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

Kimberly Morris said:Female, 42 years old, recovered from Covid about 10 days ago.
Just got blood work back today. Looking for some insight on GGT and Vitamin D levels.

Photos attached below. Thanks in advance.

The GGT numbers aren't concerning right now; no immediate action needed there. Recheck the liver panel in four weeks (include bilirubin this time). Start some Vitamin D supplementation.

Hello. I need an interpretation of the bottom section of these urinalysis results. The top part makes sense since the reference ranges are clearly listed, but the bottom section provides no guidance at all. It just says "mucus - rare"... should that be negative?
Is this normal, or is there cause for concern?
Thanks in advance.

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Maria Fisher46 said:Look, ma'am,

up to 90% of kids between 4 and 8 years old have palpable lymph nodes in their neck. From what I can see here, none of them are even hitting the 2 cm mark, and there aren't any signs of malignancy. The kid has an immune disorder, so obviously, they aren't 100% healthy. We don't fully get the underlying cause yet (ALPS has been ruled out, though, like I mentioned before, there's this whole category of "ALPS-like" disorders—conditions that mimic ALPS but don't show the classic markers, so maybe only genetic testing could actually pin down what we're dealing with). As for the cytology, nothing stands out; hypochromia just means the red blood cells look a bit pale, which might point to lower hemoglobin levels, but you'd need a standard CBC to confirm if that's really the case. All in all, these results are satisfactory. They aren't perfectly normal, but given the circumstances—since there's an existing immune disorder—they're fine. You really ought to sit down with a hematologist and an immunologist to discuss whether genetic testing is necessary for disorders in that immune dysregulation group. I think I’ve already touched on this in one of the other threads you posted in. Honestly, I don't see any other way to figure out the root cause, even though there's a chance the genetic analysis comes back uninformative (and yeah, sometimes even when there is a genetic disorder, it doesn't show up).

Thanks for taking the time to share your thoughts.

What’s still eating at me is the fact that my child has some kind of immune disorder, but since it hasn't been clearly identified, it could potentially cause issues throughout his life, or it might never bother him at all. It's such a toss-up, right?

Now that he's 8, some of those nodes have definitely improved, but others have popped up in new spots—specifically around his head area.

Right now, we don't have any real oversight unless his pediatrician decides to keep an eye on things, which usually just means getting blood work done every few months and an ultrasound about once a year.

He was being regularly monitored by hematology at Mayo Clinic, but because his doctor fell ill, we were redirected to communicate via email with another physician. We got exactly ONE response saying we needed to continue monitoring. After that, our subsequent email consultations were met with total silence; we're basically sending in results and just getting ghosted.

I'm honestly lost. Should we keep monitoring him? How often? Who should we even talk to? Should we seek out a different hematologist since we can't get a hold of his current doctor, and the alternative is just ignoring our emails (which, mind you, we didn't even start sending on our own—the department told us to use email)? Or, since the results look stable, should we just stop contacting the hematologists and everyone else altogether?

Because someone mentioned during an earlier visit that a disorder like this could develop into a latent lymphoma, I just can't bring myself to ignore everything and drop the check-ups. I'm terrified we'll miss a major change. But right now, everything we're doing is just based on the goodwill of his pediatrician (who he'll soon be transitioning away from toward a specialist at a large HMO, and I have no clue how they're going to handle his care there).

At the end of the day, there's a lot going on here that isn't even directly related to the thread title, but believe it or not, this anonymous space is the only place where we're actually getting any real answers.

62yo female, obese, survived a nasty heart attack two years ago with a stent put in. She cleared Covid about a month ago without much trouble. Just got her D-Dimer results back today—it's at 0.65 mg FEU/L, while the reference range is <0.5.

Is that high enough to worry about, and what's the move now? Should she be looking at vein ultrasounds or maybe color Doppler?

First off, why were they even bothering to run D-Dimer tests in the first place? Second question: what’s the actual statistical likelihood here of dealing with a DVT or a PE? Third, what does the combined score look like when you tally up the Wells, PESI, and the Geneva criteria? And finally, what was the reasoning behind whoever actually ordered those D-Dimers to begin with?

brightgull95 said:First off, why even bother with D-dimer tests? Second, what's the actual risk level for DVT or PE here? Third, what does the combined score from the Wells, PESI, and Geneva scales look like? And finally, who was the one actually responsible for ordering those D-dimer tests in the first place?

