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

Olivia Castillo562 said:I’ve run AST tests several times now—both when I was feeling under the weather and when I was perfectly healthy.

What kind of illness (inflammation) are we talking about here—something like pharyngitis or just a sore throat?

Dec 10, 2012: 484 IU/ml (sick). Dec 22, 2012: 502 IU/ml (following a full course of antibiotics). Jan 8, 2013: 406 IU/ml (healthy) and 678 IU/ml (sick). Reference range < 200 IU/ml.

AST-O levels typically trend back toward baseline roughly 6 to 12 months after the illness subsides. The peak usually hits about a month into the onset.

Throat swab was done back on December 10, 2012. Results showed physiological flora. I haven't had any nasal or ear swabs done.

I had my CRP tested twice. On December 18, 2012, it was 17.46 mg/l while I was on antibiotics. By January 8, 2013, even though I felt fine, it was 14.28 mg/l. The normal range is under 6 mg/l.

If that throat swab was taken before starting antibiotics, it likely wasn't a strep infection.

When looking at CRP levels, timing is everything. It really comes down to how long ago the illness first showed up—and specifically what kind of illness we're talking about.

Skin tests aren't showing an allergic reaction to any standard inhaled allergens, except for histamine—which shows a 5x5 response—while the autologous serum test came back negative.

A histamine reaction is standard. If there weren't a reaction to histamine, the test itself would be questionable—like testing someone who’s already on antihistamines. This is a textbook finding.

The reasoning behind running an autologous serum test isn't entirely clear if we aren't dealing with chronic urticaria.

Knee pain started about five or six years ago. No swelling in the joints—just this dull ache deep inside. It fluctuates; sometimes it feels like I actually "have" knees, and other times it becomes intensely painful, especially when I'm tackling stairs. Prompted by that discomfort, my doctor ordered a Waller Rose test and checked for LE cells. As for what those LE cells actually signify in my specific situation? I haven't a clue.

The LE cell test isn't really the gold standard it used to be. These days, the ANA test has taken its place. If that comes back negative, the likelihood of systemic lupus is extremely low.

Yes, I am referring to throat/pharyngeal inflammation. The initial bout occurred on August 12, 2012, though no tests were performed then since it was my first flare-up after roughly three years. The second started on October 28, the third on December 10, and the fourth began on February 8, 2013. That was the last time I was sick. Every single time, I was put on antibiotics and dealt with extremely high fevers, often hitting around 104°F during the onset.

The swab was taken on the day the illness began; the throat irritation was present, the inflammation was visible, and I had a fever exceeding 102°F, which is my standard pattern.

To be clear, the first instance was August 12, 2012, but the first CRP wasn't run until December 18, 2012, during the third flare-up. A second CRP was repeated during a period when I was healthy.

Frankly, I know nothing about the tests or the immunology work done for me in Washington, D.C., because the immunologist at the Mayo Clinic saw me for all of two minutes, scribbled down all the orders, and kicked me out of her office. I didn't even have a chance to ask questions. Consequently, I have no idea why an autologous serum test is necessary, why I need computerized telethermography (beyond what a quick Google search says), or why I’m required to undergo ultrasound of the arm and leg arteries.

vividsailor7 said:The result is high.
But you can't make a clinical assessment based on that number alone; you'd need a Childov score and the presence of complicating factors from alcohol use—like portal hypertension, encephalopathy, ascites, etc.
To be perfectly blunt, the situation will likely play out this way: the patient returns to drinking, and depending on those additional complications, they'll end up needing more frequent hospitalizations.

Thanks; unfortunately, we’re already well aware of the reality regarding the relapse.
During the first hospitalization (ever) back in November of last year, his condition was quite dire. I don't have the actual records on hand, but there were arrhythmias, high blood pressure, fluid in the abdomen (edema?), and I believe they mentioned "ascites."

What I'm wondering about—at least theoretically—is how long it takes for that specific lab value to return to a normal range once someone actually abstains.

The thing is, he claims that during that first hospital stay, he was admitted with a level of 900, and it dropped dramatically day by day—to 700, 500, 300... whereas now, after a week of sobriety, the result is 823, though it started at 995.

So, I find myself questioning whether he made up the numbers from the first time, if it's truly impossible for the levels to improve that quickly, or if his condition is actually worse now, which might explain why it only dropped by 170.
Are we talking about a recovery period measured in days, or perhaps months, to get that value back to normal?
I'm also curious if having one glass of red wine a day would even be considered abstinence (for someone who used to consume—during heavy binge phases, which occurred about six times a year for several weeks at a time without any detox periods—at least a liter of wine, several hard liquors, and maybe a few beers; while during the rest of the time when he wasn't "drinking," it was "only" a few drinks a day).

