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

urbanangler6 said:if anyone can help out here:

-white blood cells 5 ref(3.4-9.7)
-neutrophils 30 ref(44.0-72.9)
-basophils 1.1 ref(0.0-1.0)
-lymphocytes 50 ref(20.0-46.0)
-monocytes 13 ref(2.0-12.0)

WBCs look fine, but neutrophils are running low while basophils, lymphocytes, and monocytes are all a bit up. Everything else seems standard.
I don't really have any symptoms to speak of, other than feeling a little more wiped out than usual, though I just figured that was the spring weather and hitting the gym pretty hard lately. My stomach's been acting up too, but since I deal with gastritis, that’s basically my baseline. Anything here worth worrying about? 🕺

Honestly, it could just be some random virus you've been fighting off for a few days and you're currently in the tail end of recovery.

But hey, that's just me looking at these bare-bones numbers.
Your doctor is going to be the one to actually make sense of this, since they're the ones who see the whole clinical picture. 😉

Hey, I'm Mary,
I'm 64. About 5.5 years ago, I had surgery on my kidney—cancer, but thankfully no metastasis—and ever since then, I've been super prone to UTIs. Up until a year ago, it was mostly E. coli and Proteus mirabilis (counts between 10,000 and 100,000). When it hit that 100,000 mark, I’d take Cefixim once a day for a week, or just try to chug water and hope for the best.
About a year back, I ended up in the hospital with a nasty respiratory infection and had to use a catheter for five days. They put me on six IV doses of Sumamed and twelve Klavocin tablets.
Six months after that, I did a urine culture. The results showed 10^6 CFU/ml—gram-positive cocci and an equal amount of gram-negative rods. The note basically said the sample wasn't great and the bacterial isolate should be considered colonizing flora.
My doctor prescribed Klavocin twice a day for ten days.
Now, two months later, the results look almost identical, though the bacteria dropped slightly to 10^4.
The lab insists I contaminated the sample. They won't hear a word about how my diabetes, hypertension, and diuretics make things difficult... honestly, I'm waking up to pee nearly every two hours at night. There is zero chance I can properly clean up right before giving a sample because if I don't make it from the bed to the toilet in ten seconds, well... it's a mess. And that's also why I can never catch a perfect midstream flow.
Please, I need advice: how am I supposed to provide a "clean" sample when dealing with incontinence? And do I really need to go on another round of antibiotics?

Thanks,
Mary

I'm 51 years old. I just went in for an EMG on my legs because of some spinal issues—basically sciatica—and this was the result they gave me:
The EMG of the legs shows signs of severe acute L5 radicular lesions, chronic severe left-sided, and bilateral severe S1 radicular lesions, along with conduction disturbances in the tibial and deep peroneal nerves on both sides within the respective myotomes related to the radicular lesions.
Could someone please help me out? If anyone knows what all this jargon actually means, could you explain it to me in plain English?

Betty Gray36 said:Thanks for the reply. I'm not sure how useful this will be, but we also did HLA typing which showed: A2/ ND B35/ND DR16/11 DQ1/3
The current diagnosis is seronegative arthritis, though nothing concrete has been established—specifically, the exact cause of this joint swelling remains undefined. No other issues with the remaining joints..

You have HLA-B35, which is linked to a specific type of enteropathic arthritis (Type 1)—joint inflammation seen in patients with inflammatory bowel diseases (like ulcerative colitis or Crohn's disease) and other intestinal issues.

That is what the HLA typing indicates.

I agree that a diagnosis of seronegative arthropathy/arthritis would be the logical option for now.

Megan Jones27 said:Thanks for the response! I agree...
I suppose she'll need to see an internist privately then (any recommendations?), since going back to her primary doctor and begging for a referral isn't working out.

I don't have anyone specific to recommend. Try asking in the "Looking For..." thread.

