Lab Feedback Requested - I'm Confused on Some of This!

[OnMyWay2Thin]

Hello,

I just got my labs back and I'm not sure what to think. My doctor is out today so I can't get her feedback, and besides, I value the experts on here! I've given the name of the test, range, then my level following the comma. Here they are:


Parathyroid Hormone, Intact 14-64, 24 - Good, I think
Calcium 8.6-10.2, 8.9 - Should I try and increase this, maybe add another dose, it is trending up

Red Blood Cell Count 3.80-5.10, 3.65 - Low, do I need to do anything?
RDW 11.0-15.0, 15.4 - High, I've got to look up what this is, not sure if I need to do anything
Hemoglobin 11.7-15.5, 11.3 - Low, I've got to look this up, too
Absolute Neutrophils 1500-7800, 8022 - High, looking this up
Hematocrit 35.0-45.0, 34.6 - Low, do I need to do anything?
Ferritin 10-232, 265 - High
White Blood Cell Count 3.8-10.8, 10.9 - High
HDL Cholesterol >46, 40 - Low

Neutrophils Didn't give range, 73.6%
Basophils Didn't give range, .2%
Lymphocytes Didn't give range, 22.0%
Vitamin D, 25 OH, D3 Didn't give range, 36
Monocytes Didn't give range, 3.1%
Vitamin D, 25 OH, D2 Didn't give range, <4
Eosinophils Didn't give range, 1.1%

Glucose 65-99, 81
LDL Cholesterol <130, 79
MCV 80-100, 94.9
Albumin 3.6-5.1, 4.4
Potassium 3.5-5.3, 4.0 - I had been low last time, with my prescription potassium, I think I'm now good
Alkaline Phosphatase 33-115, 62
Protein, Total 6.1-8.1, 6.8
Vitamin D, 25 OH, Total 30-100 , 36
Iron Binding Capacity 250-450, 275
Absolute Monocytes 200-950, 338
Urea Nitrogen (BUN) 7-25, 22
Chol/HDLC Ratio <5.0 , 3.4
MCH 27-33, 30.9

Globulin 1.9-3.7 , 2.4
Chloride 98-110, 107
Prealbumin 19.5-35.8, 20
AST 10-35, 15
eGFR African American >60 , 131
Absolute Eosinophils 15-500 , 120
Creatinine .50-1.10 , .54
Platelet Count 140-400 , 243
Albumin/Globulin Ratio 1.0-2.5, 1.8
Carbon Dioxide 19-30, 21
Hemoglobin A1C <5.7 , 4.9 - This is my second test where it's normal, do you think my diabetes is gone?

Non HDL Cholesterol No range given, 94
ALT 6-29 , 20
MCHC 32-36 , 32.6
% Saturation 11-50 , 19
Absolute Basophils 0-200, 22
eGFR Non-AFR American >60 , 113
Cholesterol Total 125-200 , 134
Sodium 135-146, 141
Triglycerides <150, 76
Bilirubin, Total .2-1.2 , .9
Calcium 8.6-10.2, 8.9
Iron, Total 40-190, 52
Absolute Lymphocytes 850-3900, 2398

Vitamin A No range given, 40
Beta-Gamma-Tocopherol No range given, .3
Alpha Tocopherol No range given, 12.7

Folate, Serum No range given, 18.2
Vitamin B12 200-1100, 670

I'm going to try and look up what a few of these things mean. I'm also not seeing my Vitamin E and K tests, and am not sure if my A and D are okay because they didn't give a range! Let me know if you see anything else missing.

Any assistance you can provide in deciphering this lab test is greatly appreciated! As always, thank you very much.

Have a wonderful day,
Kelly

[newyorkbitch]

You need more calcium, more D, you need more protein (see your pre albumin level) and you need to see a hematologist.

[OnMyWay2Thin]

Thank you, NYB. I'll call the doctor's office to get the referral to the hematologist now. I'll up the Calcium and D, hopefully, that will do it! I just finished researching and it appears I'm anemic I'll set up the hematologist appointment as soon as possible. Hopefully, the doctor can get me in quickly because I'm sure he or she won't infuse at my first appointment.

I appreciate your assistance,
Kelly

[newyorkbitch]

Nov 5, 2014 9:46:10 GMT -5 OnMyWay2Thin said:

Thank you, NYB. I'll call the doctor's office to get the referral to the hematologist now. I'll up the Calcium and D, hopefully, that will do it! I just finished researching and it appears I'm anemic I'll set up the hematologist appointment as soon as possible. Hopefully, the doctor can get me in quickly because I'm sure he or she won't infuse at my first appointment.

I appreciate your assistance,
Kelly

As soon as you have your hematologist appointment set up, send over a copy of these labs with a note that you'd like the doctor to review prior to your visit and that you'd like to consider being infused at your appointment. You will save time and hopefully get infused at the first visit - maybe not, but it could help.

How much calcium and D are you taking now? How's your protein intake?

[OnMyWay2Thin]

That's a great idea, thank you, I'll do that.

