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

Amy Cruz8 said:I took photos of all three pages. The first one is at the link.
Aside from being under the weather last week and the week before, I'm not on any medication. I took some DayQuil and one effervescent Vitamin C aspirin tablet, though I can't recall if I took the aspirin the day before the tests or the day after.
Otherwise, my results look fine, except my iron levels haven't budged above 6 since I gave birth back in 2018.
I don't remember exactly when my last full CBC was done. Maybe a year ago.

Ma'am,

Based on the new data you provided in your previous post, that slight, currently non-significant thrombocytopenia appears to be nothing more than a "trace" left behind by a recent viral infection. It doesn't require any intervention right now. Just repeat the CBC in 2 to 3 weeks.

Regarding the iron, we need to determine your ferritin concentration. If ferritin is below 30 ug/L, we're looking at iron deficiency without anemia. In that case, I’d recommend dietary adjustments—incorporating meat, poultry, or fish at least five days a week, along with legumes and leafy greens—plus iron supplements and periodic checks of your hemoglobin and ferritin. If that's the situation, you can ignore the raw iron concentration value itself.

Once the ferritin results come in, consult with your primary care physician. If it is low, they will need to investigate the underlying cause and take appropriate steps.

Thanks so much for the reply. 🙂

Maria Fisher46 said:👍

If you rule out all other potential causes, seeing neutropenia pop up alongside an autoimmune condition like Hashimoto thyroiditis is actually quite predictable.

The endocrinologist you mentioned seems to be flatly contradicting both real-world clinical experience and established scientific literature, such as this: https://pubmed.ncbi.nlm.nih.gov/26061308/

Given that we are looking at a mild case of neutropenia—one that hasn't actually increased susceptibility to infections—if it is indeed linked to the autoimmune thyroid disease, there is no need for treatment.

Hi everyone,

I just got my swab results back; Chlamydia Mycoplasma/Ureaplasma came back negative, but they did find Streptococcus agalactiae (BHS-B) present in both the mycological and bacteriological tests. View on imgur
Does this shed any light on the symptoms I’ve been describing?
I have an appointment scheduled with a urologist next week regardless...

So, I just started taking iron supplements—literally only two days ago—but I’ve also got a blood test coming up to check my ferritin levels. Is there any issue with that? Should I pause the supplements for a bit, or would just skipping one day be enough?
I mean, obviously, two days isn't going to work any miracles since a normal course usually runs anywhere from six to twelve weeks, but I figured it's better to ask than to totally mess up the results, right?

Emily Ortiz27 said:I just started taking an iron supplement (two days ago), and I still need to go get my ferritin levels checked. Will that interfere with the results? Should I stop taking it for a bit, or is a one-day break enough?
I realize two days isn't exactly going to move the needle when treatment usually lasts 6 to 12 weeks, but I’d rather ask than mess up the data.

The window of time you've been on the iron supplement is too short to skew the results. It shouldn't be an issue.

vividcrane24 said:Hello,

My swab results just came back. Chlamydia Mycoplasma/Ureaplasma are negative, but Streptococcus agalactiae (BHS-B) showed up in both the mycological and bacteriological tests. View on imgur
Does this shed any light on the symptoms I mentioned earlier?
I have an appointment with the urologist next week regardless...

It’s hard to say if Streptococcus agalactiae is actually linked to your symptoms. Often, it's just colonization—about 30% of women carry it in their gut or reproductive system. Treatment is usually reserved for specific circumstances, such as pregnancy. Your gynecologist, who ordered the test, should be the one to make that call.

Maria Fisher46 said:Hi there,

Given those extra symptoms you mentioned, it’d probably be a good idea to get your serum protein and albumin levels checked, along with an albumin-to-creatinine ratio from a single urine sample.

As for dealing with the galactorrhea, we really need to confirm if that discharge is actually milk coming from the breast. If it turns out to be milky discharge right in the center, and your prolactin levels are normal and your periods are still regular, then the risk of having a pituitary adenoma—which would be tied to everything else you're feeling—is pretty low. That said, it wouldn't hurt to expand the endocrine workup just to be safe.

Also, that glucose reading of 4.1 mmol/L isn't considered hypoglycemia, so it shouldn't have anything to do with the issues you're describing.

Everything else just depends on what those pending results show.

So, the lab results for protein, albumin, creatinine... they finally came back.
They don't look too bad to me, do they?
The only thing is that one protein value is sitting right on the edge of the normal range. Does that even matter in this situation?





