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

Amanda Carter6 said:Hey everyone on the forum,

I’m honestly hoping there’s someone here who can finally make sense of this whole back-and-forth mess I've been dealing with.

Exactly a year ago (so, right around August), I was feeling completely wiped out all the time. My mom got worried and sent me in for some routine blood and urine work just to see what was going on. And man, talk about a shock—everything came back totally normal except for my platelets, which were way too high (the average range is 178–420, but mine was 482).
The doctor sent me straight to a Hematologist because she wasn't happy about those numbers.
During that whole stretch, I was still exhausted, sleeping through the day and having zero appetite.
At the Hematology clinic, they drew more blood a month after the first time, and my platelets had jumped to 573, which caught me pretty off guard.
The doctor told me to come back in two months for a follow-up to see where things stood, so I showed up in January 2011, and my count was 563.

They sent me for an abdominal ultrasound, which turned out fine (kidneys, liver, pancreas—all good), and then a chest X-ray, which was also clear.
After that, the doctor ordered a bone marrow biopsy. 😲
The biopsy didn't reveal anything new (meaning, it's not cancer or anything like that). The only thing they noted was significant megakaryocytopoiesis and the presence of granulocytopoiesis.
They told me to come back for a check-up in a month.

A couple of weeks after the biopsy, I broke out in chickenpox.
See, when I was little (around 4 years old), my brother and sister both had chickenpox, and my mom swears I had them too and that she used that white lotion on me until it cleared up, just like it did for them. But when I went to the infectious disease specialist at the hospital because the doctor insisted it was chickenpox rather than shingles (which is what you get if it's a second infection), they recorded this: rash following the pattern of chickenpox in all stages 😕
It cleared up after two weeks of being stuck in home quarantine.
But even now, I still have these tiny blisters on my shoulders, though there aren't as many. I've got a dermatologist appointment at the end of this month because the doctor thinks they're just acne. 😕
(I'm only mentioning this in case it actually has something to do with my platelets)
My mom still insists I had chickenpox as a kid.
Anyway.

A month after that, at my follow-up in the hematology clinic, my platelets were still sky-high (561).
I was sent to a neurologist who basically said I couldn't be any more "normal" than I am.
The last time I was checked, it was at the start of July after I got back from a school trip, and my platelets were 573.
I don't have another check-up scheduled until October.
Throughout this entire year, I've stayed exhausted—like today, for example, I slept for 14 hours straight and I'm still drained and just want to go back to sleep.
My periods are regular and normal (5 days, heavy for the first 2, then tapering off).
I don't smoke or drink. I mean, I'm stressed because of school, but nothing crazy.
I have no appetite, and I'm only 46 kg at 169 cm. Even though I try to eat, I keep losing weight.
On my last lab report, the doctor wrote: "If thrombocytosis persists, a bone biopsy will be performed."😕😕😕😕

My parents are freaking out and they have absolutely no clue what to do next. Is there any point in us heading down to New York City to see a private specialist, or just doing whatever it takes??
I’m only 18, and honestly, I don't want to spend the rest of my life bouncing from one clinic to another.
Any advice would be huge!

So, what's the deal with your Erythrocytes? You dealing with anemia or maybe low Iron? What did the rest of your blood work look like??

Generally speaking, primary blood disorders involving platelets aren't really common when you're your age; they're usually secondary. Secondary means your platelet count is high because of some other non-hematological issue or condition. Stuff like various autoimmune diseases, inflammatory bowel disease, certain malabsorption issues like Celiac, or even some lymphomas can cause high platelets along with increased megakaryocytes in the bone marrow. In those cases, the megakaryocytes actually look fine—there's just more of them. Infections can also trigger thrombocytosis.

wiredcanyon2 said:So, what’s the deal with your Erythrocytes? Are you dealing with anemia or maybe an iron deficiency? How did the rest of your blood work look??

