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

Nicholas Howard4 As follows:
🙂 God, I really hope you’re right about this...

Alright, here it is—I’m going to quote a section from a post that Nicholas Myers put up on this thread back on December 3, 2012 (post #3116):
I am really not in the mood to mess around with this and end up facing something like liver cirrhosis. I think I’m actually going to go ahead and get that HFE gene test done after all. Either way, thanks for the input!

I’d strongly suggest getting a proper gynecological exam and just stop making up illnesses.
And that’s it. Nothing else.
Everything came back perfectly normal. All the results look clean.
Regarding that quoted post—I think I totally missed commenting on it before—but if my memory serves me right, that girl was dealing with elevated iron levels.
Regarding that HFE analysis—specifically looking at the C282Y/C282Y and C282/H63D mutations—we had to foot the entire bill ourselves. There wasn't an ounce of medical justification for insurance to cover it. And honestly? Even if you do find something, it might not even be linked to HFE. You could be looking at a mutation in the transferrin receptor 2 instead. It’s a complete toss-up.
These tests aren't cheap, and they aren't just thrown around randomly—they're ordered based on what each specific patient actually needs.
Cirrhosis isn't just some sudden medical event—it’s a slow, agonizing descent. It's a long, grueling road that leads straight to cirrhosis.

Keith Howard4 As requested by:
Greetings,

Alright, here’s the bottom line: we're dealing with a household member born in '53. They suffered a stroke about two and a half years ago, and since then, things have been rough. Mobility is a major struggle, appetite is practically non-existent, and they're dealing with frequent vomiting. On top of that, they're diabetic. Their medication regimen is heavy—they’re taking pills for blood pressure, heart issues, diabetes, and sleep. Specifically, they're on Glucophage, Norvasc, and similar meds, plus they stay consistent with their vitamins and Plivit total.

Here’s the situation: I’m dealing with someone who is barely eating anything at all. Swallowing is a massive struggle, and they won't touch meat. It’s almost exclusively fruit and sweets—think puddings and pancakes. As for actual cooked food like vegetables or soup? They can't even get it down without immediately throwing up. Since this person is incredibly stubborn and it's an uphill battle just to get them to agree to any kind of hospital treatment, I have to ask: could this be psychological? Is there a mental component driving this? Also, are there any specific pills that can help prevent the vomiting? I’ve attached the three most recent and critical lab results in the links below. What I really need from you all is your take on whether an endoscopy is necessary here.

With all due respect.

http://upload.slike.com/slike/L98ec.jpg

http://upload.slike.com/slike/BTRZ9.jpg

http://upload.slike.com/slike/ybJ6.jpg (By the way, in my previous blood work, both my MCH and MCHC levels were elevated.)

The EGD results point toward erosive antral gastritis and a hiatal hernia, but honestly, neither of those is cause for panic. There’s also no mention of any weight loss, which is a relief.
You could try taking IPP / Acipan at a dosage of 2x20mg. After that, it might be possible to introduce Reglan—but only after consulting with a neurologist, because you have to watch out for extrapyramidal symptoms!
The biochemistry results are mostly within the normal range, with one glaring exception: those elevated liver enzymes. I’ll need to have them retested in about three months once I've stuck to a diabetic-friendly, low-lipid diet—and that’s assuming we get the HbA1c results back to see the full picture.
Is there any kind of correlation between starting metformin/Gluformin or calcium channel blockers like Norvasc and the onset of these issues? And what about the connection to Levodopa?
Further diagnostic workups might involve esophageal manometry.
Nausea can definitely be a side effect of those meds, but there’s actually room to pivot. You could swap out the calcium blocker and the metformin for something else—maybe try Trajenta 5mg once a day or Ramed 2.5mg once a day instead.
You absolutely have to avoid maxing out on NSAIDs and Aspirin at all costs.
He could also try adjusting his diet with Enteral nutrition if he's losing weight while on TT-Glucen or Nutren.
Make sure he stays under the strict supervision of his primary diabetologist and neurologist, as previously arranged.
NOTE: Everything here is being stated without having personally examined the patient or reviewed their clinical status.

? Is it cool if I drop off my urine sample a day late? I already prepped the tube, but I won't be heading in until tomorrow...
ITKOOO

Brenda Price53 said:? Is it a bad idea if I turn in yesterday's urine sample?

I already prepped everything in the vial, but I don't head out until tomorrow..... ? ITKOOO

Yeah.
You need to use the first morning catch—midstream.

I just got my lab results back today and there's a note that says **E-shadow!**... My primary doctor is away on her annual vacation, and my covering physician isn't picking up the phone at all (what a pain), and I had to head out on a trip. Does anyone know what this actually means?

