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

My grandmother has these little lumps appearing on her body, mostly concentrated around her joints. About six months ago, she had some blood work done because of some kidney cysts and other concerns, and everything came back normal. Now, about a month ago, these lumps started popping up, though they seem to be receding... So, they want her to get her markers checked again because of that. For context, she deals with asthma, has a history of a heart attack, and struggles with rheumatoid arthritis.

Thanks so much for the reply, I didn't list the other values because they're all within the normal range. As for the digestive issues, it varies from an urgent, "get to a bathroom right now" feeling that hits while I'm driving—I have a 40-minute commute each way—to just having soft stools for days on end. This stuff started flaring up at the beginning of this summer; it settles down for a bit and then kicks back in, which makes me think it's tied to stress... I haven't had any abdominal pain, though. I did get a referral to see a gastroenterologist.

Thanks so much for looking over my results. I'm heading in for a checkup today, so I'll find out everything soon. 🙂 I guess it might be because I've been a vegetarian for years, and maybe I wasn't paying enough attention to my iron levels, but we'll see. Thanks again.

Maria Fisher46 said:Hi there,

It's hard to make sense of these results when they're only partially transcribed.

From what you've shared, it looks like your total white blood cell count is slightly elevated. When you combine that with an increase in unsegmented granulocytes, it might point toward some kind of infection.

However, the most striking thing in these labs is the elevation in liver enzymes, specifically the ALT. It’s a minor rise, but it still suggests some level of liver irritation.

The lab work alone won't tell us what's actually causing that liver stress.

You mentioned being overweight; sometimes that leads to fat buildup in the liver, which can bump those enzyme numbers up.

That said, there are plenty of other reasons why those levels might climb.

You also brought up feeling fatigued and having digestive issues—though you didn't specify exactly what those feel like or how long this has been going on.

Because of that, there isn't much more we can say right now. If these symptoms persist, or if follow-up liver tests show no improvement or get worse, you'll definitely need more intensive testing.

Best regards. 🙂

Hello,

The symptoms you're describing aren't very specific, so it's really important to get some clarity on what's happening. It would probably be a good idea to have your primary care doctor refer you to an infectious disease specialist and a gastroenterologist to start with.

I'm not quite sure what you meant by saying you've had "every possible test" done, especially since you're wondering if a bacteria might be involved. If you truly had everything checked, a stool sample would have already ruled out bacterial causes for these issues. Though, honestly, things like tremors, weight loss, headaches, and other general symptoms are hard to pin down to just a single gut bacterium.

Best regards. 🙂

Thanks for the replies. I went to see an infectious disease specialist and got tested for HIV—it was negative, thank God. The specialist told me my hormones are just acting up... I nearly lost it hearing that, because I know something isn't right with me, yet he just insists it's hormonal. I went to get my kidneys and liver checked out, and everything came back perfect. Then I had them look at my abdomen, spleen, and all that, and that was perfect too. I have a tiny heart murmur, but the doctor said that's totally normal for someone my age (I'm 17). In my blood work, only the white blood cells are slightly high, but the doctors said that's normal too... They even said this temperature is fine, around 99.0-99.1°F. Most of the day my temp is pretty steady at 97.4-97.5°F, but my head hurts and I feel dizzy constantly. This fever doesn't stay all the time; it just pops up out of nowhere, stays for a few hours, and then vanishes, but the other symptoms are still there even when I don't have a fever. For context, I was smoking marijuana about 2 or 3 joints a day for five or six months straight, every single day, and then I quit cold turkey. I thought maybe it was because of that... but I doubt it.

Maria Fisher46 said:Dear Michelle Murphy61,

Looking at these results, all we can see is that the ANA is clearly positive via the IIF test—though they didn't specify the titer (it’s obviously higher than 1:100, but the exact level is missing).

It's interesting that the ENA panel—which we run when ANA comes back positive to pinpoint exactly which antibodies are elevated—is negative.

A positive ANA on its own, without any clinical symptoms, doesn't tell us much.

Low ANA titers can pop up even in perfectly healthy people with zero underlying issues.

Additionally, certain medications can trigger a positive ANA result.

Then there are specific conditions where only one organ might be affected—like autoimmune thyroid issues (I mention this because I recall you mentioning thyroid concerns before)—or it could point toward systemic connective tissue diseases.

So, it really can be an "all or nothing" situation.