He hasn't had a drink in 12 days. Tomorrow, he's heading to some private lab to redo the GGT test because he doesn't trust the hospital's results (???!!!).
As for the fallout, his walking is currently labored (alcoholic neuropathy?) due to weakness in his legs, along with a general lack of motivation. He's taking four medications prescribed by an internist (since that first hospitalization); one is for blood pressure, and he'd have to check the names of the others.
He's also taking Vitamin B (two Neurobion tablets, which he just started), Vitamin E, Milk Thistle (for the liver, a herbal supplement), and Ginkgo (another herbal preparation).

Right now, what I am most interested in is the typical pace at which GGT decreases, if such a thing can even be estimated.

Olivia Castillo562 said:The swab was taken right when the illness started. I had a sore throat, visible inflammation, and a fever north of 102, which is pretty standard for me.

It’s entirely possible the swab came back a false negative, or perhaps the pharyngitis wasn't caused by strep at all.

So, the initial inflammation flared up on August 12, 2012, and the first CRP test was done on December 18, 2012, during the third bout of throat inflammation. A second CRP was repeated during a period when I was actually feeling healthy.

CRP levels tend to stabilize relatively quickly once treatment begins, which explains why those initial numbers weren't particularly striking. However, that second CRP definitely points toward an ongoing inflammatory process.

Did you have an ESR (sedimentation rate) done?

At this point, I don't understand the reasoning behind the autologous serum test, the computerized telethermography (I have no idea what that even is, other than what Google says), or why I need an ultrasound of the arteries in my arms and legs.

Computerized telethermography is a diagnostic tool that analyzes thermal energy—specifically, the infrared radiation emitted from the surface of the body—and maps it using various color combinations representing heat and cold.

The premise is that in many conditions, skin surface temperature fluctuates (either rising or falling), such as during inflammatory processes or changes in blood flow through specific areas of the body.

This method can be useful for diagnosing inflammatory joint diseases, connective tissue disorders, degenerative joint issues, soft tissue damage, complex pain syndromes, or analyzing circulation in the extremities.

The latter (circulation analysis) is likely why the ultrasound was also ordered.

One more thing: are you dealing with any sinus issues?

My last full blood panel was done on February 12, 2013, and my ESR was at 9 (reference range 4-24). I believe I had another test done back in November, but I don't have those specific results on hand. It’s difficult to track exact dates when you aren't holding the paperwork, especially since I've had blood drawn about 20 times now for various tests. 🙂

I dealt with sinus issues long before I underwent surgery to remove a cyst that actually pushed out along with my tonsils when I was 16. The cyst was located beneath the bone at the level of my nostrils and was extracted through the inside of my mouth. Apparently, it was about the size of a plum; I didn't even realize I had it. Following the procedure, I suffered from headaches and intense pressure in the sinus area on that side of my face. I went through several rounds of testing, but nothing turned up—eventually, the situation just resolved itself over time.

Thank you very much for the explanations; they were truly helpful. 🙂

Dr. Harvey, everything else seems to be looking okay—except for my uric acid being slightly elevated and, of course, that total bilirubin which is absolutely going wild right now.

I wanted to ask this one more time, if anyone happens to know, because I'm feeling a bit anxious about it right now.

analogcanyon29 said:Could someone please help me make sense of this lab result?

Sample: Blood serum
Immunoassay: Hepatitis B antibodies 70 mIU/mL positive

analogcanyon29 said:Let me ask one more time, if anyone knows—this is fairly urgent.

Ma'am,

If you've been vaccinated against Hepatitis B, this result is perfectly normal for a vaccinated individual, provided that only the anti-HBs is positive.

Is there anything else listed on the report? Anything else showing as positive?

Best regards.

Olivia Castillo562 said:I had sinus issues before I had a cyst removed back when I was 16. It had grown out alongside my tonsils. It was located beneath the bone at the level of the nasal bridge and was extracted through the inside of my mouth. Apparently, it was about the size of a plum; I didn't even realize it was there. Following the surgery, I dealt with headaches and pressure in the sinus on that side of my face. I went through various tests, but nothing turned up, and the situation eventually resolved itself over time.

OK, then what I mentioned previously stands.

Complete the remaining tests as scheduled, and we will see.

It’s worth noting that sometimes it takes quite a while for an autoimmune disease to manifest in a full clinical picture. Some patients can wait years before a diagnosis is actually reached.

That said, I hope that aside from the thyroid, no other autoimmune conditions are found.

