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

Olivia Hayes89 said:I have no idea which lab ran this test or what specific methodology they used. However, in the lab where I work, the machines frequently flag positive Bilirubin, so we always double-check manually—alongside proteins, Urobilinogen, glucose, and nitrites. It’s entirely possible the machine threw a false positive here.
Since the blood work came back normal, I doubt the urine results carry much weight...
And from what I know, a urine culture usually takes about 2-3 days...

bluebadger12, does your urine sediment show nothing but leukocytes and bacteria?

I agree with you that the Bilirubin reading is likely a false positive; that's actually what I noted in my previous reply. Still, given that the ketones were also quite high, I’d suggest re-running the test just to be certain. Just to clear the air.

Considering that bluebadger12—based on what I gathered from his inquiry—was also dealing with bladder pain, and seeing these sediment results, a urine culture seems necessary. That’s why the doctor decided to order one.

Preliminary results can sometimes be available within 24 hours (a doctor might even get them over the phone), though final results typically take 48 to 72 hours in most cases.

Maria Fisher46 said:I find myself in agreement with you—this is most likely a false positive regarding the bilirubin in the urine, which is exactly what I noted in my previous response. That said, I would still strongly suggest re-running the test, especially since the ketone levels were also quite high. It’s really just about ensuring we have total clarity on the situation.

Given that bluebadger12—based on what I gathered from his inquiry—was also dealing with some discomfort localized around the bladder area, and considering the specific findings in this urine sediment report, I suspect a urine culture is definitely warranted. It seems my intuition aligned with the doctor's, as she decided to order one as well.

Preliminary results can actually be available as early as 24 hours in—your doctor might even get them over a quick phone call—though, in most instances, you won’t see the final, official reports coming through until the 48 or 72-hour mark.

I agree—there’s really no substitute for running those tests again and getting a proper urine culture done. It's better to be thorough than to play guessing games with your health. 🙂
Well, in that case—we are in complete agreement on everything. 😁😉

Olivia Hayes89 said:I agree that you really need to redo those tests and get a urine culture done.🙂
Well, looks like we’re on the same page about everything there.😁 😉

Thanks to both of you for actually staying on top of my health stuff! Looking at the results that guy mentioned earlier, there's some Bilirubin and ketones present, though apparently, the levels are so tiny they still count as "negative" according to the lab report. (It's one of those weird things where they use plus signs—like, anything up to three pluses is technically negative, and I've got two pluses, which feels pretty ridiculous, but hey, whatever)

Everything else in the sediment came back negative, except for Leukocytes at 20 and a bunch of bacteria... everything else was totally clear, no silly plus signs anywhere. I am feeling this weird pressure in my lower abdomen even though I’m not having any actual trouble peeing, but since most of my issues stem from my own head and being a total hypochondriac, suddenly my kidneys start hurting and then it's this and that... you know how it goes. My brain just starts spiraling and I convince myself I’ve got some massive disease involving my testicles, kidneys, bladder... it's just awful. Anyway, getting the urine culture tomorrow...

bluebadger12 said:It’s me again :S. I was at the doctor today and she gave me a referral for a urine culture and antibiotic sensitivity test, which I’ll get done tomorrow morning. She was staring at my urinalysis and seemed really puzzled, asking if I’d been vomiting? I totally panicked and blurted out "no" immediately—nothing serious happened, but I just spiraled. Then I actually looked closer at the results and noticed some things I missed before. The values and reference ranges look weird and I don't get them. Please, I need some experts to weigh in because I'm freaking out.

Turbid
Leukocytes: 20
Bacteria: many

The following are also on there:

Ketones +++ neg to +++ neg
Urobilinogen + norm to +++ norm
Bilirubin ++ neg to +++ neg

I was only looking at the numbers, so I didn't even notice those stupid little plus signs. Based on the raw values, everything seems within range, but those pluses suggest something is actually going on, right?
And don't even get me started on what I found when I Googled "bilirubin in urine"... it was terrifying 🙂 .... The doctor mentioned that the urine culture could be ready in just a few hours at the local private clinic. Is that actually possible? I thought you had to wait days for that... Thanks in advance for the help...

Those urine results are most likely incidental findings; they need to be repeated. And you definitely need to get that culture done, which it sounds like you already are. Best regards.

bluebadger12 said:Thanks to both of you for staying on top of my case! Looking at the results as the eighth one mentioned, there’s presence of Bilirubin and ketones, though maybe the amount is small enough that according to the reference range, both should be considered negative. (It's that thing with the plus signs—up to +++ counts as negative, and I have ++, which feels a bit silly, but okay.)