Best regards. 🙂

Thanks—my doctor also mentioned that because of my Hashimoto's, I should expect a positive ANA test.

🙂

I’ve got some issues with my gallbladder; they found something at the end of September. When I went to the ER, they flagged a lesion in addition to the gallbladder issue—they're calling it fatty liver. My liver enzyme levels were:
AST 104
ALT 217
GGT 515
The attacks have calmed down a bit, so I went back for more tests yesterday, and now they're sitting at:
AST 124
ALT 249
GGT 511
Everything else looks fine—cholesterol and triglycerides are both totally normal.
Basically, my doctor is insisting this can't be caused by my gallbladder, even though I'm starting to feel symptoms again. They're sending me off for hepatitis markers and EBV and CMV serology.
Is it seriously impossible for these enzymes to be this high because of the gallbladder? Surely the ER staff would have mentioned that as a separate issue if it were actually the culprit.

So, my doctor just headed out on vacation without actually explaining what any of these numbers mean. Please, can someone tell me if I should be freaking out or not? 🙂

Prothrombin Time: 14.66 S (Normal range: 16 - 21 S)
D-DIMER: 0.48 mg/L (Normal range < 0.50 mg/L)
Fibrinogen: 5.3 g/L (Normal range: 1.8 - 3.5 g/L)

I'm pregnant, currently 13 weeks and 2 days along. During my last checkup, she mentioned my Fibrinogen was high and told me to get it retested (which is what these results are)... apparently, while Fibrinogen levels do go up during pregnancy, mine might be a bit higher than what she usually sees. She didn't really say anything about the other values, so I'm wondering what it means that my PT is on the lower side.

Thanks a million!

Angela Wright said:I've got some sludge in my gallbladder, found out at the end of September. When I went to the ER, they found the sludge plus a lesion—apparently, they're saying it's fatty liver. My liver enzymes were:
AST 104
ALT 217
GGT 515
The attacks have calmed down, so I redid the tests yesterday and now they're:
AST 124
ALT 249
GGT 511
Everything else looks fine, cholesterol and triglycerides are totally normal.
Basically, my doctor is telling me this can't be caused by my gallbladder, even though I'm starting to feel some symptoms again. They're sending me off for hepatitis markers and EBV and CMV serology.
Is it really impossible for these levels to be because of the gallbladder? Surely if there was an issue, the ER would have flagged that as a separate problem.

Hmm, I find it hard to believe that just having some sludge in the gallbladder without any signs of cholestasis could be responsible for GGT, AST, and ALT values like those—especially since they've been pretty much stuck at that level for three months now (meaning there hasn't been any significant change!). 🤔
I don't know the full clinical picture or all the lab results, but honestly, you definitely need a more serious and thorough workup here; your doctor is right to push for more testing.
What did the follow-up ultrasound of the liver show?

velvetmoose9 said:Look, claiming it's just biliary sludge without any cholestasis being the sole reason for those GGT, AST, and ALT levels—especially when they’ve been stuck at the same level for three months without any real movement—is a stretch. 🤔
I don't have the full clinical picture or all the labs, but this absolutely needs a much more serious and thorough investigation; the specialist has every right to push for more testing.
What did the follow-up liver ultrasound show?

I had my first abdominal ultrasound in the ER, and my doctor sent me home with a diet that I followed to the letter. I was supposed to get follow-up liver function tests in the meantime, but since things seemed to have settled down, and I have a baby and a two-year-old at home, I kept putting it off. I finally forced myself to go because I developed a bladder infection, and that sharp stinging sensation started coming back—mostly in the morning when my stomach is empty. I was caught totally off guard; I honestly thought those labs would have normalized by now. For context, I had an emergency C-section at 7 months because I was facing recurrent preeclampsia and HELLP syndrome. I was discharged with normal labs, and my levels were monitored regularly and stayed fine throughout the pregnancy. At the ER, they told me the sludge is likely something I picked up during pregnancy, which apparently isn't uncommon.
When I asked my doctor if I should see an internist anyway, she brushed me off, saying there was no point because they’d just tell me the same thing: stick to the diet and wait, since you don't operate on sludge. But now, she’s telling me I need to run liver panels and this other test (maybe for mono) before we decide on a plan. Now she's lecturing me because my results won't be ready until January 3rd. I barely managed to squeeze in an appointment out of order.
Here is the ultrasound report from September 17th; two doctors looked at it, one was probably a resident:
Abdominal ultrasound performed in the ER outpatient clinic shows a distended gallbladder with thickened sediment, but no thickening or layering of the wall.
No focal lesions found in the liver parenchyma, which appears diffusely hypodense, suggesting steatosis; no dilation of the bile ducts.
Morphology of the spleen, pancreas, and both kidneys is appropriate.
No free intra-abdominal fluid.