My bad, I have no clue what those acronyms mean. This isn't some long-term issue or chronic thing we've been dealing with, so we're totally in the dark. We just ran the D-dimer test ourselves because we read somewhere that it’s recommended after having COVID. No one suggested testing, and nobody explained anything to us—we'll just call our primary care doctor tomorrow to make sense of the results. If things like a bad diet, being overweight, smoking, and a sedentary lifestyle are the main drivers for DVT and PE, then I'm guessing the probability you're asking about is pretty high.

Sorry I can't give more details right now; this is the only lab result I've got. But is a 0.65 value considered an alarming red flag?

Assumption is the mother of all screw-ups. None of what you guys just listed actually factors into any of the clinical scoring systems. Look, D-dimer is incredibly sensitive, sure, but it is also wildly non-specific. What that means in plain English is that if the result comes back negative, you can pretty much rule out DVT or PE. But if it’s elevated? That tells you absolutely nothing about whether one of those two is actually happening.
It’s all well and good to go online and look up how to calculate some "score"—whether we're talking Wells, PESI, or Geneva—just to get a vague ballpark idea of the situation. But if you try calling an ER doctor tomorrow and spout that nonsense over the phone, they’ll laugh you off the line before you can even blink.
And who exactly was the genius claiming it's a good idea to check D-dimer levels right after someone recovers from a heart attack? I have no clue who said that, but it was clearly the first person to speak, and likely someone profiting from the confusion.
DVT = deep vein thrombosis
PE = pulmonary embolism

These scores aren't bad at all, not bad! One moderate risk and two low ones. You helped us out—we're keeping an eye on things.

Alright, here we go. And just to wrap this up—for anyone actually paying attention—the standard reference value for D-dimer after you hit fifty is calculated as 0.01 times your age. So, based on that math, your mother’s level is sitting at 0.62, which puts her right above the threshold.

Maria Fisher46 said:The answer to your question is—YES. You could definitely be fighting some weird microorganism from that "atypical" category. I’d suggest getting more testing done—maybe a chest X-ray—and honestly, seeing an infectious disease specialist to screen for those atypical bugs would make sense. It might even be worth throwing a macrolide antibiotic into the mix.

Hey there,

Thanks for the input.

In the meantime, I went ahead and had my blood drawn twice more.

The first time was on day three of taking Rexocef, back on Nov 19th—results looked way better immediately, so we figured the antibiotic was doing its job (only the white cell count was off at 10.23 (3.40-9.70) and CRP was 11.1 (0.0-5.0)): https://ibb.co/s635Kz4

The second time was on Nov 30th—four days after finishing the 10-day course of Rexocef 200—and the numbers were a bit high again (MPV 10.7 (6.8-10.4), WBC 10.7 (3.4-9.7), neutrophils 6.91 (2.06-6.49), and CRP 5.3 (https://ibb.co/5xTvz3c

Based on this last set of labs, my primary care doctor thinks things are finally settling down—mostly because the CRP dropped—so she didn't send me for a chest X-ray or anything. She just gave me a referral to get blood work again in a few days; if the results look worse, she'll put me back on antibiotics.

But now I'm wondering—is she actually right here? Is she handling this correctly? Do you guys see the second set of results as an improvement over the first? Her whole logic is based on the fact that the CRP is lower, even if it's borderline, but it bugs me that both my white cell count and neutrophils ticked back up the second I stopped the meds...

As for symptoms, I'm still coughing—not as much, mostly in the morning—and the phlegm has gone from yellow-green to just green, though there's less of it now, if that even matters clinically. No other symptoms.

Thanks in advance and take care!

Dear Nicholas Myers, a few months ago I asked for some advice on blood work and which specific tests would be useful for a routine checkup while following a vegan diet. I didn't run every single test possible due to the cost, but I did get most of them done. My physical also noted a slightly enlarged spleen. I'm in my late twenties. I’d love to hear your thoughts on this. Thanks.

https://ibb.co/d24P4JZ
https://ibb.co/6rgtrqN

coastalgull8 said:Hi there, could someone help me interpret the bottom section of these urinalysis results? The top part makes sense since they include clear reference ranges, but the bottom section is blank. It just lists "mucus - rare." Should that be negative?
Is this fine, or should I be worried?
Thanks in advance!

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Hello,

The results look clean.

bluepilot45 said:Hello,

Thanks for the reply.

In the meantime, I've had blood work done twice more.