Aside from that, everything else in the sediment is negative, except for Leukocytes at 20 and quite a few bacteria... everything else is negative, doesn't even have those silly plus signs... And yeah, I’m feeling some pressure in my lower abdomen even though I don't have trouble urinating. But since most of my issues stem from my own head and hypochondria, suddenly my kidneys hurt and this and that... alright, fine, it's just my head, but then I start thinking I have some severe disease involving my testes, kidneys, bladder... it's awful... getting a urine culture tomorrow...

No, we interpreted the urine results correctly. To be clear, a Bilirubin result of "++" is not a normal finding. A normal result would be "neg." That is how it should appear on the report.

The notation "neg to +++" simply indicates that the possible results can be: neg, +, ++, or +++. Only the "neg" label represents a normal finding, and that label is located in the final column (that column specifies what the normal result should be).

Your result falls into the first column and is marked as "++", which is not a normal finding.

However, we have already concluded that these are likely false elevations since your blood Bilirubin levels are normal.

Therefore, our previous advice stands (repeat the qualitative urine test and proceed with the urine culture).

Best regards. 🙂

bluebadger12 said:Thanks to both of you for staying on top of my situation! Based on the results, as the eight mentioned, there is some presence of Bilirubin and ketones—though, presumably, the amounts are so minuscule that they still fall under "negative" according to the lab's reference range. (It’s that weird system where anything up to three pluses counts as negative, and I have two pluses... a bit nonsensical, but whatever.)

Aside from that, everything else in the sediment came back negative, except for Leukocytes at 20 and quite a few bacteria... the rest was all clear—not even any silly plus signs left. And yeah, I am feeling this pressure in my lower abdomen, even though I haven't had any issues actually urinating. But since most of my problems seem to stem from my own head and a healthy dose of hypochondria, suddenly my kidneys start hurting and then this and that... well, it's just my mind playing tricks. Then I find myself spiraling, thinking I have some catastrophic disease involving my testes, kidneys, bladder... just awful. I'm doing a urine culture tomorrow...

Let us know how the urine culture turns out! I am genuinely curious to see what they find.🙂

The urine culture results come back the next day if everything stays sterile. If something actually grows, they have to subculture it on a different medium, which adds another day or two while they run the antibiogram... basically, you aren't getting those results in just a few hours.

Olivia Hayes89 said:Post the urine culture results! I’m dying to know what they come back 🙂

So, checking in again—the urine culture came back COMPLETELY STERILE!

I honestly don't know who's losing their mind here or what's actually going on, but there it is. Like, if there was some kind of infection, could it really just vanish in a day and a half because I drank some cranberry tea? One minute I'm looking at high Leukocytes and a ton of bacteria, and the next, everything is "clean." It’s driving me crazy because I have no clue how to process this... Maybe the pain is just my GERD acting up, or maybe I'm just spiraling and overthinking things in my own head. Either way, I'll probably just go get the test redone anyway... 😕

bluebadger12 said:So, I’m checking back in—the urine culture came back COMPLETELY STERILE!

I honestly don't know who's losing their mind here or what on earth is going on, but seriously? If there was an infection, how does it just vanish in a day and a half because of some herbal tea? One minute I've got high Leukocytes and a ton of bacteria, and the next, everything is "sterile." It's driving me insane because I have no clue what to make of this... Maybe the pain is actually caused by GERD, or maybe it's just all the anxiety I'm manufacturing in my own head. Either way, I'm going to have to redo the test... 😕

You really need to repeat that test; it might have just been contamination.

Because of the medications I’m currently taking, I make it a point to get my blood work done regularly, and this time I decided to include a urine test for the first time.

Here are the results from yesterday (urine):
For the most part, everything looks normal: pH 5.0, specific gravity 1.025, glucose negative, Bilirubin negative, ketones negative, Erythrocyte/Hb negative, proteins negative, Urobilinogen normal, nitrites negative, leukocyte esterase negative....

However: appearance was cloudy, color yellow, Leukocytes 8-10, Erythrocytes 2-3, squamous epithelium - plenty, bacteria - plenty

I should mention that I’m not experiencing any discomfort or symptoms at all. This was just a routine check-up. I usually have a tendency toward bladder infections, so if something were actually wrong, I doubt I would miss it—there's no stinging or anything like that.

Is it possible to get a result like this because I didn't realize I needed to provide a urine sample? I actually went to the bathroom right before heading to the lab. I barely had anything left to pass, so it took me a few minutes to force myself to go for the analysis, and instead of a midstream sample, it was just the initial (and only) flow.
What should I do now? I really don't want to take antibiotics unless it's absolutely necessary, especially since I feel fine. For what it's worth, my blood leukocytes are 9.2.