Lab results: SE SE49 E 4.22 Hb 132 Hct 0.379 MCV 90 WBC 180 L 8.3 Seg 83 Lymph 7 Mono 10.
Biochemical markers: CRP 177.1 Glucose 6.1 Urea 5.1 Creatinine 85 Na 132 K 3.4 Cl 95, Bilirubin 16.6, aspartate-aminotransferase 20, alanine-aminotransferase 18, GGT 20, LDH 169.
Urinalysis: Albumin 2, sediment shows 10-12 leukocytes, 5-8 erythrocytes.

I was wondering if anyone could offer some insight here?

ruggedgull48 said:Lab results: WBC 4.22, Hb 132, Hct 0.379, MCV 90, Platelets 180, Neutrophils 8.3, Lymphocytes 7, Monocytes 10.
Biochemistry: CRP 177.1, glucose 6.1, urea 5.1, creatinine 85, Na 132, K 3.4, Cl 95, bilirubin 16.6, aspartate-aminotransferase 20, alanine-aminotransferase 18, GGT 20, LDH 169.
Urine: albumin 2, sediment shows 10-12 leukocytes, 5-8 erythrocytes.

Could I get some thoughts on this?

It’s always a huge help when people throw in a bit more context, you know? Like, for example...
-What actually sent you to the doctor (the symptoms, how long they've been hanging around, if they keep coming back...)
-Any meds you're currently taking to deal with those issues
-Any existing health conditions you're managing
-Gender and age
-Older versions of these same tests (if you have them) just so we can see how things are shifting over time.

So, following the VidovitomMilan method here—just trying to narrow things down—it looks like we might be looking at a bacterial infection that's been lingering for at least three days. There's also a chance the urinary tract is involved too, though honestly, it would be a massive stretch on my part to go out on a limb and say it's acute pyelonephritis without more info.
Anyway, I'm asking for a little backup here too, so please, give me some more details. 😉

We are looking at a 33-year-old female patient. These tests were ordered because she’s been running an extremely high fever—it’s officially day five now... and it isn't letting up. She hasn't reported any pain, nor has she had any history of inflammatory issues or previous illnesses. She was referred to the general infectious disease clinic—hopefully, everything turns out fine. Thanks for getting back to me.

Hey everyone, I just headed out to the doctor to get some bloodwork done because I’m looking to start on Roaccutane for my acne. However, it looks like a few of my levels came back a bit high.

The results:
Total Bilirubin 23.2 (Normal: 5.0-21.0)
Direct Bilirubin 4.0 (Normal up to 3.4)
AST(GOT) 36.0 (Normal up to 35.0)

Everything else looks perfectly fine.

I'm 15 years old.
I've heard people mention that these kinds of numbers point to liver issues... is this actually something dangerous, or am I overthinking it? 🙂

Honestly, the infectious disease clinic here is one of the top-tier facilities in the US. The staff is incredibly dedicated to what they do, and I’ve got full confidence they’re going to handle this whole situation the best way possible.
Keep us posted on how things are moving along...

Harold Nguyen47 said:Hey everyone, I went to see my doctor to get some blood work done because I was planning on starting Accutane, but it turns out a few of my levels are running a bit high.

Results:
Total bilirubin 23.2 (5.0-21.0)
Direct bilirubin 4.0 (up to 3.4)
AST 36.0 (up to 35.0)

Everything else looks great.

I'm 15 years old.
I heard these might be liver issues—is this anything to worry about? 🙂

Given how young you are and the fact that your numbers are slightly, though definitely, above the normal range, I’m not entirely sure you’re the best candidate to jump straight into Accutane therapy right now.
Maybe look into using a topical treatment instead, like benzoyl peroxide, but obviously, you should still do all of that under a doctor's supervision—ideally a dermatologist.
It isn't really wise to go playing chemist with different products on your own, because you could end up doing permanent damage to your skin. You're 15; I know how frustrating this whole thing is, but honestly, most of the time this stuff just clears up on its own after a year or so.
So, just talk to your doctor about what the next steps should be, and please don't try to DIY this. 😉

It probably makes sense to run those tests again in about 6 to 8 weeks, or maybe sooner if things change.
Have you dealt with any liver issues lately, like jaundice or maybe even mononucleosis recently? Or perhaps you have Gilbert's syndrome?

velvetmoose9 said:Given your age and the fact that your labs are hovering just above the normal range, I’m really not convinced you’re a great candidate for Roaccutane therapy right now.
Maybe look into some topical stuff instead—something like benzoyl peroxide—but for heaven's sake, do it under a doctor's supervision, preferably a dermatologist.
It is incredibly reckless to go playing chemist on your own with random products; you could permanently wreck your skin. You're 15, and trust me, I know how miserable this feels, but usually, this stuff clears up significantly on its own after a year or two.
Bottom line: talk to a professional about your next steps. Don't go rogue. 😉

It actually makes sense to redo those tests in about 6 to 8 weeks, or sooner if you need to.
Have you dealt with any liver issues, jaundice, or maybe infectious mononucleosis lately? Or perhaps you have Gilbert's syndrome?