Generally speaking, primary blood disorders aren't super common at your age; they’re usually secondary. Secondary basically means your platelet count is high because of some other non-hematological issue or condition. Things like various autoimmune diseases, inflammatory bowel disease, certain malabsorption issues like Celiac, or even some lymphomas can cause high platelets along with increased megakaryocytosis in the blood count. In those cases, the megakaryocytes look fine, there are just more of them. Infections can trigger thrombocytosis too, I guess.

I'm not anemic, my iron levels are totally normal, and everything else on my urine and blood tests looks completely fine.
It's just that whole thing with the platelets...

Thank you so much, you honestly just saved me from endless trips to the Hematologist clinics when it's clearly something else entirely.
I owe you one, because so far, none of my doctors have given me anything concrete besides just saying, "Oh, it's all just puberty."
Thanks a million!!! 🙂

Amanda Carter6 said:I'm not anemic, my Iron levels are totally fine, and everything else on my blood work and urine tests looks completely normal.
The only thing is those platelets...

Thanks so much, you honestly just saved me from the endless headache of dragging myself to hematology clinics when it's clearly something else entirely.
I owe you one, because so far not a single doctor has given me anything concrete besides "it's just puberty."
Thanks a million!!! 🙂

Look, you definitely need to keep an eye on your CBC and stay under a hematologist's radar. It’s entirely possible we're looking at some kind of developing blood disorder, so being monitored by a specialist is the move. Your hematologist should also be digging into other potential causes and probably consulting with colleagues. If you aren't feeling any symptoms, just chill out a bit, live your life, but keep up with the checkups. 🙂

Hey everyone. Got a few questions. I’ve got this weird sensation in my hands—specifically my right hand—like the motor skills are just off. Same thing with strange tingling in my right leg. Most bizarre of all is my face; the right side, both upper and lower lip, feels weird too.

I haven't found the root cause yet. This has been going on for about five years now. All my test results seem fine on paper, but I was hoping you guys could help me make sense of these specific points:

* Mid-voltage basic cerebral activity shows mixed alpha frequencies. Some partial blocking, but no asymmetries or paroxysmal activity.
Results are within normal limits.

* VEP: conduction disturbances in fibers projecting to the 1st optic nerve.
For stimulation of both eyes, a P100 wave of borderline amplitude is recorded, with prolonged latencies for the crossed fibers of the right eye and uncrossed fibers of the left.

* SSEP: Neurograms detected over the brachial plexus, spino-grams over C7, and cortical responses over the sensory region for the hand.

CT and MRI were all clear.

Thnx

l.p.

I'm just exhausted... I feel like sleeping all day long.

A few months back, my iron levels were pretty low, so my doctor put me on some supplements. I only took them two or three times before the next blood test, and my level was at 7.6.
Also, according to my EKG, my heart rate is kind of slow—around 51 beats per minute if I read that right—but I don't really do any sports.
I'm 17.

I'm wondering how much a low iron level (not massive, just around 8) combined with a slower heart rate affects fatigue... because I had plans to get some studying done over the break, but instead, I've been staring at the exact same page for half an hour.

I should also mention that my hemoglobin is normal (MCV, MCH, MCHC, etc.), and my erythrocytes are fine too.

Keith Long50 said:I am just exhausted—I feel like I could sleep all day long.

A few months back, my iron levels were pretty low, so my doctor put me on some supplements. I took them maybe two or three times, and then during the next check-up, my level was at 7.6.
Also, according to my EKG, my heart rate is a bit slow—around 51 beats per minute, if I read that correctly—but then again, I’m not exactly an athlete.
I’m 17 years old.

I’m wondering how much this combination—low blood iron (not massive, but around 8) and a slower heart rate—contributes to this fatigue. I had planned to get some studying done over the break, but right now, I find myself staring at the same page for half an hour without absorbing a single word.

I should also mention that my hemoglobin is normal (MCV, MCH, MCHC, etc.), as are my erythrocytes.

Did they have you wear a Holter monitor? Send you for an exercise stress test? Run any liver or kidney panels? Check your electrolytes or thyroid hormones?
It is entirely possible that the fatigue is stemming from both the iron deficiency (standard reference ranges for men usually start around 10, so 7.6 is still quite low) and that slow heart rate. Fatigue is a common symptom for both issues. Are you experiencing anything else—paleness, dizziness, general weakness, or perhaps brittle nails?
I don't know exactly which tests you've already undergone, but you definitely need a comprehensive workup!