Bloodwork - all within range: Erythrocytes 4.45, hemoglobin 132, hematocrit 0.408, MCV 91.7, MCH 29.7, MCHC 324, RDW-CV 12.7, leukocytes 9.2, neutrophils 64.4, lymphocytes 21.7, MID 13.9, platelets 274, PDW 12.8, MPV 9.8, ESR 12
Other values - glucose 4.8, urea 3.8, creatinine 86, AST 16, GGT 10, potassium 4.3, cholesterol 5.2, Triglyceride 0.6

Regarding the blood work, what I'm curious about is that last time my iron was low. I took treatment for a month, but on this report, I don't see iron listed—unless I'm just missing the abbreviation (last time it explicitly said "Iron, Fe"). Because of that, I'm not sure where my levels stand now. Also, my monocytes were high last time, but I don't see that here either...

I'm taking these results to my primary care physician next week, but until then, I'm wondering where those bacteria in my urine came from. Perhaps it really is just because I wasn't prepared and provided the sample incorrectly.
Thanks..

Dear Kyle Lee7,

1. Regarding the urine results, you hit the nail on the head: the sample wasn't collected properly. Because the stream was caught too early, the final part of the urethra wasn't "flushed," leaving the sample contaminated. It’s essentially dirty, making it unreliable for any real analysis.

2. Contamination can easily produce these kinds of results. In other words, this doesn't necessarily point to a urinary tract infection. In fact, given your situation—zero symptoms, improper collection technique, and a high presence of epithelial cells—it looks much more like a contaminated sample than an actual infection. Furthermore, your leukocyte count isn't particularly high; strictly speaking, up to 5 leukocytes per field is standard, though many labs consider 5–10 to be the upper limit of normal.

Be sure to mention your own observations to your doctor—specifically the lack of symptoms and the issue with how the sample was taken.

Whether you need a urine culture to rule out an infection is entirely up to your primary care physician's discretion.

3. Iron was not tested this time. Looking at the results you provided, there is no mention of iron; you correctly noted its absence.

4. In your differential blood count, they have specified neutrophils and lymphocytes, but the remaining cells (including monocytes) are tucked away under the "MID" category. That is where the monocytes are hiding.

It's a matter of how the machinery works. Some analyzers split white blood cells into three groups: granulocytes, lymphocytes, and MID. Others use five groups: granulocytes, lymphocytes, monocytes, eosinophils, and basophils—which is the breakdown we are more accustomed to seeing.

Based on your report, your neutrophil and lymphocyte counts look normal, but since the monocytes aren't listed separately, we can't determine their specific value.

On a final note, I should mention that you seem very well-informed on these matters and your conclusions are spot on.

Best regards. 🙂

Oh, thank you so much!
I'm not a doctor, just someone following along closely. 😁
I really believe people need to stay informed, especially when they’re dealing with a tedious chronic diagnosis.
The only thing I don't quite get is why the doctor didn't check on iron levels since they were low last time—she probably just forgot. Is it possible that those dizzy spells when moving from lying down to standing up (I notice it during my yoga practice, specifically during "Sun Salutations") could be linked to an iron deficiency, or maybe just low blood pressure?
My hemoglobin levels look normal on the blood work—so I guess I'm not technically anemic? That said, I don't eat meat very often, and I'm not exactly a huge fan of green vegetables either.

The dizziness you're feeling when standing up doesn't seem linked to low iron levels. I’d be more inclined to attribute those symptoms to low blood pressure or perhaps orthostatic hypotension—that sudden drop in pressure when you change positions.

Your assessment is spot on: with those hemoglobin, erythrocyte, and MCV numbers, you aren't technically anemic. If you want a real look at your iron stores, Ferritin is the metric to watch. When you schedule your next blood draw, make sure your doctor includes Ferritin, Iron, and TIBC on the lab order.

You're also right about the underlying cause. Between a diet lower in meat and the monthly iron loss that comes with being a woman, your reserves are clearly running low, putting you at a higher risk for iron deficiency.

bluebadger12 said:So, I’m checking back in—the urine culture came back completely sterile!

I honestly don't know who's losing their mind here or what's actually going on, but there it is. If there was some kind of infection, could it really just vanish in a day and a half because I drank some herbal tea? One moment I have high Leukocytes and a ton of bacteria, and the next, everything is "sterile." It's enough to drive me up the wall—I truly don't know how to process this... Perhaps the pain is just triggered by GERD, or maybe it's just the sheer anxiety I'm manufacturing in my own head. Regardless, I'll be repeating the urine test... 😕

There’s no reason to worry since the culture is sterile!
Just redo the test and make sure you collect the sample properly! 😉

Can anyone help me make sense of this—my MCHC is 348 (normal range is 320-345). It’s almost always elevated, yet my doctor never seems to comment on it... My potassium and sodium levels are consistently below normal, my cholesterol is up at 5.05, and my ALP is low at 50 (range is 54-119). Glucose is also low at 4.5—my doctor just chalks that up to hunger. On top of everything, I've been dealing with low blood pressure, dizziness, and those sharp pains around my heart for years now; they haven't found a cause, just labeled them as myalgia or non-specific chest pain.