Thanks for all the help so far.

Hey there.

So, I went ahead and had all my iron levels checked.
Everything looks totally fine, except my TIBC is running a bit low.
The result came back at 43.7—the standard reference range is usually 49 to 75.

I’m honestly not sure if this is low enough to actually worry about, or if doctors just shrug their shoulders at a result like this.
Thanks.

Emily Ortiz27 said:The results for protein, albumin, creatinine... they finally came back.
Doesn't look too bad to me, right?
Is it just one value for protein being right on the edge? Does that even matter in this context?





Thanks for all the help so far.

The cytology smear report says: right-side smears show plenty of polymorphonuclear phagocytes and secretion. Left-side smears show no cellular elements at all.

I've still got a breast ultrasound scheduled in about 20 days.
Is there anything else I should be getting done?

I could really use some expert insight here...
I'm 37 years old, and I've been dealing with Hashimoto for about 15 years now, along with vitiligo for the last three. I'm not currently on any medication. Back in June 2021, I got my SARS-CoV-2 vaccine and had a reaction that felt like arthritis; my ankles were mostly affected and quite swollen, and my knees were painful though not swollen... it lasted about a month and I just managed it with ibuprofen. Since then, I've actually been feeling pretty good, though I get some minor knee aches when the weather shifts, but that happens less and less often. Honestly, I feel fine, it's just that I stopped exercising entirely after all that happened...
I'm finally seeing a rheumatologist because they scheduled me back then, and even though I'm only getting the appointment now, I wouldn't have bothered going if I wasn't already on the books, since I don't really have symptoms anymore...
The main thing I'm wondering about is my ANA...
That was actually why I was sent for further testing. Back in December 2021, my ANA came back speckled with a titer of 1:320 (ref That follow-up test from Quest in February 2022 showed an ANA of Now, my latest results from Mayo Clinic from March 2022 just arrived, and they show this
: The ANA result is described as speckled, but it doesn't list a specific titer value, and the reference range is 40 is positive)...
So, I'd love to hear what you think...
I also received my HLA system results, and they are as follows:
HLA-A 2:-
HLA-B 18:51
HLA-C NT:NT
HLA-DRB1 01:14
HLA-DQB1 NT:NT
Could someone help me interpret these?

Just to add, everything else looks perfect: sedimentation, CRP, CBC, C3, C4, chest and heart X-rays, ACE, proteins, IgA, IgG, and IgM...
Cryoglobulins were not detected, monoclonal protein immunotyping was normal, ANCA was negative, total complement activity was 99% (ref int 69-129), and the serum protein electrophoresis was all okay...
Thanks so much in advance...

Emily Ortiz27 said:The cytology smear results show: right-side smears contain numerous polymorphonuclear phagocytes and secretions. Left-side smears show no cellular elements.

I have a breast ultrasound scheduled in about 20 days.
Is there anything else I should be doing?

Dear lady,

Looking at your lab work, nothing is quite clear. Your ferritin levels don't align with iron-deficiency anemia. On the flip side, a normal sedimentation rate doesn't point toward chronic inflammation, which might otherwise explain why your ferritin stays within the normal range. It might be wise to run a CBC with a differential and a CRP, though I'm not certain that will yield any new insights. Since you've already started iron supplements—which perhaps was premature before all test results were in (not that a short window would significantly alter ferritin, but it adds a layer of confusion to the data)—one could monitor how you respond to the iron to better determine if deficiency is indeed driving the anemia. It also wouldn't hurt to check reticulocyte counts and perform a peripheral blood smear.

Based on the cytology report, it looks like galactorrhea, given the milky content. However, since your prolactin levels are normal and your menstrual cycles are regular, hyperprolactinemia seems unlikely. Most clinical guidelines would stop here, given that the prolactin level is fine. I agree that a breast ultrasound is the next logical step. If I recall correctly, you've already had your thyroid hormones checked, so that shouldn't be the culprit behind the galactorrhea either.

cosmicsurfer17 said:Hi there.

I've checked all my iron-related labs.
Everything looks normal, except my TIBC is a bit low.
The result was 43.7, while the reference range is 49-75.

I'm not sure if this is low enough to worry about or if it's just something doctors overlook.
Thanks.

