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

Mark Anderson90 said:Thanks for getting back to me.
My spirometry results were normal—115/126/92. They haven't checked my bilirubin lately, but twice before, it was elevated at 29.7 and 22. They didn't check my haptoglobin. Sorry to be a nuisance, just a layman's question: Does hemolysis actually happen during anemia? If so, how is it that my Erc and Hgb aren't sitting at the bottom end of the scale?

The thing about my tonsils—I only mentioned it because I heard they can act as breeding grounds for all sorts of health issues, much like teeth.

Apologies for the delay; life got in the way and I couldn't get to the forum.

You're right to ask. Usually, with hemolysis, you'd expect Erc and Hgb to be at the low end or even below it.

There are, however, some very rare instances where you might see pathological hemoglobin alongside both erythrocytosis and hemolysis. That's why, as part of a full workup, a hemoglobin electrophoresis should probably be performed.

Best regards.

Sandra Hernandez9 said:Hepatitis markers
Hepatitis B surface antigen - non-reactive
Anti-HBsAg antibodies - 0.05 mIU/ml
Anti-HBc antibodies - non-reactive
Anti-HBc IgM antibodies - non-reactive
Anti-HBe antibodies - non-reactive
Hepatitis B e antigen - non-reactive
Anti-HCV antibodies - non-reactive

Enzymes
AST 39
ALT 77
yGT 59
Alkaline phosphatase 94 (ref. range 60-142)

It’s clear that the liver enzymes, which are only mildly elevated, seem to be trending downward. The question is whether follow-up liver function tests will be performed in the near future. It isn't as if the enzymes are at 1000 or higher, requiring constant monitoring. I suspect waiting at least a month would be the ideal window for a new check.

Since some diagnostic workup has already begun, it appears that viral hepatitis (B and C) is not the culprit behind this deviation.

There are numerous reasons why liver enzymes might spike. Often, these elevations are transient, and in many instances, the underlying cause is never even identified.

If you're wondering what could trigger a result like this, I'll tell you right now: it's a massive spectrum of possibilities. We're talking everything from medication or herbal supplements, sodas, dietary excesses, fatty liver, iron or copper storage diseases, autoimmune liver issues, thyroid problems, celiac disease, adrenal gland disorders, heart-related congestion, or enzyme deficiencies (like alpha-1 antitrypsin), among others. A vast array of different conditions.

If a full investigation proceeds, they will have to rule out these conditions one by one.

Thank you so much! She’s scheduled for an ultrasound this Monday—then we'll finally see what the next steps look like.

Hello everyone. Since my doctors seem completely stumped by my situation, I was wondering if anyone here might have an idea why my blood work has consistently shown low neutrophils and high lymphocytes for over a year and a half now? This all started right after I gave birth... My last normal blood count was back in November 2014, just a few days before delivery, when everything was perfectly within range. I am really looking for some guidance or direction on where to turn or which specialist to see who won't just dismiss my symptoms and lab results. I would be incredibly grateful for any help...

My most recent results from today:
http://i67.tinypic.com/2nsm6wg.jpg

If anyone recalls, I wrote quite a bit about all of this last year, but I don't mind repeating myself if necessary.

To add a bit more detail...

Iron/Fe: 10 (8-30)
TIBC: 64 (49-75)
UIBC: 53 (26-59)

Regarding symptoms... I'm still dealing with occasional digestive issues, specifically loose stools and strange pains. Last year, I frequently had this dull ache that would radiate from my abdomen to my back and vice versa. (I had an abdominal ultrasound and stool tests done back then, and everything supposedly came back normal). Then there are those mornings when I wake up feeling shaky, ravenously hungry, weak, and nauseous, accompanied by an urgent need to use the bathroom...

Occasionally, my face gets itchy and breaks out in bumps that look like mosquito bites. (It was the same last year; my scalp was quite itchy too, along with my face. Back then, my eosinophils were also above the upper limit.

I am naturally thin, but I have lost even more weight recently (I'm currently at about 95-97 lbs).

What kind of specialists should I see? Perhaps a nephrologist, a hematologist, or an infectious disease specialist? There has to be a logical explanation for these abnormal neutrophil and lymphocyte levels that have persisted for nearly two years...

Thank you.

Hi everyone,
I decided to go ahead and get some private lab work done to check my total and free testosterone levels.
Results: Total testosterone: 10.45 nmol/L (Ref. 6.07-27.10)
Free testosterone: 310.0 nmol/L (Ref. 91-579)

The symptoms I've been dealing with include insomnia, lack of motivation, mood swings, sensitive nipples, dizziness, and lethargy...

I'm 33 years old, 5'9", and weigh about 172 lbs.
Are my total testosterone levels considered too low for someone my age?
If they are, what should my next step be?
Thanks.

