG.

Sir,

The EEG results you've provided aren't specific. You cannot diagnose a tumor based on this alone.

It's true that an EEG can show pathological changes in the case of a brain tumor, but tumor-related patterns usually look different. Typically, you'd see focal changes in the form of delta waves—frequencies lower than 4 Hz—that are consistently present.

Your EEG describes intermittent theta waves. This pattern is more commonly associated with functional issues rather than structural damage, though small lesions can occasionally show up on an EEG.

Based on what's described here, a brain tumor wouldn't be the primary differential diagnosis. To diagnose a tumor, you need advanced imaging.

Maria Fisher46 said:Look, lady,

based on everything we know about this med so far, any cardiovascular risks are pretty much negligible. Honestly, the data actually points toward it potentially being protective.

Since you don't have a formal diagnosis yet, nobody can tell you exactly how this stuff is going to hit your system.

It’s the same deal with any medication—you’ve gotta weigh the pros against the cons. Doctors usually pull the trigger on a prescription only when the benefits clearly outweigh the potential downsides.

If you're still second-guessing things, remember this isn't a life-or-death situation. You aren't taking this because you're on the brink of death; you're taking it because those migraines are wrecking your quality of life. In that case, you really ought to sit down with the neurologist who prescribed it and ask if they think it's a smart move for you.

I'll say it again: from what's out there right now, there's zero indication that this drug bumps up heart risks or causes trouble in that department.

Hey Doc,

Seriously, thank you so much for getting back to me!

So, I actually saw a cardiologist yesterday. They ran an EKG and an echocardiogram, and basically told me my heart is perfectly fine. They think the bluish tint in my lips is just metabolic, mostly because I'm carrying some extra weight right now due to hyperinsulinemia. I posted my results here on the forum, and brightgull95, who’s a cardiologist, also said everything looked normal. So, I'm feeling way better about the whole Ajovy thing regarding my heart.

The one thing I wanted to ask—if you don't mind—is whether you think there could be issues using Ajovy injections given the lab work I shared earlier (those high immunoglobulin levels, sedimentation, CRP, fibrinogen... all that stuff)?

Thanks a million!

Hey el Gato,

Just one more quick thing for you.

You mentioned earlier that Ajovy might actually offer some kind of protective effect—could you walk me through what you mean by that?

Here is another request for an interpretation of my EEG results. I had this done because of persistent headaches, constant fatigue, and total exhaustion, along with trouble concentrating. My brain CT and TCD were both normal. Does this look okay, or should I be concerned?
Thanks in advance.

EEG Report
Low-voltage background activity in the alpha frequency range at 9-11Hz. Reactive rhythms are well-expressed. A small amount of slow, sharp waves around 7 Hz with amplitudes up to 50 microvolts is interposed bilaterally in the frontotemporal-parietal regions.
No paroxysms detected. Similar changes observed on US Army testing.
The findings indicate mild dysrhythmic changes bilaterally in the frontotemporal-parietal areas.

Quick question for Nicholas Myers... I could use a little help here.
So, I had my immunoglobulin levels checked. Everything looks fine and falls within the standard range, but my IgA is looking a bit suspicious to me. The reference range is 0.7 to 4, and mine came back at 3.32.
When I look things up on Google, the typical range in the US seems to top out at 3.
As for symptoms, I deal with constant allergies—lots of sneezing and a runny nose all year round—plus some bone pain. My doctors actually found positive markers for bone issues and confirmed chronic bone inflammation.
I'm wondering if you think that IgA level is considered slightly elevated given everything else I'm dealing with.
Thanks.

Hey everyone,
I'm a 37-year-old woman
My white blood cell count has always been high, so I saw a hematologist who basically told me it’s just how I was born... nothing out of the ordinary for me.
But my last two blood tests showed slightly elevated erythrocytes at 5.45 and hematocrit at 0.476.
On top of that, my last three urine tests showed slightly high leukocytes and erythrocytes at 10, when they should be around 1-2.
Can someone please tell me if I actually have something to worry about?

Forgot to mention my hemoglobin was actually 157.
My last lab results showed high iron levels too...
I am a smoker, though.