I haven't had any issues until now. I saw my dermatologist, and he told me I needed blood work done before starting Roaccutane, and well... here are the results. Everything else is fine; I don't have any pain or anything like that. 🙂

By the way, last night I drank about five glasses of apple juice, and then around 1:30 in the morning, I ate half a loaf of bread and had another glass of juice. Then I went in to get my blood drawn around 10:00 AM.

Greetings,

I just finished a full physical and everything came back normal—except for my bilirubin, which hit 60. Two days later, I got called back specifically to get a Coomb's test. If anyone knows why they'd send me for that—what exactly are they trying to pin down with it—I’d appreciate the insight.

Thanks to everyone for the help. 😉

You can find some general info right here: http://www.cigna.com/individualandfa...s-hw44015.html

But if you want anything specific... you're gonna have to tell me a bit more about yourself and what's actually going on with your health.

23 years old, college student—all my labs came back normal except for elevated bilirubin. Ultrasound was fine too. I’ve done some reading on bilirubin, but I'm specifically looking for the connection between a Coomb's test and high bilirubin levels. Why was I called in for a Coomb's test, and what exactly are they trying to rule out? Thanks.

EDIT: Both my mother and I are Rh+

I just went in for my routine checkup, and here’s the doctor’s final takeaway:
-Definitely repeat the CBC and differential. If eosinophilia shows up again, we need to start with a stool sample to check for parasites—treat if positive, then follow up with another CBC.
If the parasite test comes back negative but the eosinophilia persists, we'll need more extensive testing (allergy, pulmonary, and Hematology).
-Run a urine culture; if it's positive, treat based on the antibiogram. Follow up with a urine check once therapy is done.

Now, I'm not sure if it matters that I had this exam a few days before my period started, but here are the wonky numbers from the checkup:

eosinophils 14.9, ref 0-7
MCHC 347, ref 320-345
MPV 10.9, ref 6.8-10.4

About 15 days later, I did the urine culture, and here’s what it said:

Microbiological test results
Leukocyte esterase test: negative
Nitrite test: negative
Sediment: no leukocytes found
Culture:
Sterile

Ten days after the initial checkup, I had bloodwork done again, and here are the values that aren't hitting the reference ranges:

Hemoglobin 117, ref 119-157
Granulocytes 7.7, ref 2.06-6.49
Hematocrit 0.35, ref 0.356-0.470
Granulocytes 7.7, ref 2.06-6.49
Lymphocytes 1.0, ref 1.19-3.35
Granulocytes 85, ref 32-68
Lymphocytes 11, ref 20-46

Just looking for some input—is all of this okay, or am I looking at more follow-ups?
Thanks

If you've got high bilirubin levels and there's any suspicion of autoimmune hemolytic anemia, that's when they run a Coomb's test.

Is this anything to worry about? Here is the rest of my lab data

total protein 72

albumin 51

glucose 4.4

bilirubin 44.3 from the last test

What are the odds—is there any way to actually conclude if I have that condition based on these numbers?

Hey there,
I had surgery ten days ago, and because I was constantly needing to pee in the ICU, the nurses tried to put in a urinary catheter. They botched it, plain and simple. It was such a mess they had to yank it out after just two hours because my bladder was filling up but nothing was actually draining through the tube. The whole process was agonizing. Since then, I’ve been dealing with this constant burning and scratching sensation along my urethra, plus I'm hitting the bathroom non-stop. The doctors basically just told me to "drink more fluids," which is such a joke—it hasn't helped at all, and honestly, things are actually getting worse.

So, I just got my urine analysis back today. Does anyone here actually know how to make sense of this stuff? I’m trying to figure out if I need to jump on some treatment immediately or if this is one of those things that’ll just fix itself if I leave it alone. Any insights?