Emily Walker said:Can anyone help me make sense of this? My MCHC is 348 (the range is 320-345). It’s almost always slightly high, yet my doctor never mentions it. Also, my potassium and sodium levels are consistently low, my cholesterol is up at 5.05, and ALP is lower than normal at 50 (should be 54-119). Glucose is also low at 4.5—though the doctor just chalks that up to hunger. On top of everything, I've dealt with low blood pressure, dizziness, and those sharp pains around my heart for years now. They haven't found a specific cause, just labeling it "myalgia" or "unspecified chest pain."

The doctor isn't commenting on the MCHC because it’s essentially fine—being slightly elevated doesn't really matter in this context! And your glucose isn't actually low; a normal range goes from 4.4 up to 7. As for the cholesterol, they usually recommend staying under 5, so yours isn't even significantly high...
It is quite possible that those sharp pains near your heart are actually just spasms in your intercostal muscles.

Olivia Hayes89 said:The doctor isn't commenting on the MCHC because it's fine—the elevation doesn't really matter! Glucose isn't low either; normal levels are between 4.4 and 7. They recommend keeping cholesterol under 5, so yours isn't actually that high...
And honestly, it's entirely possible that those sharp pains near your heart are just intercostal muscle spasms.

Thanks so much for the comment!😉

I'm wondering if we're looking at potential signs of a tumor here. We’re talking about an elderly person who’s been dealing with abdominal pain for a few days now. As for the lungs, they had some shadows on them a while back—some form of tuberculosis (they aren't a smoker)—but that was treated and cleared up a long time ago.

Radiology report:

On the summation imaging of the thoracic organs, there are several small, oval soft-tissue shadows seen perihilar on the right and in the caudal spread of the right hilus—summation effects, or perhaps nodular shadows?
The domes are well-aligned and positioned. Free costophrenic sinuses.
The heart shadow width is within normal limits, though the ascending aorta shadow appears prominent.

On the standing plain abdominal X-ray, there is one air-fluid level in the ileocecal region, with meteoritic loops of bowel without distension and no pneumoperitoneum.

WBC=5.1; Erythrocyte=4.16, Hb=128, Hct=0.83, MCV=92.1, MCH=30.8, MCHC=334, RDW=12.1, Platelets=161, MPV=10.3, Glucose=5.2, Urea=3.0, Creatinine=55, Bilirubin=8, Amylase(S)=29, CRP=2.7

Diagnosis: Chronic cholelithiasis
Suspicious for colon neoplasm.

Olivia Hayes89 said:There’s really nothing to worry about since the urine culture came back sterile!
Just redo the test and make sure you provide the sample correctly this time! 😉

So, I went ahead and got a second urine test done just to double-check things after that sterile culture, and I felt like I should share the update with everyone here.

Basically, the color looks exactly how it’s supposed to look now—not cloudy anymore. Leukocytes are at 1, squamous epithelium is at 3, and everything else is totally negative. It’s honestly wild; there isn't even any Bilirubin, or anything else, no bacteria, just all negatives. I still can't quite wrap my head around how a lab error like that can happen, especially since I gave the sample the exact same way I did the first time, yet this result is completely different and, more importantly, clean. I'm not even going to dwell on $100 and how much I was stressing over whether I was actually sick 🤷 Thanks, everyone!

boldwalker12 said:I'm wondering if this points toward some kind of tumor? We're talking about an elderly person who's been dealing with abdominal pain for a few days now. Regarding the lungs, there was history of shadows on the lungs—some form of tuberculosis (they aren't a smoker)—but that was treated a long time ago.

Radiology report:

On the summation imaging of the thoracic organs, there are several small, oval soft-tissue shadows visible perihilar on the right and in the caudal spread of the right hilus—summation effects, or perhaps nodular shadows?
The domes of the diaphragm are well-defined and positioned correctly. Free left costophrenic sinuses.
Heart shadow width is within normal limits, though the ascending aorta shadow appears prominent.

On the upright non-contrast abdominal image, an air-liquid level is visible in the ileocecal region; there are meteorismic loops of bowel without distension and no pneumoperitoneum.

WBC=5.1; Erythrocyte=4.16, Hb=128, Hct=0.83, MCV=92.1, MCH=30.8, MCHC=334, RDW=12.1, Platelets=161, MPV=10.3, Glucose=5.2, Urea=3.0, Creatinine=55, Total Bilirubin=8, Amylase(S)=29, CRP=2.7

Diagnosis: Cholelithiasis (Gallstones)
Suspicion of colon neoplasm (colon cancer)

Cholelithiasis = Gallstones.
Suspicion of colon neoplasm = Suspected bowel cancer/tumor.
Mild anemia; all other blood counts are normal.
They need to see a pulmonologist immediately for follow-up via CT scan and bronchoscopy.