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

Dear all, I am reposting this because I am feeling quite anxious again.

I have previously mentioned my poor lab results: AST 53 (8-30)
ALT 62 (10-36)
CRP 68
MPV 11.1
LEUKOCYTE 11.7 (3.4-9.7)
MONOCYTES 1.33 (0.12-0.84)
NEUT.GRAN. 73 (44-72)
LYMPHOCYTES 15 (20-46)
MONOCYTES 11
Ten days after my initial blood draw, everything had improved—except for an AST of 31 and ALT of 49.
Now, my three-year-old son has a fever along with these results:
MCV 72.6 (73.6-89.4)
MCH 24.0 (24.3-29.2)
RDW 16.3 (11.9-16.2)
BANDS 3 (0-2)
SEG.GRAN. 26 (30-72)
ATYPICAL LYMPH 9
AST 59 (24-49)
ALT 44 (9-20)
He has been running a high temperature for five days now, and there is a very strong odor coming from his breath.
Is it possible that we are both dealing with infectious mononucleosis? Thank you so much for any insight.

Hey there!
I’ve been dealing with tremors in my hands and legs lately. I went to see a neurologist, had an abdominal scan, and even got my eyes checked—everything came back totally fine. Following that, the neurologist ordered some blood work, which I went ahead and did about nine months ago. Since I was out of the country at the time, I couldn't pick up the physical copies, so I just emailed him a few days later asking him to send over the results. Now, I need to take those specific labs to my primary care doctor, but I’m wondering: are these results still relevant, or am I going to have to go through the whole blood draw process all over again?

Also, the main thing I’m trying to figure out is if anyone here can help me make sense of this. Three of my levels are sitting outside the normal range, so if anyone knows what those specific markers represent and whether they are actually a major concern, I’d really appreciate it. Thanks in advance.
Total Bilirubin result=32.6, Rel interval=7-30
Urea result=7.0, Rel interval=2.7-6.8
Copper result=9.6, Rel interval=11-22

Noah Barrett12 said:Hey there!
I've been dealing with some hand and leg tremors lately. I went to see a neurologist, had an abdominal scan, and even checked in with my eye doctor—everything came back totally fine. Then the neurologist sent me for a
blood draw, which I did about nine months ago. Since I was out of the country, I couldn't swing by the office, so I just emailed him to ask for my results. Now I need to take those labs over to my primary doctor, but I'm wondering if they’re still actually useful or if I'll just have to go through the whole thing again and get tested from scratch???
And the main thing I'm sweating right now—if anyone knows, could you let me know? (Three of the values are outside the normal range, so if anyone can figure out what they mean and if it's actually a big deal?) Thanks in advance.
Total Bilirubin result=32.6, Rel interval=7-30
Urea result=7.0, Rel interval=2.7-6.8
Copper result=9.6, Rel interval=11-22

So, looking at these, your bilirubin is slightly elevated while your urea and copper are coming in a bit low. Honestly, if we were just staring at these numbers in total isolation—they could look a whole lot "worse."
It would be a lot easier to make sense of this if I had a few more details. For instance, how old are you? How long have these tremors been hanging around? Did they hit you out of nowhere, or did they creep up on you gradually? Is it happening in both hands and legs at the same time? Also, how did your neurologist describe the movement—was it a "fine" tremor or a "coarse" one (meaning small vs. large amplitude), or maybe something like a "flapping tremor"? It would also help to know if you've dealt with any other health issues in the past, or if anyone in your immediate family has struggled with tremors (and if so, did they start when they were young or older?). Plus, did you do any other tests beyond the ones that came back clear, like ceruloplasmin, a 24-hour urine copper test, a full CBC, a Cummings test, or screening for hepatitis and stuff like that?
Have you noticed any shifts in your mood over the last couple of years?
And what exactly did the ophthalmologist do—was it a slit lamp exam or something else?

velvetmoose9 said:The labs show slightly elevated bilirubin along with slightly low urea and copper levels, which means if you were looking at these results in total isolation—they could actually look a lot "worse."
It would be much easier to provide clarity if we had more specific details. For instance, how old are you? How long has this tremor been going on? Did it hit you suddenly or develop gradually over time? Is it occurring simultaneously in both hands and legs? How exactly did your neurologist describe the movement—was it a "fine" tremor or a "coarse" one (meaning small vs. large amplitude), or perhaps something like a "flapping tremor"? What other medical conditions have you dealt with in the past? Does anyone in your immediate family suffer from tremors (and if so, at what age did they start)? Also, what other tests have you undergone outside of these standard results, such as ceruloplasmin levels, a 24-hour urine copper test, a full CBC, a Cummings test, or hepatitis markers?
Have you noticed any shifts in your mood over the last few years?
What exactly happened during your ophthalmology appointment—was it a slit-lamp exam, or something else?