Noah Cook13 said:Greetings,
On my own initiative, I went to a private lab to get my total and free testosterone levels checked.
Results: Total testosterone: 10.45 nmol/L Ref. 6.07-27.10
Free testosterone: 310.0 nmol/L Ref. 91-579

The symptoms I'm dealing with are insomnia, lack of drive, mood swings, sensitive nipples, dizziness, lethargy...

I'm 33 years old, 5'9", and weigh about 172 lbs.
Are my total testosterone values too low for my age?
If they are, what should my next step be?
Thanks.

In my opinion, that total testosterone is borderline low. You definitely need to run these tests again. Furthermore, you really ought to get your PRL, LH, FSH, TSH, total and free testosterone, and estradiol checked—honestly, getting a full blood panel would be a smart move.

Maria Fisher46 said:Sorry for the late reply, man! Just been swamped with stuff lately and haven't had a second to hang out on the forum.

You're totally right, though—when you've got hemolysis going on, you'd usually expect the K. erythrocyte and Hgb to be sitting at the low end of the scale or even dropping below it.

That said, there are some super rare cases where you actually see pathological hemoglobin alongside both erythrocytosis and hemolysis. Because of that, it’s probably a good idea to get a hemoglobin electrophoresis done as part of the workup just to be safe.

Best,

My latest KKS results are pretty much identical: erythrocyte 5.74, MCV 82, MCHC 350, retic 25

And on the protein electrophoresis, these values are outside the normal range:

alpha 2 globulins - 7.0 (7.4 - 12.6)
beta globulins - 7.3 (7.5 - 12.9)
A/G ratio - 2.26 (1.10 - 1.80)

The rest:
Total protein: 79 (66-81)
Albumin - 69.3 (59.8-72.4)
alpha 1 globulin 1.8 (1.0-3.2)
gamma globulin 14.8 (8 - 15.8)

I'm gonna go get those tests you mentioned done privately and I'll hit you up with the results once they come in.

Megan Jones27 said:To add some context...

Iron/Fe: 10 (8-30)
TIBC: 64 (49-75)
UIBC: 53 (26-59)

Symptoms... Still dealing with intermittent digestive issues—mostly loose stools and strange pains. Last year, I constantly had this dull ache spreading from my abdomen to my back and vice versa. (Had an abdominal ultrasound and stool tests done back then; everything supposedly came back normal). Then there are those mornings where I wake up with tremors, intense hunger, weakness, and nausea accompanied by an urgent need for bowel movement #2.

Occasionally, my face gets itchy and breaks out in bumps, almost like mosquito bites. (Same thing happened last year; my scalp was pretty itchy too, along with my face. Back then, my eosinophils were also above the upper limit.

I’m naturally thin, but I’ve lost even more weight recently (currently at about 95-97 lbs / 43-44kg).

What tests should I look into? Nephrology, hematology, infectious disease? There has to be an explanation for these abnormal neutrophil and lymphocyte levels that have been hanging around for nearly two years now.

Thanks.

It’s unlikely an infectious disease specialist will be the answer, given you've been dealing with this for two years already. Honestly, it's surprising you haven't seen a gastroenterologist yet for a full workup, including a colonoscopy, considering the symptoms you described (abdominal pain, changes in bowel rhythm and consistency, etc.). Furthermore, it's surprising you haven't pursued endocrine testing (thyroid hormones, sex hormones, adrenal hormones, glucose levels...)!

If you're planning to handle all of this through private specialists, be prepared—you'll need a significant amount of cash for that!

How much time usually needs to pass after a bad cold before the blood work gets back to normal?

thx 🙂

Maria Fisher46 said:It’s unlikely an infectious disease specialist will be the key here, especially since you've been dealing with this for two years already. Honestly, it's surprising you haven't seen a gastroenterologist yet for a full workup—including a colonoscopy—given everything you mentioned, like the abdominal pain and changes in bowel habits. Beyond that, it seems odd that you haven't had an endocrine panel done to check thyroid levels, sex hormones, adrenal function, or blood glucose...

If you're planning to handle all of this through private specialists, you better brace yourself; it’s going to cost a fortune!

My doctor is truly unbelievable; she doesn't see a single issue. I went to her the other day with my latest labs and questions, and after all that, she basically just gave me a referral for ferritin. She keeps ignoring the other symptoms I've brought up a hundred times, claiming there's no reason for further testing because everything falls within "borderline" ranges and nothing looks alarming.

I suppose the problem is that whenever I see her, I act perfectly fine... maybe I should start faking intense pain and rolling around on the floor instead.