There’s likely no cause for alarm, but it would be helpful if you listed all the values and the reason for the testing.

darkmoose58 said:Looking for an expert opinion.
I'm 37. I’ve been dealing with Hashimoto for 15 years and vitiligo for three. Currently, I’m not on any medication. Back in June 2021, I received the SARS-CoV-2 vaccine and experienced a reaction in the form of arthritis. My ankles were the worst part—they actually swelled up—and my knees were painful, though without swelling. That lasted about a month; I managed it with nothing but Advil. Since then, I’ve felt fine. I get some minor knee discomfort when the weather shifts, but that happens less and less frequently. Overall, I feel good, though I haven't picked up my exercise routine again since it all happened.
I’m only seeing a rheumatologist because my doctor specifically ordered the referral. If I hadn't been scheduled like that, I wouldn't have even bothered showing up. I don't have any symptoms.
What I'm actually interested in is Ana.
Because of her, I was sent for further testing. Back in December 2021, my titer came back at 1:320 (ref That lab result from Breyer back in February '22—the ANA was So, I just got my latest lab results back from the hospital—the three-month follow-up from February—and here’s what they show:
The ANA results are somewhat vague. They show a speckled pattern, but there’s no specific titer listed—only a reference range of I'd appreciate some insight here. What do you all think?
We just received our HLA system results. Here they are:
HLA-A 2:-
HLA.B 18:51
HLA-C NT:NT
HLA-DRB1*01:14
HLA-DQB1
I'm looking for an interpretation.

Just to be clear, everything else came back perfect: ESR, CRP, CBC, C3, C4, chest and heart X-rays, ACE, protein levels, IgA, IgG, and IgM.
Cryoglobulins? Not found. Monoclonal proteins via immunotyping? Normal. ANCA came back negative. Total complement activity sits at 99%, right in the middle of the 69-129 reference range. Serum protein electrophoresis shows nothing out of the ordinary. Everything looks clean.
Thanks in advance.

To whom it may concern,

Based on what you’ve laid out here, I don't see any actual indicators of inflammatory rheumatic disease. It isn't clear to me why hydroxychloroquine was even recommended in this case.

Regarding the ANA results, I won't bother commenting on anything from a private lab. In my view, the data coming out of Mayo Clinic is what actually matters.

Ana’s latest ANA results aren't quantified. It’s positive—the titer is over 1:100—but there's no specific number, so we're flying blind on the exact scale. Based on the AC-5 pattern, this isn't an automatic red flag; you see these kinds of results in healthy people from the general population all the time. Of course, in patients with autoimmune issues, it could point toward things like lupus, systemic scleroderma, overlap syndromes, or undefined collagen diseases. As for the anti-U1 RNP, I don't see much significance there, though given the rest of the picture, it probably warrants keeping a close eye on things moving forward.

Regarding your HLA profile, you have a predisposition for rheumatoid arthritis. Specifically, hla-drb1*01 is linked to an increased risk of seronegative rheumatoid arthritis in adults. If joint issues resurface, that’s where your focus should be. You also carry HLA-B51, which can be tied to another rheumatic condition, but in our clinical setting, it doesn't carry much weight for asymptomatic individuals. I wouldn't dwell on it right now.

All things considered, one could draw a conclusion—though I’ll add a massive disclaimer here since this forum isn't a substitute for seeing a doctor, reviewing full lab results, a complete medical history, or a physical exam. For now, I don't see any clear signs of active rheumatic disease, but you'll need regular monitoring. You definitely have certain predispositions that could lead to autoimmune issues down the road.

Hey everyone, it’s me again, back with more questions about my daughter... honestly, does it ever end? It feels like we're just constantly dealing with something new.

My girl (she's 12) dealt with this lingering fever that hit 101.5°F and stayed elevated for several weeks after she caught SARS-CoV-2. Because of that, we ended up at a post-COVID clinic where an immunologist took her on.
There wasn't really any "major" exam because, honestly, she didn't have much to complain about besides some random bouts of nausea and these quick, passing little headaches or stomach aches.
Since she's been having her period for over a year now, I wondered if maybe that was causing the pains, but given how high and how long that fever lasted, we figured it wasn't just cycle-related—it felt way too intense for that.
The doctor ordered a whole mountain of tests, but since the results haven't all come back in for five weeks now, we're stuck in limbo. We can't even go back to consult with the doctor to get a real opinion until everything is finalized.
So, while we're sitting here waiting for all these pieces to fall into place, I was wondering if anyone could take a look? Does anything in these results look concerning to you guys?








Thanks so much!