The first time was on day three of taking Rexocef, Nov 19th. Results showed immediate improvement, suggesting the antibiotic was working (only white blood cell count was high at 10.23 (3.40-9.70) and CRP was 11.1 (0.0-5.0)): https://ibb.co/s635Kz4

The second time was four days after finishing the ten-day course of Rexocef 200, on Nov 30th. There were still some deviations: MPV 10.7 (6.8-10.4), WBC 10.7 (3.4-9.7), neutrophils 6.91 (2.06-6.49), and CRP 5.3 (https://ibb.co/5xTvz3c

Based on this last panel, my primary care physician thinks things are heading in the right direction—mainly because the CRP dropped—so she hasn't ordered a chest X-ray yet. She just gave me a referral for one more blood test in a few days; if the numbers look worse, she’ll prescribe another round of antibiotics.

But I'm wondering: is she making the right call? Do you see the second set of results as an improvement over the first? Her logic rests on the lower CRP, which is nearly normal, but I'm concerned that both my white cell count and neutrophils ticked back up once I stopped the meds...

As for symptoms, I'm still coughing, though less frequently. It's worst in the morning, producing phlegm that shifted from yellow-green to green, and there's less of it now, if that matters clinically. No other symptoms.

Thanks in advance for your help. Best regards.

Hello,

It seems you are recovering despite the Rexocef rather than because of it. That isn't unusual; many causes of atypical lower respiratory infections are self-limiting. If your symptoms persist or you take a turn for the worse, I suggest following the previous advice.

Amy Cox79 said:Dear Nicholas Myers, a few months ago I asked for recommendations regarding blood work—specifically, what a vegan diet should necessitate in terms of a routine checkup. I haven't run every single test due to costs, but I've done most of them. My physical also noted a slightly enlarged spleen. I'm in my late twenties. I would appreciate your perspective. Thank you.

https://ibb.co/d24P4JZ
https://ibb.co/6rgtrqN

Ma'am,

It's clear your diet isn't providing sufficient B12; the results speak for themselves. You'll need supplementation. Additionally, you should increase your intake of potassium-rich foods, as your levels are low, and B12 supplements can sometimes drive potassium even lower. I suggest checking your ferritin levels. Also, was your blood sugar tested while fasting?

Maria Fisher46 said:Ma'am,

The report is in order.

Using masculine pronouns—thanks 😁

Quick question,

We just got our son's blood work back, and here’s what it shows:
(K) Erythrocytes 4.90 x10e12/L 4.43 - 5.88
(K) RDW 13.3 % 11.6 - 14.3
(K) Hemoglobin 147 g/L 129 - 166
(K) Hematocrit 0.393 L/L 0.390 - 0.487
(K) MCV 80.2 fL 76.5 - 92.1
(K) MCH 30.0 pg 24.3 - 31.5
(K) MCHC 374 g/L 304 - 346 H
(K) Platelets 142 x10e9/L 178 - 420 L
(K) Reticulocytes 24 /10e3 Erc 4 - 19

Eosinophil gran. 0.6 % 0 - 9
Basophil gran. 1.6 % 0 - 3
Neutrophil gran. 25.9 % 34 - 69 L
Lymphocytes 61.5 % 19 - 52 H
Monocytes 10.4 % 5 - 13
MORPHOLOGY: Out of 100 differentiated leukocytes, 20 were found to be
atypical lymphocytes.

Liver enzymes look great, and everything else seems totally fine—right within the normal range.

Urinalysis showed some phosphate salts and a little bit of bacteria...

Based on this, the doctor did an exam. Nothing was swollen except for one lymph node, so he's sending him in to check for mono.

The specific blood tests he wants to run to confirm if it's mono are these:

EBV VCA IgM positive 81.8
CMV IgG positive 149.0
All other EBV, EBNA, and CMV markers came back negative.

To me, it looks like he has mono, but I'm not really sure what exactly he's dealing with right now...

Thanks a ton in advance for any help! 👍

Sarah Anderson34 said:Question,

we had blood drawn for our son and the results were:
(K) Erythrocytes 4.90 x10e12/L 4.43 - 5.88
(K) RDW 13.3 % 11.6 - 14.3
(K) Hemoglobin 147 g/L 129 - 166
(K) Hematocrit 0.393 L/L 0.390 - 0.487
(K) MCV 80.2 fL 76.5 - 92.1
(K) MCH 30.0 pg 24.3 - 31.5
(K) MCHC 374 g/L 304 - 346 H
(K) Platelets 142 x10e9/L 178 - 420 L
(K) Reticulocytes 24 /10e3 Erc 4 - 19

Eosinophil gran. 0.6 % 0 - 9
Basophil gran. 1.6 % 0 - 3
Neutrophil gran. 25.9 % 34 - 69 L
Lymphocytes 61.5 % 19 - 52 H
Monocytes 10.4 % 5 - 13
MORPHOLOGY: Out of 100 differentiated leukocytes, 20 atypical lymphocytes were found.