Clearly, my only option left is to take all these records to a private specialist, regardless of the cost...

brisknomad6 said:How long does it take for blood work to normalize after a cold?

thx 🙂

A complete blood count doesn't necessarily have to be off during a cold. If it is, things should stabilize within a few days. Usually within a week, at most two weeks.

Megan Jones27 said:It looks like I have no choice but to take all my records to a private specialist, regardless of the cost.

Switch doctors and save some money!

Hey there!

Just got my cortisol results back (the post-1mg dexamethasone test), but the lab didn't list the reference range. My doctor won't see me until the rest of the labs come in, so I'm stuck waiting. My level came back at 16 nmol/L. Is that considered a good result? Thanks. 🙂

analogpilot28 said:Hi there!

I just got my cortisol results back (post-1mg dexamethasone test), but they didn't list the reference range. My doctor won't see me until the rest of the labs come in. My level is 16 nmol/L. Is this considered a good result? Thanks. 🙂

Yes, it’s a normal result if the cortisol value is under 50 nmol/L.

Maria Fisher46 said:Yeah, the results are fine as long as the cortisol level stays under 50 nmol/l.

Alright, thanks for the answer. 🙂

Maria Fisher46 said:So, look, when you've just got a common cold, your blood work doesn't necessarily have to be messed up at all. And even if things do look a little funky on the labs, they should pretty much get back to normal within just a few days. Like, definitely within a week, or maybe two weeks tops if you're having a rougher time.

thanks 🙂

Hello everyone,

My father recently went in for a routine checkup—just a preventive screening to stay on top of things. He is 66 years old. As far as we can tell, he isn't experiencing any symptoms at all; there’s no pain, no issues with his appetite, and nothing seems out of the ordinary regarding his digestion... everything appears fine on the surface.

The lab results were as follows:

erythrocyte 2.96 hemoglobin 89 lymphocyte 12.3 eosinophil 2.4 basophil 5,75 (ref 4.34-5.72)
Hemoglobin - 168 (ref 138 to 175)
Hematocrit - 0.505 (ref 0.415 - 0.530)
MCV - 87.8 (ref 83.0-97.2)
MCH - 29.2 (ref 27.4 - 33.9)
MCHC - 333 (ref 320-345)
leukocyte 10.6 (ref 3.4-9.7)
Neutrophil seg. - 65.0 (ref 44-72)
eosinophil - 4.1 (ref 0-7)
basophil - 0.9 (0-1)
lymphocyte - 22.4 (20-46)
Monocyte - 7.6 (2-12)
Platelets - 253 (ref 158-424)
S-glucose - 5.30 (ref 4.40-6.40)
Urea - 8.4 (ref 2.8 - 8.3)
Creatinine - 109 (ref 64-104)
Amylase - 266 (ref 0-400)
AST - 24 (ref 11-38)
ALT - 22 (ref 12-48)
Cholesterol 6.6 (ref < 5.00)
Triglycerides 1.4 (ref < 1.7)
PSA - 1.69 (ref 0-4)

His urine analysis was completely normal.

Following that, he had some imaging done on his lungs.
A chest X-ray and a profile summary scan of the thoracic organs. The lung parenchyma shows clear transparency bilaterally. The sinuses are free. No acute infiltrates or pleural effusion were detected. The heart shadow looks normal.

After that, they took stool samples from three consecutive days to test for occult blood.
Day 1 - blood reaction - trace
Day 2 - blood reaction - positive
Day 3 - blood reaction - positive

Then he underwent an abdominal ultrasound.
The liver is normal in size, shape, and contour, and it appears Inhomogeneous. The gallbladder is free of pathological content. The pancreas is normal in size and Inhomogeneous. Both kidneys are normal in size and shape, with wavy contours and no signs of ectasia or lithiasis. The spleen is also normal in size and shape.

Because of this, I suggested he ask his doctor for a few more specific tests, so here is the additional information I requested he have performed.
Iron: 8.6 (ref 11-32)
UIBC - 51 (ref 25-54)
TIBC - 59 (ref 49-72)
CRP - 1.6 (ref < 5.0)
CEA - 0.6 (ref up to 5.0)
CA 19-9 - 8.6 (ref < 27)

Could this potentially be indicative of colon cancer? Is anyone able to interpret these findings, or is it impossible to say anything definitively until he undergoes a gastroscopy and a colonoscopy?

frozenheron53 said:Hey everyone,

My father just went for a routine physical—basically a preventative checkup. He’s 66. As far as we can tell, he isn't showing any symptoms at all; no pain, no issues with his stomach or appetite, nothing. Everything seems fine on the surface.