Michelle Morris74 said:Please help me interpret these results. My mother has rheumatoid arthritis. Because her rheumatologist suspected multiple myeloma after hearing her full list of symptoms, they ran a serum protein electrophoresis. Her gamma is 18.3 (ref range 8.9–13.5), while albumin is 52.4 (ref range 55.8–66.1). They also found an M-protein in the gamma fraction. Consequently, she had blood work done for immunoglobulins; here are the full results:

Immunoglobulin levels
Immunoglobulin levels
Immunoglobulin levels
Rheumatoid factor 109
The serum protein immunofixation electrophoresis noted: Monoclonal IgG kappa type
Autoimmune serology ENA-screen was positive
Anti-SS-A/Ro (60 kDa) 131 (normal up to 30)
Anti-SS-A/Ro (52 kDa) 179 (normal up to 30)
Anti-SS-B/La 66 (normal up to 30)
Other antibodies are normal
ANF. Negative
CA 242 tumor marker normal......0.8

I know she needs a 24-hour urine test and a bone marrow biopsy, but in the meantime, could you provide an opinion or analysis of these findings? The issue is that she presents with all the symptoms associated with that malignancy, which is why the doctor became suspicious, and naturally, we are terrified. I am sincerely asking for any help you can provide based on these results.

Your mother has monoclonal gammopathy; that’s the extent of what these results tell us. Essentially, several different conditions could fall under this umbrella based on this finding (monoclonal IgG kappa). Primarily, we're looking at multiple myeloma and its variants, or MGUS (Monoclonal Gammopathy of Undetermined Significance). MGUS is a condition where there's a risk—roughly 1% annually—of progressing to multiple myeloma, while for others, it remains benign and requires no treatment.

One cannot determine which path she is on based solely on this test. However, the fact remains that MGUS—the more favorable option—is asymptomatic. You, conversely, mentioned that your mother is exhibiting "all the symptoms of multiple myeloma."

She also deals with rheumatoid arthritis (potentially involving secondary Sjögren's syndrome or overlap with systemic lupus erythematosus, given the positive anti-SS-A and SS-B antibodies; though these can also appear in RA cases), which certainly needs to be factored in. But if her symptoms truly align with multiple myeloma, then that diagnosis becomes much more probable.

Without the specific tests mentioned, determining whether this is multiple myeloma or not is impossible.

Kyle Mendoza16 said:I’d really appreciate it if Nicholas Myers could clear out his inbox just a little bit. I’ve been trying to send him a message, but it won't go through. Thanks so much.

The inbox fills up incredibly fast. With my current schedule, I simply don't have the bandwidth to read or respond to private messages. Managing this volume has become a burden, and frankly, it's eating into the limited free time I have to actually participate in the forum discussions. Consequently, I've decided to stop accepting private messages for the time being.

If you have a question, please post it here. When I have a moment and if I can provide an answer, I will.

Thanks for understanding. 🙂

Jessica Chavez4 said:So the issue was the hemoglobin, thanks. It isn't critically low yet, but it's heading that way—they scared me because they said it was terribly low. I had a gynecological exam which is why the tests were done; stool samples haven't been analyzed yet. I've been referred to hematology and have an appointment scheduled. They told me to bring my records, but didn't specify if I should come fasting or if they'll be drawing blood again during that first visit.

No, the hemoglobin is definitely too low and requires treatment once the cause is identified. I'm not sure what kind of referral you received, but typically with any referral (even an A1 which covers the minimum), one specific test can be included, so they should be able to perform it there. Therefore, I think it would be wise to arrive fasting if at all possible.

Michelle Barnes53 said:Hi, I'm Mary,
I'm 64 years old. About five and a half years ago, I had surgery for kidney cancer (no metastasis), and since then, I've been quite prone to urinary tract infections.

Your inquiry doesn't make it entirely clear whether you are currently experiencing symptoms like burning during urination, discharge, or similar issues. What exactly is the indication for the urine culture?

I'm trying to figure out what this stuff on my CBC means
what do these abbreviations actually stand for? (never seen them before):

(K) LUC
(K) MXIV
(K) LI—this one’s bugging me because there’s no reference range listed

Megan Ross36 said:I'm curious about what these specific abbreviations on a CBC (complete blood count) result
actually mean regarding these low values (first time seeing them):

(K) LUC
(K) MXIV
(K) LI—this one is particularly interesting since there's no reference range listed

LUC stands for large unstained cells. This category includes atypical lymphocytes and blasts. An elevated value might point toward the presence of blasts (immature white blood cells) or atypical/reactive lymphocytes (lymphocytes that swell due to antigen stimulation, such as from viral infections like EBV, CMV, or viral hepatitis).