Best regards. 🙂

Kimberly Richardson56 said:Thanks, but unfortunately, we already know all about that whole relapse into drinking business.
During my very first hospitalization last November, things were looking incredibly grim. I don't have the lab results on hand right now, unfortunately, but the situation was dire: I was dealing with arrhythmias, high blood pressure, and fluid buildup in my abdomen—I think they specifically used the term "ascites."
So, I’m sitting here wondering: did he just make that up on the spot? Or is it actually physically impossible for those levels to bounce back that quickly? Honestly, there's a third possibility that's even more frustrating—maybe things have taken a turn for the worse, and that's why the numbers only dropped to 170 instead of going down further. It doesn't add up.
Are we talking about days here, or are we looking at months? I mean, how much time does it actually take for a lab result like that to swing back into the normal range?

I also want to know: does having just one glass of red wine a day actually count as abstinence? I’m asking for someone who used to go through these intense benders—we're talking about six times a year where they'd drink non-stop for weeks on end without any breaks. During those stretches, they were knocking back at least a liter of wine, plus several hard liquors and maybe a few beers here and there. Then, during the periods when they weren't "drinking," it was still "only" a few drinks every single day. Does that one glass even move the needle?

He hasn't touched a drop in 12 days now. Tomorrow, he’s heading to a private lab to get that GGT retested because—get this—he actually doesn't trust the results from the hospital. (Are you kidding me???!!!)
As for the fallout, walking has become a real struggle right now—it feels like some kind of alcoholic neuropathy given how weak my legs have been feeling lately. On top of that, there's this overwhelming sense of lethargy. I'm currently on four different medications prescribed by an internist back when I had my first hospitalization; one is for blood pressure, and I’ll have to double-check the names of the other three.
He’s currently taking Vitamin B (Neurobion, two tablets—he just started this), Vitamin E, Milk Thistle (for his liver, a herbal supplement), and Ginkgo.

Right now, what I’m actually most curious about is the pace at which that GGT level drops—specifically, how fast it usually goes down if it's even possible to estimate.

Ascites is nothing more than free-floating fluid buildup in the abdomen. Period.
Based on the meds, it looks like they’re likely on a regimen of Lasix, Aldactone, and maybe some Inderal or Carvelol, among other things.
Neurobion and Milk Thistle can stay, but everything else is completely pointless.
If his neuropathy is really getting to him, we could look into starting him on Katena or Lyrica.
When we're talking about abstinence—if we're being strictly technical—this isn't actually true abstinence. But, honestly? Given everything else that's going on, you can be relatively satisfied with where things stand.
GGT is incredibly volatile. It’s all over the place because it depends on so many different factors—everything from the specific stage of liver or kidney failure to just how much stress your system is under. You can't just look at one number and call it a day; there's way too much going on behind the scenes for that.

Robert Adams88 said:Dr. Harvey, everything else looks fine, except for my uric acid being slightly elevated and, of course, that total bilirubin which is absolutely going haywire.

I can only restate exactly what I said in my previous post.

I’m honestly not quite sure what Dr. Harvey wants me to say, exactly. But, whatever... it doesn't really matter 🙂

Anyway, I went back for more blood work, and my bilirubin levels have dropped significantly (down to 36). I should probably mention—just in case it matters—that I stayed pretty sedentary for about two days before the draw, so I was wondering if physical activity actually has an impact on bilirubin levels?

vividsailor7 said:The patient has ascites and free fluid buildup in the abdomen.
Given the medication list, he’s likely on Lasix, Aldactone, Propranolol/Carvelol, and things of that nature.
Neurobion and Milk Thistle can stay, but I suppose there isn't much point in keeping the rest.
If his neuropathy becomes particularly bothersome, maybe Katena or Lyrica could be introduced.
Regarding abstinence—strictly speaking, this doesn't qualify as true abstinence, though considering everything else, one could arguably be relatively satisfied with the situation.
GGT levels are highly variable; they depend on many factors, such as the degree of liver and kidney failure, and so on.

Thanks.

Kimberly Richardson56 said:Thanks.

Don't mention it. If you need anything else at all, I'm right here.

I'm not going to type out every single detail because there's way too much to go through, so I'll just summarize what I had checked:

Complete blood count, differential, hematology, urinalysis, sediment, substrates, enzymes, electrolytes, and trace elements.

Everything looks totally normal, except my MPV came back high. The reference range is 6.8-10.4, and I'm sitting at 11, so it's just slightly elevated.

As for the substrates, my glucose is 4.2 while the reference range is 4.2-6.0. Should I be worried about that?

They also ran some thyroid hormone tests, but those all came back fine.

The reason I went in for blood and urine work was because of some weight loss. Even though I changed up my diet, the weight was dropping a bit too fast for my liking, so I figured I'd get everything checked out just to be safe.

I'm a 23-year-old male.

To whom it may concern,

Due to significant cartilage loss in my knees—HHS scans actually showed a 2mm reduction in less than two months—and pain that seems to intensify by the day, I’ve been sent off for a battery of blood tests. So far, my results for ASTO, Waaler-Rose, and Latex RF have all come back negative. My CBC is normal, CRP is 3.43, ESR is 8/21, and fibrinogen is 2. I am still waiting on the ANA screen, ANCA, and anti-CCP results. (I am providing this full context so everyone understands the scope of my situation; I do grasp what these numbers mean.)