To give you the full picture: I am 19 years old, and this tremor has been present for about four years now. I actually only discovered it by accident. It started simultaneously in both hands and consists of fine amplitudes. I haven't suffered from any other illnesses, and there is no history of tremors in my family. I’ve had a full CBC done, and everything else falls within the normal range except for those three specific outliers mentioned earlier. I haven't noticed any changes in my mood. During the eye exam, I just stared at a single point while the specialist looked through a device at me (the results were all normal). Well, I hope that provides enough context for you to comment on my situation... thanks in advance.

I’m guessing (though I can’t say for sure since I don't have the full clinical picture or all your test results in front of me) that the workup is going to expand. You'll likely end up doing those tests I mentioned in my last post, and they'll probably ramp up the imaging side of things too, maybe getting an MRI or something similar out of it.
Are you having any trouble swallowing food or liquids, or noticing any changes there?
Any issues with your speech?
When you saw the neurologist, did you happen to notice if there was any sort of tongue tremor?

velvetmoose9 said:I’m assuming (granted, I don't have access to the full clinical picture or all the test results, so I can't say anything for certain) that the diagnostic workup is going to expand—most likely including the tests mentioned in my previous post and an expanded radiological evaluation, such as an MRI...
Are you experiencing any issues or changes when swallowing food or liquids?
Any difficulty with speech?
When you saw the neurologist, did they happen to notice any potential tongue tremors?

No, no, everything is perfectly fine; I'm not having any problems whatsoever in that regard. 🤷

Noah Barrett12 said:Hey there!
I’ve got tremors in my hands and legs. I went to see a neurologist, had an abdominal scan, and saw an eye doctor—everything came back totally fine. Then the neurologist ordered a blood draw, which I went ahead and did... but that was 9 months ago. I emailed him a few days ago asking for the results since I couldn't make it in personally while I was out of the country. Now I need to take those results to my primary doctor, but are they even still valid? Or am I going to have to get poked all over again???

And the main thing I wanted to ask: if anyone knows, please let me know (three substances are outside the normal range, so if someone can tell me what they are and if it's serious?) thanks in advance.
Total bilirubin result=32.6, Rel interval=7-30
Urea result=7.0, Rel interval=2.7-6.8
Copper result=9.6, Rel interval=11-22

Noah Barrett12 said:Basically, I'm 19, and this tremor has been going on for about 4 years now. I noticed it by accident; it started in both hands at the same time with low amplitude. I haven't dealt with any other illnesses, and no one in my family or relatives has ever had tremors... I did a full blood panel, but everything else is within the normal range except for these three outliers... I haven't noticed any changes in my mood, and when I saw the ophthalmologist, I just stared at a point while she looked through some equipment (the findings were normal). So, I hope that helps you guys enough to comment on my situation... thanks in advance.

You absolutely need more testing. Generally speaking, that would include
Urine Cu/creatinine ratio, ceruloplasmin, AST, ALT, GGT, ALP, total bilirubin and direct, Fe, UIBC, ferritin, Ca and P, 24h urinary calcium
Abdominal ultrasound with specific focus on the liver and kidneys
Possible Cu biopsy of liver tissue
Possible genetic testing via ATP7B gene sequencing
Follow-up ophthalmology exam
And we should also consider an EMG of the extremities.

Sophia Chavez50 said:I just got my lab work back because I’m supposed to start birth control pills soon. I'm wondering if it's okay to take them given these slight deviations in my results?
leukocyte - 4.9 (3.4-9.7)
RBC - 4.91 (3.86-5.08)
Hemoglobin - 144 (119-157)
Hematocrit - 0.409 (0.356-0.470)
MCH - 29.3 (27.4-33.9)
MCHC - 351 (320 - 345)
MCV - 83.3 (83.0-97.2)
Platelets - 279 (158-424)
RDW - 11 (9.0-15.0)
MPV - 6 (6.8-10.4)
Cholesterol - 5.5 ( Triglycerides - 0.5 ( Prothrombin time - 0.82 Q% (0.70-1.00)
Prothrombin time - 1.12 INR (0.8 - 1.12)
Thanks in advance! :-)

These results look normal to me.