I spoke with my kids' pediatrician, and she mentioned it's possible something migrated into the bile duct, which might be why my liver is under so much stress.

Honestly, I'm terrified. I have no idea how long I can stay in this state before it causes permanent liver damage. Should I just bite the bullet and go private immediately to get a new ultrasound?

It's also possible that things actually *did* start normalizing during those three months of flare-ups, especially since my bladder infection and the trip to the doctor coincided with the return of that stinging pain. Dammit, I should have gone for that liver panel sooner...

I've been taking Silymarin and Rowachol on my own.

Hey there
I just got my blood work and urinalysis results back, and I was wondering if anyone could help me make sense of this mess.
CBC
RBC 4.63 (3.86-5.08)
Hemoglobin 140 (119-157)
Hematocrit 0.397 (0.356-0.470)
MCV 85.8 (83.0-97.2)
MCH 30.2 (27.4-33.9)
MCHC 352 (320-345) *high
RDW 14.4 (9.0-15.0)
Platelets 177 (158-424)
MPV 12.8 (6.8-10.4) *high
WBC 7.7 (3.4-9.7)
Differential
Neutrophils 4.8 (2.06-6.49)
Neutrophils % 62 (44-72)
Lymphocytes 2.3 (1.19-3.35)
Lymphocytes % 30 (20-46)
Monocytes 0.50 (0.12-1.27)
Monocytes % 7 (2-19)
Other Hematology
ESR 20 (4-24)
Biochemistry
Total Bilirubin 9.4 (3.0-20.0)
Glucose 5.8 (4.4-6.4)
Creatinine 76 (49-90)
ALT 12 (10-36)
ALP 61 (54-119)
AST 14 (8-30)
GGT 15 (9-35)
Potassium 4.55 (3.90-5.10)
Sodium 142 (137-146)
Iron 16.2 (8.0-30.0)
UIBC 42.6 (26.0-59.0)
TIBC 58.8 (49.0-75.0)

So, I’m 31, and I actually went in for these tests because I’ve been feeling completely wiped out lately. Between the constant fatigue, dizzy spells, occasional heart palpitations, and just getting winded doing basically nothing—like walking up a flight of stairs—it’s been rough. It feels really weird to me because just a few months ago, I could ride my bike all the way to 31 miles every single day without breaking a sweat.
If anyone has any insight from a medical perspective, I'd really appreciate it.
Thanks

Eric Fisher2, you’re describing some very specific symptoms related to thyroid dysfunction. Your doctor really ought to refer you for some blood work to check your thyroid hormone levels.
This result looks perfectly fine to me.
For instance, if you notice your hands shaking when you hold them out straight in front of you while standing still, or if you're having any trouble swallowing, those are two more distinct red flags to watch for.

Michelle Murphy61 said:Thanks—my doctor actually mentioned that because of my Hashimoto's, I might see a positive ANA test result.

🙂

I'm dealing with Hashimoto's too—my TSH levels are normal, but my Anti TPO is over 1000 and my Anti TG is elevated as well.

I had my ANA tested and it came back positive, just like yours. Now I'm just waiting on the results for the other antibodies (like ENA and stuff like that...)

But my immunologist is telling me that regardless of the Hashimoto's, the ANA shouldn't be positive unless there's some other systemic issue going on🤷...
which means, according to him, there isn't really a connection between the thyroid and the ANA. (I'm really hoping he's wrong)

Thanks for the heads up. 🙂

I'd love to get your take on these lab results:

View on imgur

Angela Wright said:I had my first abdominal ultrasound done in the ER, and my doctor just sent me home with a strict diet to follow. I really should have gone back sooner for a follow-up liver panel, but honestly, between having a baby and a two-year-old running around at home, I kept pushing it off. Things seemed to be settling down, so I figured I'd wait—until I ended up with a bladder infection and that sharp, stinging sensation came back, mostly in the morning when my stomach is empty. It totally caught me off guard; I really thought those levels would have normalized by now. For context, I had my baby at 7 months via emergency C-section because I was facing the threat of recurring preeclampsia and HELLP, but once I was discharged, my labs looked fine, and they were monitored regularly throughout the pregnancy without issue. At the ER, they told me I likely picked up some sludge during the pregnancy, which apparently isn't that uncommon.
When I asked my doctor if I should still see an internist, she basically brushed me off, saying there was no point since she’d just tell me the same thing—stick to the diet and wait—because you don't operate on sludge. But now she's telling me I need to get my liver tests and this other thing (maybe mononucleosis?) checked out first before we decide on a plan. She's giving me a hard time about the fact that results won't even be ready until January 3rd. I barely managed to talk my way into being seen ahead of schedule.
The ultrasound from September 17th—done by two doctors, one of whom I think was a resident—noted:
Abdominal ultrasound performed in the Emergency Department outpatient setting shows a distended gallbladder with thickened/sedimented contents, but no thickening or layering of the wall.
No focal lesions found in the liver parenchyma, which appears diffusely hypodense, suggesting steatosis; no dilation of the bile ducts.
Spleen, pancreas, and both kidneys show appropriate morphology.
No free intra-abdominal fluid.

I chatted with my kids' pediatrician, and she suggested it's possible some of that material migrated into the bile duct, which might be why my liver is feeling the strain.

To be honest, I'm pretty freaked out. I have no idea how long I can stay in this state before it causes permanent liver damage. Should I just go ahead and handle this privately right away, maybe get a new ultrasound?

It's also possible that things actually *did* start normalizing during those three months leading up to now, especially since my bladder infection and the trip to the doctor lined up perfectly with this renewed stinging sensation. Man, I really should have just gone for that liver panel sooner...

I've been taking Silymarin and Rowachol on my own initiative.

The enzyme levels haven't shown much movement over the last three months. It's hard to say for sure, but if there isn't a significant worsening of clinical symptoms, there's a chance this isn't cause for panic.
However, further investigation is definitely needed to figure out why the enzymes rose in the first place and why they aren't normalizing.🤔
The timing is a bit awkward since everyone is on vacation, but I know from experience that a decent internist won't just brush you off like that.
If your symptoms take a turn for the worse, HS is always an option.

Personally, I wouldn't recommend those supplements until we have a clearer clinical picture.
Some of my colleagues and I don't see eye-to-eye on this.

velvetmoose9 said:The enzyme levels have been flatlining for about three months now. It's hard to say for certain, but if there isn't any significant worsening in how you actually feel, there's a decent chance things are stable—and there's really no reason to panic.
That said, you absolutely need to follow up and figure out why those enzymes spiked in the first place and why they aren't returning to baseline. 🤔
The timing is a bit awkward since everyone is heading off for the holidays, but I can tell you for a fact that not just any random internist is going to give you a quick fix or an easy answer.
If your symptoms start taking a turn for the worse, there’s always the option of HS.

Personally, I wouldn't recommend those supplements UNTIL we have a clear clinical picture of what's happening.
Not all my colleagues and I see eye-to-eye on this.

Thanks so much for your input.
I figured that was more or less the case. Regarding the supplements, I'm not the type to just swallow anything blindly, but I have a strong gut feeling that they might actually help. Luckily, I have some doctors in my extended family who are close with an internist, so I'll reach out through those connections to see what they suggest doing right now. I also have the option to get things moving through my insurance. I'll probably start with an ultrasound this Monday.
Thanks again, and I'll reach out if I hit another wall.

Could someone please help me make sense of these sputum culture results:
isolate 01: haemophilus influenzae—less than 1/3. This isolate is considered part of the normal physiological flora.
Gram stain: 20-30 epithelial cells, 5-15 neutrophils and polymorphonuclear leukocytes, with some Charcot-Leyden crystals present.
Interpretation: Having more than 25 epithelial cells and fewer than 25 PMNs or neutrophils in the field of view suggests the sample quality is poor.

I decided to get this checked because I’ve been dealing with this cough for four weeks now, hacking up greenish and yellow mucus.
Thanks

steelwalker68 said:My grandmother has these lumps under her skin... mostly around her joints. About six months ago, she had blood work done because of some kidney cysts and everything came back fine. Now, about a month ago, these lumps appeared, though they seem to be receding... That's why they want her to redo the markers. She also has asthma, a history of heart attack, and deals with rheumatism.

Ma'am,

Based on what you've shared, it’s difficult to give a more precise answer.

It seems likely the doctor ordered repeat markers due to changes seen during an abdominal ultrasound.