MXIV isn't a standard term; you likely meant MPIX—the mean peroxidase index. A high value could stem from megaloblastic anemia, an infection, or certain types of leukemia. Conversely, a low value might indicate congenital or acquired peroxidase deficiencies, or certain leukemias.

LI refers to the lobularity index. If this is low, it suggests the presence of immature leukocyte forms, specifically blasts.

Maria Fisher46 said:LUC—large unstained cells—basically covers atypical lymphocytes and blasts. A high number could mean you've got blasts (immature white blood cells) or just reactive/atypical lymphocytes (cells that swell up from antigen stimulation, like when you're fighting off stuff like EBV, CMV, or viral hepatitis, etc.);

There’s no such thing as MXIV... you probably meant MPIX—mean peroxidase index. If that's high, it could be megaloblastic anemia, an infection, some type of leukemia, etc. If it's low, it might point to certain congenital or acquired peroxidase deficiencies, or even certain leukemias.;

LI—lobularity index—if this is low, it suggests there are immature leukocyte forms or blasts present.

But it doesn't list any reference values for the LI on the report.
And those first two numbers are totally normal...

I suspect anything north of 1.9 is standard for Lupus International.

Maria Fisher46 said:I think anything over 1.9 is pretty standard for Lupus...

Thanks a ton. That’s exactly what me and my doctor found too. Usually seeing stuff between 1.9 and 3. It's so stupid they don't just list the range on the lab report, leaves you totally freaking out...

Quote: Felix the Cat

Maria Fisher46 said:So, you've got the HLA-B35 marker. I guess that means there's a link to a specific kind of enteropathic arthritis—Type 1, I think they call it. It’s basically when joint inflammation kicks in for people dealing with inflammatory bowel diseases, like Crohn's or ulcerative colitis, or just other gut issues. Maybe it's related, maybe not, but that's the connection.

That’s what comes through in the HLA typing, I guess.

I guess a diagnosis of seronegative arthropathy or arthritis would be on the table too. Maybe.

They usually talk about polyarthritis—you know, swelling in multiple joints—when discussing enteropathic arthritis. They also mention how it’s tied to bowel disease. In my case, though, I don't have polyarthritis, and there isn't any sign of intestinal issues either. I've never really had gut problems, to be honest. I went through the whole routine too: urine tests, swabs for chlamydia, ureaplasma, and mycoplasma, plus a stool culture. Everything came back totally clear. I guess I'm just left wondering how all of this fits into the bigger picture. It doesn't really add up.
Sorry for all the questions, but I’m just genuinely stumped here. I guess I'm wondering if there's any chance of some kind of mechanical failure that an MRI just wouldn't pick up?

Maria Fisher46 said:It’s not entirely clear from your inquiry whether you’re currently dealing with any symptoms—like burning during urination, discharge, or whatever else—basically, what exactly is the reason for the urine culture?

The whole point of this culture is just a follow-up with my urologist after kidney surgery... if the bacteria count comes back too high, like over 10^5, then I'm stuck taking more antibiotics.
This time things were a bit rougher—burning, constant trips to the bathroom, even some bleeding... so my primary care doctor figured a follow-up culture after ten days on Klavocin was standard procedure. But honestly, doctors hand out antibiotics like candy these days, so I definitely need a second opinion... 🙂

Maria Fisher46 said:Your mother has monoclonal gammopathy—that’s all those results tell us. Essentially, this finding (monoclonal IgG kappa) could point to several different conditions. The primary suspects are multiple myeloma and its various forms, or MGUS (Monoclonal Gammopathy of Undetermined Significance). MGUS is a condition where there's a certain percentage of patients who eventually progress to multiple myeloma—we're looking at about a 1% annual risk—but for everyone else, it stays benign and doesn't require treatment.

Based strictly on that one lab, we can't distinguish between the two options. However, the fact remains that MGUS—the more favorable scenario—is asymptomatic. You, on the other hand, mentioned that your mother is exhibiting "all the symptoms of multiple myeloma."

She also deals with rheumatoid arthritis—which might involve secondary Sjögren's syndrome or an overlap with systemic lupus erythematosus, given the positive anti-SS-A and SS-B antibodies (though, keep in mind, these can also show up in RA cases)—so that definitely needs to be factored into the clinical picture. But, if she truly is presenting with symptoms consistent with multiple myeloma, then that diagnosis becomes much more likely.