Liver enzymes look great, everything else is fine—all within normal ranges.

Urine shows phosphate crystals and some bacteria.

Based on this, the doctor did an exam; nothing was swollen except for one lymph node, so he's sending him in for mono testing.

The follow-up blood work to check for mono is:

EBV VCA IgM positive 81.8
CMV IgG positive 149.0
All other EBV and CMV tests are negative.

To me, this looks like mono, but I'm not sure what exactly he already went through?

Thanks in advance for any insight.👍

Hello,

The lab results and serology align with an acute infection from the Epstein-Barr virus, which causes infectious mononucleosis. According to the data, the child previously had a cytomegalovirus infection, which also triggers mononucleosis syndrome. While there are clinical differences between these two viruses, they aren't always easy to distinguish in practice. With a CMV infection, you typically see a prolonged fever accompanied by liver and spleen enlargement, while sore throat and swollen lymph nodes are usually less prominent. Conversely, EBV infections often present with swollen lymph nodes, a sore throat combined with fever, fatigue, and frequently, an enlarged liver and spleen. Based on these findings, the child appears to be at the very onset of the infection, so the clinical picture may still develop (meaning symptoms could become more pronounced).

Maria Fisher46 said:Hey there,

The lab work and serology point toward an acute Epstein-Barr virus infection, which causes infectious mononucleosis. Based on the results, the kid also previously had a cytomegalovirus infection, which can trigger similar mono symptoms. It’s sometimes tricky to tell them apart clinically because they overlap, but there are differences. With CMV, you usually see a longer fever along with an enlarged liver and spleen, while sore throats and swollen lymph nodes are typically less intense. For EBV, though, you often see those swollen nodes and a nasty sore throat alongside the fever, fatigue, and sometimes liver or spleen issues too. Looking at these results, it seems like the child is just at the start of the infection, so things might actually get a bit more intense before they settle down...

Thanks so much for taking the time to help out! 🙂

Maria Fisher46 said:Hello,

It looks like you aren't getting nearly enough vitamin B12 through your diet. Based on your results, you're definitely going to need supplements. You should also try to eat more foods high in potassium since those levels are looking low, too—just keep in mind that taking B12 can sometimes drive your potassium even lower. I’d suggest getting your ferritin checked next. Also, was your blood sugar tested while you were fasting?

Hi there, I actually went ahead and started using a B12 spray on my own! My primary care doctor didn't suggest any supplements yet; instead, they just sent me in for follow-up labs (glucose, iron, UIBC, and TIBC) in about a month. Thanks for the heads-up on the potassium; I'll make sure to check my ferritin levels. The blood work was done fasting. One thing I have noticed over the last few months is that my hair has been thinning quite a bit. I'm also not sure if it's worth mentioning, but I experience heart palpitations occasionally. They don't really bother me, but I read somewhere once that they might be linked to potassium levels. Thanks!

So, I recently decided to go through the military enlistment process, which meant undergoing a full medical screening at the Cleveland Clinic... part of that included a complete blood panel. Everything looked perfectly fine, except for my bilirubin levels, which were sitting at a high 98. I should probably mention that right before the blood draw, even though I’d traveled to NYC the day before 124 miles, I had barely slept or eaten anything all day, let alone stayed hydrated. I showed up to the lab hungry and absolutely exhausted, which might be relevant because when the doctors reviewed the results, they suggested I likely have Gilbert's syndrome... especially since every other marker—AST, ALT, GGT—was right at the bottom of the normal range. They explained that if you have Gilbert's, being sleep-deprived and fasting will send your bilirubin skyrocketing. Anyway, they asked me to come back and repeat the tests within 20 days.

I went back and did everything again, and this time the bilirubin was 64, while everything else remained totally normal.

Then, just recently, I had some follow-up blood work done to check things over, and the bilirubin came back at 48... here are the links to my full blood and urine panels.

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I'm an athlete, 30 years old, about 5'9" and 165 lbs, and honestly, I haven't stepped foot in a doctor's office since I was a kid, so seeing that bilirubin number really caught me off guard. My doctor says there's no reason to worry because my liver enzymes are excellent, but no one has ever officially told me, "Yes, you definitely have Gilbert's," nor have they sent me for any specialized testing. Should I be scheduling an ultrasound of my liver or looking into more extensive diagnostics? I also can't help but remember a conversation from maybe ten years ago, where my friends were teasing me about how yellow the whites of my eyes looked... I never thought much of it back then, but now I realize it was likely the bilirubin. Thanks for any insight...