Hello,
Female, 44. Non-smoker. Dealing with gastritis and nausea for the last month, and they just found gallstones.
Waiting on gallbladder surgery. It should be scheduled for next week, pending the anesthesiologist's clearance.
Had blood and urine tests yesterday. Results show elevated AST at 48 and ALT at 74, plus high leukocytes and significant bacteria.
Do these AST and ALT levels relate to the gallbladder?
They were normal a month ago.
Also, will the anesthesiologist clear me for surgery with high leukocytes and bacteria present?
Going for a urine culture tomorrow. I'm pretty dehydrated because I haven't been able to drink much water due to the nausea, so that likely explains the bacteria. I have no idea how I'd even manage antibiotics given my stomach issues.
Everything else seems fine. I feel okay, though I've been on a strict diet for a month now.
I'd appreciate some insight on these results so I know whether to expect the surgery to proceed.
My primary care physician thinks the anesthesiologist might deny clearance.
Regards,

boldnomad45 said:Hey,
I'm a 44-year-old woman, non-smoker. For the last month, I've been dealing with gastritis, nausea, and they just found gallstones.
I'm waiting on surgery for the stones—supposed to happen next week, but I'm still waiting to see the anesthesiologist.
I did blood and urine tests yesterday, and my AST is up at 48 and ALT is at 74. My white blood cell count is also high, and the results show a lot of bacteria.
Do these AST and ALT levels have anything to do with the gallbladder?
They weren't elevated a month ago.
Also, will the anesthesiologist even clear me for surgery with high leukocytes and bacteria present?
I'm going for a urine culture tomorrow. I'm pretty dehydrated because I haven't been drinking enough water due to the nausea, so that probably has something to do with the bacteria. Plus, I have no idea how I'm supposed to take antibiotics with my stomach being like this.
Everything else seems fine, I feel okay, I've just been on a super strict diet for a month now.
I'd really appreciate some insight on these results so I can prepare for whether I'll actually go through with the surgery or not.
My primary care doctor thinks the anesthesiologist won't let me proceed.
Thanks.

I don't think they will.

Kimberly Ward said:I doubt it happens.

That’s exactly what I was afraid of. I had fully prepared myself to just get it over with.
Who knows how many more gallbladder stone issues I'll deal with while waiting on decent urine results.

Kimberly Morris said:Dear Doctor,

I can't thank you enough for the response!

Yesterday, I saw my cardiologist. He performed an EKG and an echocardiogram, and he confirmed my heart is perfectly healthy. His take is that my blue lips are metabolic—likely due to extra weight caused by hyperinsulinemia. I posted my results here on the forum, and brightgull95, who is a cardiologist, mentioned the findings look normal. So, regarding Ajovy, I don't think there will be any issues with my heart.

If you could, I have one more question: do you think there might be any complications with Ajovy therapy given the lab results I shared earlier (elevated immunoglobulins, sedimentation, CRP, fibrinogen...)?

Thanks in advance!

Kimberly Morris said:Dear Nicholas Myers,

Just one more quick clarification, please.

You mentioned that Ajovy might have a protective effect; could you expand on that?

Ma'am,

This medication can have adverse effects in patients with Raynaud phenomenon—both primary and secondary—which often occurs in those with systemic connective tissue diseases. In such patients, using this drug could worsen Raynaud symptoms, leading to more intense, frequent, or prolonged vasospasm episodes, potentially resulting in ulceration or necrosis. For these specific patients, the application is not recommended. That addresses the impact on rheumatic conditions.

As for the potential beneficial effects on the cardiovascular system, I phrased it that way intentionally to leave room for nuance. Currently, there are only indications of such effects in animal models, specifically mice, which is still a far cry from the human organism.

coastalgull8 said:Looking for some help interpreting an EEG. The test was ordered because of headaches, constant fatigue, exhaustion, and trouble concentrating. Brain CT and TCD were both normal. Is this result okay, or should I be concerned?
Thanks in advance!

EEG Results
Low voltage o.c.a. in the alpha frequency range of 9-11Hz. Well-expressed RVB. A small amount of slow, sharp waves at approximately 7 Hz with an amplitude up to 50 microvolts is interposed bilaterally in the frontotemporal posterior regions. No paroxysms present. Similar changes noted on HV. The findings show mild dysrhythmic changes bilaterally in the FT posterior areas.

Hello,

There is a specific category of headaches referred to as dysrhythmic headaches. These can manifest in various ways—typically resembling migraines—but they carry one distinct feature: altered EEG readings (most often characterized by dysrhythmic changes). When imaging results come back clear, we classify this as a primary headache.