Maria Fisher46 said:Look, ma'am,

Looking at these lab results you've pulled, nothing really adds up. I mean, those ferritin levels just don't scream "iron deficiency anemia." On the flip side, since your sedimentation rate is totally fine, we can't exactly point to chronic inflammation being the reason why your ferritin looks normal. It might be a smart move to get a CBC with a differential and a CRP test, though honestly, I'm not even sure if that's going to clear anything up. There’s also this chance—since you already started taking iron supplements, which maybe wasn't the best call until all your other tests came back (not that such a short time could have skewed the ferritin reading, but it still muddies the water here)—that we could just monitor how you respond to the iron therapy to figure out how much of this anemia is actually due to a deficiency. You might also want to check your reticulocyte count and get a peripheral blood smear done.

From what I can tell looking at that cytology report, it sounds like you're dealing with galactorrhea, basically milky discharge. If your prolactin levels are normal and your periods are still regular, then hyperprolactinemia probably isn't the culprit. Most medical guidelines would pretty much stop right there since that prolactin number is in the clear. That said, I definitely agree that getting a breast ultrasound is the way to go. If I remember correctly, you've already checked your thyroid hormones, so that shouldn't be causing the discharge either.

Thanks.
Yeah, my TSH, prolactin, kidney function, and liver panels are all perfectly normal.
So, basically, absolutely nothing makes sense. 😁

I'm waiting on the breast ultrasound, the OB-GYN exam, and my appointment with the endocrinologist, and I'll try to get those extra tests you mentioned done too.

The discharge hasn't stopped, even after more than a month. Is it really okay to just leave it alone if all the other exams and labs come back normal? I'm so confused. 🤔

Every now and then, I just spiral into this anxious tension because the dizziness is still there—which is the whole reason I went for the initial blood work and TSH in the first place. Now that I'm stressing out about everything else, I'm also noticing these regular headaches in my forehead. They aren't new, but I used to just blame them, along with the dizziness, on my neck issues, not drinking enough water, or PMS... Neither the pain nor the dizziness is unbearable, but the dizziness is actually more annoying than the headache, especially when I'm not even moving; like, if I'm just sitting there and suddenly feel this weird sensation like I'm being yanked to one side.

Emily Ortiz27 said:Hello, I'm back with more questions regarding my daughter. It feels like the issues never end.

My daughter (12 years old) dealt with a prolonged fever reaching 38.6°C for several weeks following a SARS-CoV-2 infection. We were referred to a post-viral clinic where she was seen by an immunologist.
There wasn't a specific diagnostic exam because her only complaints were occasional nausea and brief, passing bouts of mild headaches or stomach aches.
Since she's been menstruating for over a year now, those pains could theoretically be cycle-related, but given how long that fever persisted at such high levels, we didn't think it was just hormonal.
A battery of tests was ordered, but since the results haven't been finalized for five weeks, we still can't follow up with the doctor to get a definitive opinion.
So, while we wait for all the paperwork to come together, I’m asking if anyone sees anything concerning in these results.

Hello,

The labs show positive antinuclear antibodies at a significant titer of 1:640. These antibodies can appear in various systemic autoimmune diseases, but they are also found in about 3% of perfectly healthy individuals—and often follow different infections, including SARS-CoV-2. However, we also know that the SARS-CoV-2 virus itself can act as a trigger for autoimmune conditions, and these antibodies can sometimes surface years before clinical symptoms actually manifest.

All of this makes interpreting this single finding quite complicated. From what you've described, the girl isn't showing other major symptoms besides the extended fever, which adds another layer of complexity. Which specific results are you still waiting on? Were anti-ds DNA and antiphospholipid antibodies requested? Has a urinalysis been done—specifically checking the albumin-to-creatinine ratio? Was a serum protein electrophoresis performed? And has she had an abdominal ultrasound?

Emily Ortiz27 said:Thank you.
Yes, my TSH, prolactin, kidney function, and liver panels all came back normal.
So, nothing actually lines up. 😁

I’m waiting on a breast ultrasound, a gynecological exam, and an appointment with the endocrinologist. I’ll also try to get those other tests you mentioned done.

The discharge is still happening after more than a month. Is it normal to just leave it alone if the remaining tests and labs also turn out fine? I’m confused. 🤔

Occasionally, I let myself spiral into this uncomfortable anxiety. It’s because the dizziness—which was the whole reason I sought out these initial blood panels and TSH checks—is still there. Now that I’m worrying about everything, I’m noticing regular frontal headaches too. They aren't new, but I used to just blame them, along with the vertigo, on neck issues, dehydration, or PMS. Neither symptom is unbearable, though the dizziness is actually more unsettling than the headaches, especially when I'm not even moving. Sometimes I'll just be sitting there and feel this sudden pull to one side.