MICROSCOPIC URINALYSIS
ERC: 1 (0-2(x400))
Granulocytes: 0
Hyaline casts: zero.
Mucus: plenty (0(x400))
Fungus levels: 0
LKC: 5 (0-(x400))
Bacteria: plenty of them (0x400)
Squamous epithelial cells: 7 (Normal range: 0-1 (x400))
I can't even deal with this right now. It’s just zero. Absolutely nothing. Total void.
salt: 0

hollowmoose75 said:Hey there,
About 10 days ago I had surgery, and because I was needing to pee constantly while in the ICU, the nurses put in a urinary catheter (it wasn't done quite right), and they actually had to pull it out after two hours because my bladder was filling up but nothing was draining through the tube. Honestly, the whole process was pretty painful, and ever since then, I've been dealing with this constant burning and scratching sensation along my urethra along with frequent urges to go. My doctors just told me to drink tons of fluids, but that hasn't really done much for me so far; if anything, things seem to be getting worse.

I went ahead and got a urine analysis today, so if anyone here knows how to read these things, could you please let me know if there’s an indication that I need medication, or if this is just one of those things where it'll "fix itself"?

MICROSCOPIC SEDIMENT EXAMINATION
RBC: 1 (0-2(x400))
Granular casts: 0
Hyaline casts: 0
Mucus: plenty (0(x400))
Fungi: 0
WBC: 5 (0-(x400))
bacteria: plenty (0x400)
squamous epithelial cells: 7 ( 0-1(x400))
crystals: 0
salts: 0

Given the recent surgery (whatever it was), the catheterization, the stay in the ICU, these specific lab results (especially the bolded parts), and the fact that your symptoms aren't letting up, it is ABSOLUTELY necessary to get a urine culture and antibiotic sensitivity test done as soon as possible.
Your attending physician will make the final call on whether you need to expand the diagnostic workup further, since they have the full picture of your clinical status and medical history.

feralmason34 said:I went for my routine physical, and here is what the doctor wrote in the final summary:
-Definitely repeat CBC and CMP. If eosinophilia shows up again, first run a stool test for parasites, then follow therapy based on findings and monitor via CMP.
If the parasite test is negative but eosinophilia persists, more extensive follow-up is needed (allergies, pulmonology, hematology).
-Do a urine culture; if positive, treat based on antibiotic sensitivity. Monitor urine after treatment is finished.

Now, I don't know if it matters that I had the exam just a few days before my period started, but here are my problematic values from the physical:

eosinophilic granulocytes 14.9, ref 0-7
MCHC 347, ref 320-345
MPV 10.9, ref. 6.8-10.4

About 15 days later, I did a urine culture and the results say:

Microbiological examination results
Leukocyte esterase test: negative
Nitrite test: negative
Sediment: no leukocytes
Culture:
Sterile

Ten days after the checkup, I had blood drawn again, and here are the values from that report that fall outside the reference ranges:

Hemoglobin 117, ref. 119-157
Granulocytes 7.7, ref. 2.06-6.49
Hematocrit 0.35, ref. 0.356-0.470
Granulocytes 7.7, ref. 2.06-6.49
Lymphocytes 1.0, ref. 1.19-3.35
Granulocytes 85, ref. 32-68
Lymphocytes 11, ref. 20-46

Please, I just need an opinion—is everything okay with these results, or do I need to follow up on something else?
Thanks

Post the initial Mayo Clinic labs and the follow-up ones.

Joseph Davis13 said:Is this dangerous? Here is the rest of the data from the report:

total protein 72

albumin 51

glucose 4.4

bilirubin 44.3 on the last result

What are the chances that these results can actually tell me whether I have this disease or not?

Read the first post.

hollowmoose75 said:Hi,
About 10 days ago, I had surgery. Because I was urinating constantly in the ICU, the nurses put in a urinary catheter (incorrectly), and they had to take it out after 2 hours because my bladder was full but nothing was coming through the catheter. The whole process was painful, and since then, I’ve had constant burning/stinging along my urethra with frequent urination. Doctors just advised me to drink plenty of fluids, but that hasn't helped so far; in fact, things are getting worse.

I did a urine analysis today, so I would really appreciate it if anyone could help interpret them and let me know if there's any indication for treatment, or if this will just "fix itself"?

MICROSCOPIC SEDIMENTATION ANALYSIS
Erc: 1 (0-2(x400))
Granular casts: 0
Hyaline casts: 0
Mucus: significant (0(x400))
Fungi: 0
WBC: 5 (0-(x400))
Bacteria: significant (0x400)
Old squamous epithelial cells: 7 (0-1(x400))
Crystals: 0
Salts: 0

It is absolutely essential to run a UK + ABG. You cannot just jump into empirical therapy—like starting Cipro or Xanax—without those results first!