Michael Sanchez7 said:Hey there, I just got my allergy blood work back and the diagnosis at the end says "dz 23." What on earth does that mean? Thanks a lot.

Sophia Moore38 said:I had some blood tests done because of stomach issues.

The only thing that came back high was my GGT at 63. My AST is 36 and ALT is 22.

Could that elevation be caused by gallstones?

For both of you, go ahead and transcribe the full complete findings.

vividsailor7 said:ev. genetic sequencing of the ATP7B gene

What on earth is a genetic screen for? They haven't even finished the basic diagnostic workup for Wilson's disease yet! 🙂

ophthalmologist exam

The notes clearly state the ophthalmologist exam was already done! 🙂

frozentinker992 said:Just checking in with an update.
Here are my results
Day 1.
Morning cortisol 379.6 (171-536)
Afternoon cortisol 399.5 H (64-327)

Morning ACTH 3.42 (1.6-13.9)
Afternoon ACTH 10.12 blank field on the report

Day 2. (Took 1mg of dexamethasone at 10:30 PM the night before)
Morning cortisol 24.19 L (131-536 )
I was wondering if anyone could weigh in on the ACTH levels? From what I understand, those should be dropping too.
P.S. And yeah, I didn't get the ACTH checked on the second day after the dexamethasone because my wonderful doctor failed to include both cortisol and ACTH on the referral—she only put down the dex test. Even though I told the nurse in the lab and showed her the orders saying I needed both, she just insisted they weren't necessary.

Look, we can't solve this through a web forum. Period.
You need a thorough endocrine evaluation and a coherent diagnostic workup, which is exactly what’s missing here.
The dexamethasone suppression test is considered normal if cortisol drops below 80 nmol, but keep in mind it can still come back "normal" even when there's episodic ACTH and cortisol secretion happening.
And honestly? The fact that a primary care physician doesn't even know how to write a proper referral isn't even surprising anymore. It's just pathetic.

vividsailor7 said:Results look normal.

Thanks for the reply! 🙂

Chris Howard3 said:I’m posting this again because I’m worried.

I’ve already mentioned my poor results—AST was 53 (range 8-30).
...
Now, there's been a high fever for five days and strong breath odor.
Could we both be dealing with infectious mononucleosis? Thanks for any insight.

Ma'am,

Since you seem to be moving past the acute phase—or perhaps it's already over—the only way to confirm is through serology. That means a blood draw to check for antibodies against the primary causes of infectious mononucleosis syndrome, specifically EBV and CMV, and others if necessary. Did anyone mention that option to you?

If those elevated liver enzymes persist without a clear explanation, you'll need to see a specialist—ideally a gastroenterologist—who can direct your next steps.

For the child, it would also be wise to run a CBC, check LDH levels, and, depending on clinical judgment (which is impossible to determine via an online forum), perform serological testing as well.

Best regards. 🙂

Maria Fisher46 said:Dear lady,

Since it seems you are either moving past the acute phase or have already cleared it, the only way to get definitive confirmation is through serology—essentially a blood draw to test for antibodies against the primary triggers of infectious mononucleosis syndrome. We're talking primarily EBV and CMV, though other tests might be necessary depending on the situation. Was this option ever brought up to you?

If those elevated liver enzymes persist without any clear explanation, you’ll need to see a specialist—ideally a gastroenterologist—who can guide you through the next steps of diagnostic testing.

For a child, it would also be wise to run a complete blood count, check LDH levels, and—depending on how things look clinically (which, let's face it, is impossible to judge accurately over an internet forum)—perform further serological testing.

Best regards. 🙂

Hello,
thank you so much for the response. I've already had a blood draw for EBV, CMV, ELISA, HCV, and HIV; the Hepatitis B results should be ready tomorrow. Honestly, I have no idea what all these acronyms actually mean, but we'll just have to wait and see. I did an abdominal ultrasound and everything looks fine, except for some hyperechogenicity in the liver, though the parenchyma is homogeneous. Meanwhile, my son has been running a fever of around or even above 38°C for six days now—is that considered normal? And his eyes are hurting him. The doctor told us to come back for a follow-up in a week.