Unfortunately, there isn't a complete understanding yet of why these headaches occur. What we do know is that for these types of pain, standard over-the-counter analgesics may not provide sufficient relief. In those cases, adding an antiepileptic to the treatment plan often makes sense.

Patients are sometimes confused, wondering why they are being prescribed such medication if they haven't been diagnosed with epilepsy. However, an epilepsy diagnosis isn't a prerequisite for this type of treatment; these drugs are utilized for several different conditions and disorders.

redpilot37 said:Question for Nicholas Myers... I could use a little help.
So, I had my immunoglobulins checked and everything looks fine and within the standard range... except for my IgA, which seems suspicious. The reference range here is 0.7 to 4, and mine came back at 3.32.
When I check Google, the normal range in the United States goes up to 3...
As for symptoms, I have pronounced allergies—constant sneezing and runny nose year-round—plus bone pain. My scans show signs of bone issues and confirmed chronic bone inflammation...
I'm wondering if you think that IgA level is actually elevated, considering these symptoms.
Thanks.

Ma'am,

In my view, an IgA value of 3.32 g/L is not elevated.

Jessica Sanders60 said:To whom it may concern,
I am a 37-year-old female.
I've had elevated white blood cell counts my entire life; I saw a hematologist about it previously, and they noted it was just my baseline.
My two most recent blood panels show a slight elevation in erythrocytes at 5.45 and hematocrit at 0.476.
Additionally, my last three urinalysis results showed mildly elevated leukocytes and erythrocytes at 10, whereas normal is typically 1-2.
Please, could you tell me if there is any reason to be concerned?

Jessica Sanders60 said:I forgot to mention that my hemoglobin was 157.
In the lab work prior to that, my iron levels were also high.
I am a smoker.

Ma'am,

Generally speaking, polycythemia testing is indicated when hemoglobin exceeds 160 g/L or hematocrit climbs above 0.48.

The values you provided are borderline.

To provide an actual assessment or suggest next steps, I would need the full data set. Phrases like "mildly elevated leukocytes" or "iron was high" are too vague to draw conclusions or offer specific medical recommendations.

Maria Fisher46 said:Hey there,

this specific med can be pretty rough on patients dealing with Raynaud syndrome—whether it's the primary kind or secondary stuff tied to systemic connective tissue diseases. For those folks, taking this drug might actually make their Raynaud symptoms worse, leading to more frequent or intense vasospasm episodes, and could even cause ulcers or necrosis. So, yeah, it’s definitely not recommended for people with those rheumatic issues.

As for any potential "good" effects on the cardiovascular system? I phrased it that way on purpose to keep things vague. Right now, we're only seeing hints of those benefits in animal models, like mice, which is still a massive leap away from how a human body actually works.

Hey Nicholas Myers,

Thanks for the deep dive and for taking the time to explain everything.

Maria Fisher46 said:There is a group of headaches referred to as dysrhythmic headaches...

Thanks.

Erythrocytes 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
Neutrophil granulocytes 65.9
Lymphocytes 21.7
Monocytes 9.4
Eosinophil granulocytes 2.5
Basophils 0.5
Neutrophil granulocytes 8.64
Lymphocytes 2.84
Monocytes 1.23
Eosinophil granulocytes 0.33
Basophil granulocytes 0.06
ESR 2

Total bilirubin 28
Glucose 6.9
Standard creatinine 55
Urate 236
Urea 4.3
Iron 28
Everything else looks fine
So, erythrocytes, leukocytes, bilirubin, monocytes, and neutrophil granulocytes are all high... plus some issues with erythrocytes too.
Honestly, it's such a pain to type out this whole thing. I get blood work done pretty regularly, and this is the last one where my hematocrit actually looked normal. My hemoglobin always hangs out right at the upper limit... and my leukocytes have basically been hovering around 12 my entire life.

Urinalysis results
Leukocyte Esteaz 25
Leukocyte Esteaz 25 erythrocyte hemoglobin 150 leukocyte 8 erythrocyte 10
Leukocytes 8
Erythrocytes 10
Squamous epithelial cells: large amount
Bacteria: plenty
I’ve done this urine test three times over the last three months and it’s been identical every single time. I’m constantly running to the bathroom, but there's zero pain... and the culture came back totally sterile back in the seventh month.

Could having low iron levels be a reason to put off surgery?