Subcutaneous lumps can sometimes be associated with rheumatic diseases (which you mentioned).

Her other conditions—respiratory issues and what you called "rheuma," perhaps rheumatoid arthritis—could also influence the CEA levels.

In any case, the physicians managing her care will need to determine the cause of this increase, especially since the CEA was normal six months ago and is rising now.

Best regards. 🙂

Noah Hughes67 said:Thanks for the response. I went to an infectious disease specialist and did an HIV test—negative, thank God. The specialist told me my hormones are just acting up... I nearly lost it because I know something isn't right, but he insists it's just hormones. I had my kidneys and liver checked; results were perfect. Then I had my abdomen and spleen looked at; all perfect too. I have a slight heart murmur, but the doctor said that's normal for my age (I'm 17). My white blood cell count is slightly elevated, but doctors say that's normal as well. They even say this temperature is normal—around 99.0-99.2°F. Most of the day my temp is actually normal, around 97.5-97.7°F, but I have headaches and constant dizziness. This low-grade fever doesn't stay; it just pops up for a few hours and then disappears, but even when I don't have a fever, the symptoms persist. I was using marijuana for 5-6 months, about 2-3 joints a day, every single day, but I quit abruptly, so I thought maybe it was that... but I doubt it.

Sir,

If the infectious disease specialist has ruled out the causes of your symptoms, the next step would be to see a gastroenterologist.

Best regards. 🙂

wiredgardener68 said:My doctor went on vacation without explaining what my results actually meant. Please, is this okay? 🙂

Prothrombin Time: 14.66 S (Normal range 16 - 21 S)
D-DIMER: 0.48 mg/L (Normal range < 0.50 mg/L)
Fibrinogen: 5.3 g/L (Normal range 1.8 - 3.5 g/L)

I'm pregnant, 13 weeks and 2 days. During my last exam, she mentioned my Fibrinogen was elevated and told me to retest (which is what this is)... because while Fibrinogen is expected to be high during pregnancy, mine might be a bit higher than what she usually sees. She didn't comment on the other values, so I'm wondering what the lower PT value means.

Thanks so much!

Hello,

Regarding the fibrinogen level, it’s only a very slight deviation considering how far along you are.

In fact, according to medical literature (for example, Abbassi-Ghanavati, Greer, and Cunningham in "Pregnancy and laboratory Studies: a reference table for clinicians," published in American Obstetrics & Gynecology), fibrinogen reference ranges during pregnancy shift significantly. For the first trimester, they go up to 5.1 g/l, for the second up to 5.4 g/l, and by the third, up to 6.2 g/l. Given that, 5.3 g/l doesn't look alarming to me.

Is it technically higher? Yes. But you shouldn't use the standard non-pregnant intervals; an increase in fibrinogen is a normal physiological response during pregnancy.

On the other hand, you have a rather interesting result regarding your prothrombin time. It's not a straightforward one to interpret, mostly because clinical attention is usually focused on prolonged clotting times, not shortened ones.

The value suggests a shortened prothrombin time. Your OB likely didn't comment on it simply because she wasn't sure how to interpret it herself.

To be honest, even I am unsure how significant this specific deviation is or if it warrants any concern at all.

A shortened prothrombin time can sometimes be seen in individuals with certain fibrinogen disorders (specifically dysfibrinogenemias). Since those are rare conditions, they really require a hematologist with specialized expertise to manage.

Frankly, I'm not sure what I would do in your shoes. Perhaps I'd have the prothrombin time and other coagulation parameters retested...

Your best bet is to ask your OB about the next steps.

Best regards. 🙂

briskranger132 said:but my immunologist claims that regardless of Hashimoto's, ANA shouldn't be positive unless there's some other systemic disease involved🤷...
meaning, according to him, the thyroid and ANA have zero connection. (I hope he's wrong)

Given that it's established that ANA can show up positive (even at low titers!) in perfectly healthy people—individuals with no autoimmune issues whatsoever—this is common knowledge for anyone working in immunology. I can't get behind that immunologist's assessment (if you quoted him accurately) that a positive ANA must inevitably point to a systemic autoimmune disease ("ANA shouldn't be positive unless there's some other systemic disease involved").

Regardless, no single ANA result should ever be interpreted in a vacuum. It requires a deep dive into the full clinical picture, including physical exams and other lab work. As I've noted before, a positive ANA can mean anything from "nothing to worry about" to "something serious."