I'm taking the following:

Calcium Citrate + D with Magnesium: I'm taking four doses which equals 2000 calcium mg and 1000 Vitamin D in these pills
Dry Vitamin D: I take one a day which is 5000 IU
Protein: Last few days are Tuesday 153, Monday, 167, Sunday 137 (these numbers include one 40 gram protein drink)

I'm waiting on my referral to the hematologist, the lady in the office wants to get the okay from the doctor to refer me.

Thanks, again, NYB,
Kelly

[newyorkbitch]

Nov 5, 2014 10:09:40 GMT -5 OnMyWay2Thin said:

That's a great idea, thank you, I'll do that.

I'm taking the following:

Calcium Citrate + D with Magnesium: I'm taking four doses which equals 2000 calcium mg and 1000 Vitamin D in these pills
Dry Vitamin D: I take one a day which is 5000 IU
Protein: Last few days are Tuesday 153, Monday, 167, Sunday 137 (these numbers include one 40 gram protein drink)

I'm waiting on my referral to the hematologist, the lady in the office wants to get the okay from the doctor to refer me.

Thanks, again, NYB,
Kelly

You need much more dry D. Lots of DSers take 50,000 per day. I take 100,000 and my levels are low normal. Have you looked at vitalady's recommendations?

Up your calcium citrate per day. You can buy calcium citrate in a bigger dose. Citracal Max has 630 mg per dose (2 tabs) so that ends up 2520 per day in 4 doses. The D in those pills is doing absolutely nothing for you so don't count it as D because it's not dry D.

You need to increase your protein. Try to get up to 175 every day, consistently, for the next 3 months and then do labs again.

[OnMyWay2Thin]

As always, great advice. Yes, I look at Vitalady frequently, now I need to implement and not just look... I'm taking the iron she recommends but I'm afraid I still need the infusion which I may actually prefer. I'll jump on her site and get some dry D.

Thanks again,
Kelly

[newyorkbitch]

Nov 5, 2014 10:37:15 GMT -5 OnMyWay2Thin said:

As always, great advice. Yes, I look at Vitalady frequently, now I need to implement and not just look... I'm taking the iron she recommends but I'm afraid I still need the infusion which I may actually prefer. I'll jump on her site and get some dry D.

Thanks again,
Kelly

Get A, E, and K from her too.

I take zinc too - low zinc can also be a factor in low pre albumin. (Actually I take the whole vitalady regimen)

[OnMyWay2Thin]

Just ordered it all, I should be doing better with labs in no time. Hopefully, the hematologist referral comes through shortly.

Thanks again,
Kelly

[fullhousemom]

www.irondisorders.org/anemia-of-chronic-disease

I have struggled with iron anemia and have needed iron infusions. They did not come until I was fully examined by my hematologist and it was determined that I could not absorb iron (via iron absorption tests). This took about two or three appointments. I would not expect an infusion on your first visit, and if someone gave you one, I would question their professional ethics, not to mention the likelihood of your insurance paying for them. They need to fully diagnose the cause of the low levels first.

Most DSer infusions are iron, and most that I have seen here, are ordered because of very low ferritin levels. Your ferritin is above normal, which is odd for most DSers. Your hemoglobin/hemacrit levels are most troubling to me, and I would expect that your hema will perform an exam and come up with a diagnosis and path for recovery. I think it would be careless to expect infusions, namely iron, on your first appointment.

Let us know how your appointment goes. Best wishes.

[newyorkbitch]

Just to clarify, I think it wouldn't hurt to mention it and send the labs - as I said, it might not help, but it certainly can't hurt.

[illinids2]

Nov 5, 2014 21:28:14 GMT -5 fullhousemom said:

www.irondisorders.org/anemia-of-chronic-disease

I have struggled with iron anemia and have needed iron infusions. They did not come until I was fully examined by my hematologist and it was determined that I could not absorb iron (via iron absorption tests). This took about two or three appointments. I would not expect an infusion on your first visit, and if someone gave you one, I would question their professional ethics, not to mention the likelihood of your insurance paying for them. They need to fully diagnose the cause of the low levels first.

Most DSer infusions are iron, and most that I have seen here, are ordered because of very low ferritin levels. Your ferritin is above normal, which is odd for most DSers. Your hemoglobin/hemacrit levels are most troubling to me, and I would expect that your hema will perform an exam and come up with a diagnosis and path for recovery. I think it would be careless to expect infusions, namely iron, on your first appointment.

Let us know how your appointment goes. Best wishes.

This is exactly why I am seeing a hematologist. ..normal iron but anemic....my surgeon's office told me to take iron without even noticing that my ferritin is 280. I stopped my iron until I see the hematologist.

Your link is what I am trying to find out if is the root cause of my issues. I will let Kelly and the board know what I find out. .

[PeteA]

Could you be having some other issue that is pushing up your Ferritin? Sorry if I missed this in the thread but high Ferritin can have to do with general inflammation and might not have anything to do with iron. I've had some on-going health issues the pushed my ferritin levels up. It is hard to always draw a line between ferritin levels and iron if other things are going on. Just a thought.

While your B12 is in the normal range it doesn't hurt to push it up some more. I know there were a lot of other thoughts on your levels
I think they did a good job of going in to what you might add.

Pete