Many thanks. 🙂

It looks like this:

Immunoglobulin E Result=16 Rel interval
IP8 Inhalation Allergen Screening (dust mites, cat dander, dog dander, cockroach, ragweed, birch, mugwort) NEGATIVE

FP5 Food Allergen Screening (egg white, cow's milk, cod, wheat, peanuts, soy) NEGATIVE

Specific IgE
INHALATION ALLERGENS KIU/L
SEASONAL
GRASSES
W1 Ragweed
ALLERGEN INTERPRETATION
negative 0L
positive
Class I 0.35-0.7 KIU/L
Class II 0.7-3.5 KIU/L
Class III 3.5-17.5 KIU/L
Class IV 17.5-50 KIU/L
Class V 50-100 KIU/L
Class VI >100 KIU/L

NOTES AND COMMENTS
DZ 23

Thanks.

Chris Howard3 said:Greetings.
Thanks for the input. I had blood drawn for EBV, CMV, ELISA, HCV, and HIV; my Hepatitis B results should be ready tomorrow. I’m not entirely sure what all these acronyms signify yet, but we'll see. I also had an abdominal ultrasound—everything looks fine, though they noted some hyperechogenicity and homogeneous parenchyma in the liver. My son has been running a fever around or above 100.4°F for six days now. Is that normal? He's also complaining of eye pain. The doctor told us to come back for a follow-up in a week.

Much appreciated. 🙂

To whom it may concern,

Your ultrasound results might point toward fatty liver disease. It’s essentially just fat accumulation in the liver, and the root causes vary wildly—everything from weight issues and diabetes to cellular damage triggered by viral hepatitis or exposure to toxins like alcohol, certain medications, or other environmental factors. You should probably dive deeper into this with Dr. Hrvoj and the rest of the group here. Liver damage. Look, we're off-topic here.

Regarding the child—how is their vision? How do their eyes look? Can they lift their head from a lying position by bringing their chin to their chest? Are they sensitive to light, or experiencing any vomiting?

frozentinker992 said:Just checking in.

Standard biochemistry wasn't ordered because, according to the primary care doctor, the last cortisol level was fine (even though it wasn't).🙂🙂

Hold on a second.

Shouldn't the endocrinologist be the one interpreting these results? We aren't talking about basic screenings here; this is highly specialized sub-specialty work.

A general practitioner shouldn't even be ordering these types of tests without a specialist's prior assessment. It’s the specialist's job to specify exactly which tests are needed—down to the finest detail—since many tests come in various versions: abbreviated vs. comprehensive, or basic vs. granular. Deciding what is necessary falls squarely on the endocrinologist.

Didn't the endocrinologist explicitly list the specific tests required before you follow up for your next appointment?

Maria Fisher46 said:Hold on just a second!

Shouldn't an endocrinologist be the one interpreting these specialized endocrine results and deciding on the next steps?

Didn't the specialist explicitly list which tests you need to complete before following up with them for a review?

vividsailor7 said:Unfortunately, we can't resolve this through an online forum.
What's missing here is a thorough endocrine evaluation and meaningful analysis.
A dexamethasone suppression test is considered normal if cortisol drops below 80nmol, but it could still appear normal even in cases of episodic ACTH and cortisol secretion.
And frankly, it isn't surprising that a general practitioner wouldn't know how to properly write up these referrals.

My primary care doctor first sent me for morning cortisol along with my other hormone levels.
The morning cortisol was nearly double the normal range, so she had me repeat both morning and afternoon tests. Those showed a lack of diurnal cortisol rhythm, so she referred me to an endocrinologist since my androstenedione, testosterone, and 17-OH progesterone were also elevated.

The saddest part is that I paid out-of-pocket for $133 a specialist consultation, only to be told to run these specific tests—just ACTH and cortisol rhythm testing, plus morning values after a low-dose dexamethasone.
I was hoping they would order more comprehensive testing, but apparently, it wasn't necessary.
Based on those results, my GP wrote the referrals
and now I have no one to interpret the findings, unless I want to shell out
200-$100 dollars or wait 3-4 months for an appointment at the local hospital.

Maria Fisher46 said:What in the world? Are you kidding me? We’re jumping straight into genetic screening before even running the basic diagnostic tests for Wilson's disease?! This is absolute madness! 🙂

I don't see anything controversial here.

Michael Sanchez7 said:It’s just like this:

Immunoglobulin E Result=16 IU/L Ref. interval
I just got my results back from the IP8 inhalation allergen screening—testing for things like dust mites, cat dander, dog dander, rabbit fur, various grasses, birch, and ragweed. The verdict? NEGATIVE.

FP5 Nutritional Allergen Screening (egg white, cow's milk, cod, wheat, peanuts, soy) — NEGATIVE.

Specific IgE.
INHALED ALLERGENS — KIU/L
Ragweed Thanks.

Clean results.

Thanks so much.