Yes, the results are quite baffling. As for the galactorrhea, idiopathic galactorrhea isn't rare—that's when no obvious cause surfaces even after a full workup. In those instances, treatment can be offered if the patient prefers it.

There aren't enough words to express how much we appreciate your energy and the sheer effort you put into answering all our questions.
Honestly, what else can I say? Thank you. Seriously.

Maria Fisher46 said:Ma'am,

The labs show positive antinuclear antibodies at a significant titer of 1:640. These antibodies can be found in various systemic autoimmune diseases, but they also pop up in about 3% of perfectly healthy people, or even following different infections, including COVID-19. However, we also know that the SARS-CoV-2 virus itself can act as a trigger for autoimmune issues, and these specific antibodies might actually appear years before the clinical symptoms of a disease even manifest.

All of this makes interpreting this result incredibly complicated. From what you've described, besides the prolonged fever, the girl doesn't seem to have other symptoms, which just adds another layer of complexity to the whole situation. What other results are you waiting on? Have they ordered anti-ds DNA and antiphospholipid antibodies yet? Has a urinalysis been done—specifically checking the albumin-to-creatinine ratio? Was a serum protein electrophoresis performed? And has she had an abdominal ultrasound?

Yeah, because of the lingering fever, she was sent to a post-COVID clinic where she had this consultation with an immunologist.
She used to get stomach aches every now and then, and lately, she’s been complaining about abdominal pain quite often—mostly under the ribs, more on the left side if I had to say. Her weight is normal, she eats regular meals, and she stays active with sports. Even though she mentions the pain frequently, it hasn't actually stopped her from doing her daily activities, so we didn't take it super seriously at first. But we did mention it to the doctor during the visit.
I'm attaching a photo of the tests that were requested.



I honestly don't know what else is missing from the list; I uploaded everything that's been completed in my previous post.
But whenever we call, we just get told that everything isn't finalized yet, so we can't schedule any follow-up appointments.
No abdominal ultrasound or any of the other things you asked about has been done yet.

Maria Fisher46 said:Yes, the results are pretty confusing. Regarding the galactorrhea, it's not uncommon for it to be idiopathic—meaning no obvious cause is found after a full workup. In those cases, treatment options can be offered if the person wants them.

I guess I'll just wait until all the results are in—blood work, endocrinologist, gynecologist—and then we'll see what the overall picture looks like.
What does "treatment" even look like if the cause is idiopathic?

My white blood cell count was high and they found bacteria in my urine, so they sent me off for a culture—but I’m staring at these results and honestly, I have no clue what they mean:
leukocytes positive (~15), erythrocytes and nitrites negative. Microorganism count 10^4 CFU/ml. Resident flora of the distal urethra.

Emily Ortiz27 said:I've lost track of what else might be missing from the list. I attached everything that's been completed to my previous post.
When we call them up, the response is always the same: everything is still being processed, so there's no way to schedule any follow-up consultations just yet.
No abdominal ultrasound was performed, nor any of the other tests you mentioned.

Dear Madam,

Here’s what I’d suggest adding to the list: anti-dsDNA, anti-SS-A, CH50, LAC, beta-2-GPI, and both IgM and IgG anticardiolipin antibodies. You should also look into ANCA, serum protein electrophoresis, and a urine albumin/creatinine ratio. For basic labs, check CK, PV, APTV, fibrinogen, D-dimer, bilirubin, and an electrolyte panel including Na, K, Cl, Ca, Mg, and P. Don't forget a peripheral blood smear, three stool tests for occult blood, and calprotectin. On the imaging side, get an abdominal ultrasound, a chest X-ray, and an echocardiogram. Once those results are in, we can decide if further testing is needed based on how the symptoms present. Finally, it might be worth running serology for EBV, CMV, Bartonella, and a QuantiFERON test.

I'll wait until all the results are in—bloodwork, endocrinology, OBGYN—then we can actually see what the full picture looks like.
If the cause is idiopathic, what does the treatment plan actually look like?

Treatment follows a similar logic to managing hyperprolactinemia—think along the lines of taking Bromergon 1,25 mg to 2.5 mg daily, or perhaps Dostinex 0,25 mg once or twice a week.