Without the specific tests I mentioned earlier, it's impossible to say for sure whether we're dealing with multiple myeloma or not.

Thank you so much for the response. We actually just had the bone marrow biopsy done, and I've included the results below. If you're able to help me make sense of them... maybe we can finally get some clarity? I am desperately hoping it turns out to be MGUS—I know that doesn't require treatment, just monitoring—and we are praying with all our hearts for that outcome. Here is the full content of the bone marrow biopsy report:

Erythropoiesis: present, morphologically normal
Granulopoiesis: present, all developmental stages present
Lymphocytic cells: not increased
Plasma cells: not increased
Thrombopoiesis: present, releasing platelets
Extramedullary cells: not swollen

MYELOGRAM

GRANULOPOIESIS: NORMAL
promyelocytes: 2 (1.0-6.0)
myelocytes: 19 (8.0-15.0)
metamyelocytes: 8 (9.0-25.0)
non-segmented: 12 (9.6-15.3)
segmented: 21 (6.0-12.0)
eosinophilic granulocytes: 1 (0.0-4.0)
lymphocytes: 20 (11.0-23.0)
plasma cells: 2 (0.4-3.9)

ERYTHROPOIESIS: NORMAL
basophilic erythroblasts: 2 (1.0-5.0)
polychromatic erythroblasts: 1 (5.0-20.0)
acidophilic erythroblasts: 12 (1.0-15.0)

CYTOCHEMISTRY
DCS: non-seg 1, seg 66, eo 1, baso 1, mono 4, ly 27, Tr ++

LE/RBC ratio 5.5:1 (norm. 3-4:1)

Conclusion: hypocellular bone marrow with white/red cell ratio.

Thanks again for your previous answer, and thank you in advance for your help with this next one.

Hey,

My wife gave birth five months ago. She’s always had some minor thyroid issues and takes Levothyroxine 50 mg regularly, so she just got some bloodwork back a few days ago. Here are the results—any thoughts? Thanks.

TSH - C0.05 µIU/ml (0.25-5.00 µIU/ml)
Anti-TG - 89.3 µIU/ml (<=18 IU/ml)
Anti -TPO - 501.0 µIU/ml (<=8 IU/ml)

TSH is low, antibodies are up. I guess they need to run T3 and T4 next—could be hyperthyroidism, maybe.

I was wondering if someone might be able to walk me through this urine culture result?
The test was ordered because I've been dealing with this constant, frequent urge to pee.
Result: Morganella morganii
AM AMC CTB GM CIP NOR SXT FM LVX CFM CN
0 0 3 3 3 3 3 0 3 3 0
Thanks so much in advance!

Hello there. Just got my blood work back and wanted to run these numbers by you all for a little clarity... ESR: 2 (4-24) L, Neutrophils: 41% (44-72) L, eosinophils: 7.4% (0-7) H, absolute eosinophils: 0.50 (0.00-0.43) H. Everything else seems fine. I'm a bit concerned about the low sedimentation rate, especially since this pattern has been sticking around for nearly three years now. My levels always seem to fluctuate like this—sometimes the lymphocytes are up, too. Given that this has been my "normal" for three years, should I actually be worried? Is this considered pathological, or should I push for more testing? Thanks.

Look, can someone please make sense of these blood work results for me? Neutrophils are at 34.6 (normal range 44-72), Lymphocytes are 48.9 (20-46), eosinophils are 7.1 (0-7), Monocytes are 4.34 (1.19-3.35), and eosinophils are 0.63 (0.0-0.43). Also, Alkaline Phosphatase is sitting at 20 (50-153).
Everything else looks totally fine!!

Can someone make sense of these mono results for me?

View on imgur

I know IgM means an active infection and IgG means a past one, BUT

I read somewhere that positive VCA/EA IgG means either a recent bout of mono or a reactivation. Is that actually right?
Basically, can you tell from these labs roughly when someone had mono? (My guess is for us, it was about 3-4 months ago—we brushed it off without any major symptoms). Does this data back that up?

Asking because the CBC just shows slightly elevated relative lymphocytes (not reactive!) and everything else looks totally fine, including liver enzymes (ALT; AST)

I'm trying to make sense of these parameters: LUC, LI, and MPXI.
Also, there are two types listed for Lymphocytes, Monocytes, Neutrophils, Eosinophils, and Basophils. Why are they broken down like that? Thanks.