They didn't run any extra tests on me, it was more of a side note during the visit, so the doctor just told me to take some iron tablets. I honestly wasn't sure if an iron deficiency could actually cause fatigue if my hemoglobin levels are looking fine...
And no, I don't think I have those symptoms you mentioned, or anything else that would point toward a specific illness—just the exhaustion. Except for that fainting spell and collapse I had back in May, but that was probably just stress or burnout from school...

Thanks for getting back to me.

Keith Long50 said:I'm exhausted. Just sleeping all day long.

I had pretty low Iron a few months back, so my doctor put me on some pills. I took them maybe 2 or 3 times, and on the next test, I was at 7.6.
Also, according to my EKG, my heart rate is kind of slow (around 51 bpm if I read that right)—not that I do any sports or anything.
I'm 17.

I want to know how much low blood Iron (not huge, just around 8) and a slow heart rate actually impact fatigue. I planned on studying through the break, but instead, I've been staring at the same page for half an hour.

Oh, and I should mention my hemoglobin is fine (MCV, MCH, MCHC, etc.), and my erythrocytes are okay too.

Which pills were you taking and for how long? You seriously only took iron two or three times? And when you stopped, how soon after did you get tested? I’m asking because you have to take iron for a while to actually replenish your body's stores. Taking two or three pills and then immediately getting blood drawn isn't going to cut it—of course it'll show an improvement in Fe if you just popped one today and bled right after. :/ I think this needs a real follow-up because you might be looking at the early stages of iron deficiency anemia. It has several phases, and one of them is where the Fe level drops but the hemoglobin stays within the normal range. You really need to figure out what's causing this.🙂

I took three Ferrum Lek 100 mg chewable tablets, and then, after more than a month had passed, I went back for another blood test.

Keith Long50 said:I took 3 chewable Ferrum Lek 100 mg tablets, then went back for more blood work just over a month later.

Look, you don't just pop these pills for a week and expect magic. You’re looking at months of this.

I know, but I stopped because my hemoglobin levels were looking fine.
Nothing left to do now but get these tests done, once I finally recover from surgery 🙂
Thanks for everything, take care.

Keith Long50 said:I know, but I stopped because my hemoglobin levels looked fine at the time.
Now all that's left is to get my tests done once I finally recover from surgery. 🙂
Thanks for everything, cheers.

Go ahead and get your TIBC and Ferritin checked so you can actually see where those iron stores are sitting. Best!

Keith Long50 said:I understand, but I stopped because my hemoglobin levels had stabilized.
Now, all that’s left is to get through the tests—once I've finally recovered from the surgery.🙂
Thanks for everything, take care.

And when did the surgery happen? What was it for?
Fatigue can definitely be a side effect of surgery—the body simply needs a window of time to recover.

Olivia Hayes89 said:And when was the surgery? What kind of surgery were we talking about?
Fatigue can be caused by surgery too! The body just needs some time to recover!

I was feeling worn out even before the procedure. It was just a tonsillectomy back on August 4th—nothing major. Only thing is, I had some bleeding last night, so it’ll probably take a little while longer before everything settles back to normal...

I could really use some clarity regarding this whole anemia situation.🙂
About two and a half years ago, I stumbled upon the fact that my iron levels had tanked down to 7.
I spent six months taking Heferol, and managed to bump it up to 14.
Fast forward two years—I begged my doctor for a follow-up check, and wouldn't you know it? It was back down to 7 again.
After four months on Heferol, it climbed back up to 11.
I just got another box, so I'm still grinding through the supplements.

Here’s the part that’s actually eating at me: I have absolutely no clue why this keeps happening.
My doctor initially said she’d send me for more intensive testing if my levels didn't stay up, but now she’s acting like it isn't even necessary.
My hemoglobin stays in a good range, but I haven't bothered checking my Ferritin or TIBC lately.