I was also referred for HLA B27 and HLA B35 testing. Today, I received the lab report which states the following:

HLA phenotype A 2,3, B 7,18, Bw6-.

Could someone please help me interpret this? I am assuming that since B27 and B35 aren't listed, they weren't found? My mother is HLA B27 positive and has been diagnosed with Bechterew's disease. Years ago, she received a result from this same lab showing HLA-B27 as positive—it looked nothing like what I have here.

I was wondering if anyone could offer some advice on whether I should pursue further testing because my prolactin levels came back high (704.4 mU/L, while the normal range is 72-511) and my free testosterone is at 0.0227 nmol/L (with a reference range of 0.004-0.039). So far, this is the third time I’ve had hormone panels done, and it's actually the first time I've specifically checked my free testosterone. In all my previous tests, my prolactin has always been elevated, though my doctor just chalked it up to stress, I guess. Everything else seems to be within the normal range.
I am 28 years old, and I’ve been dealing with excess hair growth on my stomach, chest, face, and back since I was going through puberty. Lately, though, the hair seems to be getting longer—like 5mm long now—and darker too. From a gynecological standpoint, everything is apparently fine, which is why my family doctor hasn't really sent me anywhere for specialized follow-ups. No one else in my family deals with excessive hair growth, but it honestly bothers me so much. For a few years, I used tweezers to pluck the hair around my nipples, and now for my stomach, I’ve been using waxing based on a dermatologist's suggestion, but I also try regular depilatory creams, which unfortunately leave me with several pimples after each use. I feel like I could be hair-removing every other day because it grows back so fast. I have this nagging feeling that I might just be making things worse by doing this. I wonder, will I just keep getting hairier? Is there any way I can actually fix this problem permanently?

Robert Adams88 said:I should have noted that I was active two days before my blood draw. Does physical activity have any impact on bilirubin levels?

To whom it may concern,

I won't comment on your specific situation, but generally speaking, physical exertion—like a heavy workout—can cause a subtle bump in bilirubin levels even in healthy people. That said, it certainly wouldn't reach the levels you're seeing. Furthermore, with certain conditions like Gilbert syndrome, bilirubin levels (which are already elevated) can spike even further following physical strain.

It isn't just one thing; other factors play a role in bilirubin concentration as well.

I followed the advice given by my doctors, including Dr. Harvey.

Greetings. 🙂

feralbadger2 said:Everything is within the normal range, except for my MPV. The reference interval is 6.8–10.4, and I’m sitting at 11—so, just a bit elevated.

To whom it may concern,

MPV stands for mean platelet volume. Given the value in your results—especially if your actual platelet count is within the normal range (which I assume it is)—it shouldn't carry much clinical weight. Not in my book.

By the way, you didn't mention how much weight you've lost or over what timeframe. Also, are you still dealing with any symptoms, and have you been advised on any further follow-up or treatment?

Greetings. 🙂

Hannah Lopez29 said:I received my lab results today, and they show the following:

HLA phenotype A 2,3, B 7,18, Bw6-.

Hello,

Your interpretation is spot on; you don't have HLA-B27 or HLA-B35.

Based on what was tested—specifically the A and B groups, though others exist—you carry HLA-A2, HLA-A3, HLA-B7, and HLA-B18.

These specific markers aren't strongly or uniquely linked to any particular autoimmune condition. While almost any HLA type can be associated with a slightly higher risk for certain issues, the ones most definitively tied to disease (within the A and B groups, to keep it simple) aren't present in your report.

Best regards. 🙂

feralbadger2 said:I'm not going to type out every single detail because there's honestly a mountain of data here, so I'll just summarize what I went over:

CBC, differential, hematology, urinalysis, sediment in the field of vision, substrates, enzymes, electrolytes, and trace elements.

Everything looks pretty standard, except for my MPV, which came back high. The reference range is usually 6.8-10.4, but mine hit 11, so it's just a little bit elevated.

As for the substrates, my glucose was 4.2, while the reference range is 4.2-6.0. I'm wondering if I should be "worried" about that one?

They also checked my thyroid hormones at the same time, but everything there seems fine too.

I had my blood and urine tested because I've been losing weight. Even though I changed up my diet, the drop felt a little too fast for comfort, so I figured I'd get everything checked out just to be safe.

I'm a 23-year-old male.

Based on those specific results, you really don't need to worry right now.😉

Maria Fisher46 said:To whom it may concern,

You interpreted those results perfectly—you don't have HLA-B27 or HLA-B35.

Thanks for the confirmation! 🙂