Here are the results:

Erythrocytes - 5.75 (ref 4.34-5.72)
Hemoglobin - 168 (ref 138 to 175)
Hematocrit - 0.505 (ref 0.415 - 0.530)
MCV - 87.8 (ref 83.0-97.2)
MCH - 29.2 (ref 27.4 - 33.9)
MCHC - 333 (ref 320-345)
Leukocytes - 10.6 (ref 3.4-9.7)
Neutrophil seg. - 65.0 (ref 44-72)
Eosinophil - 4.1 (ref 0-7)
Basophil - 0.9 (0-1)
Lymphocytes - 22.4 (20-46)
Monocytes - 7.6 (2-12)
Platelets - 253 (ref 158-424)
S-glucose - 5.30 (ref 4.40-6.40)
Urea - 8.4(ref 2.8 - 8.3)
Creatinine - 109 (ref 64-104)
Amylase - 266 (ref 0-400)
AST - 24 (ref 11-38)
ALT - 22 (ref 12-48)
Cholesterol 6.6 (ref < 5.00)
Triglycerides 1.4 (ref < 1.7)
PSA - 1.69 (ref 0-4)

Urinalysis was normal.

After that, he went to get his lungs checked out.
Chest X-ray and profile summation imaging of thoracic organs. Lung parenchyma shows normal bilateral transparency. Free phrenic sinus. No acute infiltrates or pleural effusion found. Heart shadow appears normal.

Then, he took a stool sample from three different days to test for occult blood.
Day 1 - blood reaction - trace
Day 2 - blood reaction - positive
Day 3 - blood reaction - positive

Following that, he had an abdominal ultrasound.
The liver is normal in size, shape, and contour, and it looks homogeneous. The gallbladder has no pathological content. The pancreas is normal in size and homogeneous. Both kidneys are normal in size and shape, with wavy contours and no signs of ectasia or lithiasis. The spleen is normal in size and shape.

Because of this, I recommended he ask his doctor for some additional tests, so here is what I asked him to request.
Iron: 8.6 (ref 11-32)
UIBC - 51 (ref 25-54)
TIBC - 59 (ref 49-72)
CRP - 1.6 (ref < 5.0)
CEA - 0.6 (ref up to 5.0)
CA 19-9 - 8.6 (ref < 27)

Could this potentially be colon cancer? Can anyone interpret these results, or is it impossible to say anything until he undergoes a gastroscopy and colonoscopy?

It’s possible the blood is coming from hemorrhoids, but he definitely needs a full colonoscopy to 100% rule out cancer or even polyps.
He should also get his ferritin checked, along with a 24-hour proteinuria test and creatinine clearance.
Does he have any issues with blood pressure?
What does the complete lipid panel look like (LDL, HDL)?
Depending on those results, he might be put on a statin, like Lipitor 10mg or Crestor 5-10mg.
Is he taking any medications (aspirin, NSAIDs)?

vividsailor7, thank you so much for getting back to me. Regarding my father, he does struggle with blood pressure issues... I believe he is currently on medication for it. He makes it a point to check his levels at home every single morning, and so far, they always seem to come back within a normal range.
As for the lipid panel, his doctor didn't actually order those specific tests for him. Everything he has had checked is what I’ve listed here...

Here is the list of medications he takes on a daily basis:
- Rivotril 0.5 mg (two tablets, three times a day) - prescribed for his hand tremors
- Iruzid 1 tablet in the morning (10+12.5 mg)
- Propranolol Sandoz 40 mg (half a tablet in the morning, half at noon)

I showed him your response, and I suggested that he should ask his physician about moving forward with those specific tests. In the meantime, he is just waiting on the call to schedule his upcoming gastroscopy and colonoscopy...

Once again, I truly appreciate your help and your response.👍

Could you please help me make sense of this EMG report? I'm trying to understand what these findings actually point toward.
CONCLUSION: Mild chronic natural lesions were noted in the left abductor digiti quinti and left extensor digitorum brevis muscles. The neurographic findings appear normal.
Repetitive stimulation test: During stimulation of the right median nerve with registration over the right abductor pollicis brevis muscle, there was neither an increase nor a decrease in CMAP amplitude (neither at 3Hz nor at 11Hz).
The EMG results suggest a mild chronic radicular lesion at C8/TH1 LEFT and L5 left.
I already know about the disc protrusions at L5 S1 and TH12L1, as well as degenerative changes at C5-C6 and C6-C7. There's some suspicion regarding myasthenia gravis, but honestly, I'm more worried about the constant pain in my shoulders, elbows, my entire thorax, and my knees... I get tingling in my hands and feet, and the absolute worst part is all these random shooting pains throughout my body... There's a lot more to it, but I don't want to overwhelm you. Thank you again for all the answers you've provided in my previous posts.🙏