So, what do you think? Should I push harder for more tests, or am I just overthinking things and there's no real reason to worry?

Hannah Nguyen said:I could use a little clarification regarding anemia as well. 🙂
Two and a half years ago, I stumbled upon the fact that my Iron was down to 7.
I've been taking 6 mg of Heferol, and my levels hit 14.
After two years, I finally asked my doctor for a checkup. It was 7 again.
It rose to 11 after four months on Heferol.
Got another box, so I'm staying the course.

Now comes the real headache: I have no idea what’s actually causing this anemia.
The doctor initially mentioned sending me for more testing if my levels didn't improve, but now she thinks it's unnecessary.
Hemoglobin levels always look good. I haven't had my Ferritin or TIBC checked yet.

I’m torn. Should I push for more testing, or is there really nothing to worry about?

To whom it may concern,

Based on everything here, you aren't looking at anemia—at least not yet. Your hemoglobin levels look fine, and I’d bet your erythrocyte count is steady too. It looks more like sideropenia: essentially, just some level of iron deficiency in the system.

To get a more reliable picture, we really need to pin down both Ferritin and TIBC levels. I’m assuming the MCV was already tested, but I’d strongly suggest getting that done too.

Women frequently deal with lower iron stores due to blood loss during menstruation. Because of this, their daily iron requirements are often double what men need—a gap that isn't always bridged by their diet.

We need to pinpoint exactly why those serum iron levels have been consistently low over time. It isn't just about one number; it’s about the whole picture. We should look at whether heavy menstrual cycles are playing a role, or if increased physiological demands—based on age, past pregnancies, or breastfeeding—are draining the tank. We also need to dive into dietary habits and get a clear sense of digestive health. Ultimately, the goal is to gauge your actual reserves by looking closely at your Ferritin and TIBC.

Based on this data and everything else we have, a decision needs to be made regarding whether further processing is required—and if so, to what extent.

We need to establish some clarity here. We have to pin down exactly what we’re dealing with, quantify just how severe this iron deficiency actually is, and identify the root cause behind it.

I strongly suggest you make sure to consult with your family doctor regarding this.

Greetings. 🙂

What does it mean if my hemoglobin is normal, but my MCV and MCH are slightly low?
Everything else on my blood work looks fine

And where can I get tested for lead poisoning?

Megan Ross36 said:which suggests that if hemoglobin levels are normal, but MCV and MCH are slightly low.
everything else in the blood work is normal

and where can I check for lead levels in my system?

Hello,

The degree of deviation in MCV and MCH matters—whether we are looking at a negligible fluctuation or something more significant.

Regardless, even with normal hemoglobin and erythrocyte counts, these results could be early indicators of depleted iron stores. To be clear: I am talking about low iron levels, not anemia. Anemia is specifically defined by hemoglobin and erythrocyte values.

Generally speaking, a low MCV indicates smaller erythrocytes, known as microcytes, a condition called microcytosis. The most frequent culprit is indeed low iron, though other factors occasionally play a role.

It might be wise to supplement these findings with Ferritin, serum iron, and TIBC to get a clearer picture. Of course, this depends on whether your doctor deems it necessary based on how much those MCV and MCH values actually deviate from the norm.

As for your second question, I don't have a definitive answer. What I do know is that occupational medicine handles mandatory periodic screenings for employees professionally exposed to lead; they typically test blood lead levels and d-DALK. It might be worth contacting an occupational health clinic to ask which laboratories perform these specific tests and under what clinical indications.

Best regards. 🙂

thanks a ton

I could really use some help here. I just got my thyroid hormone results back from the lab, and honestly, I’m feeling a bit lost. To me, it looks like everything is sitting right within the normal range, but I’d be so incredibly grateful if someone who actually knows their stuff could take a look and give me a second opinion... just to put my mind at ease. Thanks a million!

T3 - 2.1 (ref. 1.3 - 3.1 )
T4 - 121 (ref. 59 - 154 )
TSH - 1.21 (ref. 0.27 - 4.2 )