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Old 07-27-2013, 10:53 PM   #1
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Help understanding test results?

Hi! I went to the doctor a week ago after having some heart palpitations that worried me. Other issues that I have had over the past year or two have included headaches, nausea, restless leg syndrome, canker sores (almost constant) fatigue, very bad heartburn (I have been seeing a GI doctor for this for more than a year, have been taking Rx Zantac for it), stomach cramps, heavy periods and a few other things that I'm sure I'm forgetting right now.

I hadn't been seeing a GP for a number of years, just going to my Gyn and GI doctors. I scheduled to see a new GP and she ran bloodwork for a number of things including celiac, lupus and thyroid. The test results came in via the online thing on Friday, so I haven't been able to talk to the doctor yet. She did call in an Rx for ferrous sulfate twice per day with vitamin C too. She said the lab results showed my thyroid to be normal and I am negative for celiac. Nothing was mentioned about the Lupus, so I am guessing that is normal too. The notes just say iron deficiency anemia, to start the new medicine and to come in for a re-check in 4 weeks.

From what I have read online, it looks like my heavy periods plus taking the PPI (Zantac) could probably be leading to this anemia; but I don't really know what to do about either of those. My heartburn is really, really bad. I can sometimes go off of Zantac for a week or two; but then have to go back on something as it just gets too bad. And I can't do birth control pills to control my periods - I did that before and it messed with my blood pressure and increased my migraines. I have considered a hysterectomy; but I'm just not sure if I'm ready to do that (I do have kids and don't plan to have more; but mentally I just can't bring myself to do a hysterectomy...)

I have tried to include all of the results - normal, high and low. I have the highs in red, the lows in blue. And then there was one comment from the doctor interpreting the lab results that I can't figure out what it is supposed to mean and haven't been able to figure it out from google.

If anyone can look at these and help me to understand a little more. I mean, if it were to come down to serious health problems or a hysterectomy I'd obviously do the hysterectomy. But is this at "serious" yet? I do realize that I'm always tired, and I'm happy to find out that maybe it isn't just that I have gotten lazy or something. ;-) But should the supplements most likely fix everything? Or should I prepare that I might have to do the hysterectomy or figure something else out for my acid reflux (surgery has been discussed for that; but if possible I'd like to avoid that too!)?

Anyway... the lab results include this:

TSH 2.95 Normal normal is 0.4 - 4.5
Ferritin 4 Low normal is 10 - 154
ANA Screen/IFA Negative normal is negative
Gliadin AB/IGA 8 Normal less than 20 is antibody not detected
ImmunogobulinA 205 Normal normal is 81 - 463
Tissue Transglutaminase 1 Normal
CBC Morphology Normal
Absolute Basophils 39 Normal Normal is 0 - 200
ABSOLUTE EOSINOPHILS 147 Normal Normal is 15 - 500
ABSOLUTE LYMPHOCYTES 2813 Normal Normal is 850 - 3900
ABSOLUTE MONOCYTES 755 Normal Normal is 200 - 950
ABSOLUTE NEUTROPHILS 6047 Normal Normal is 1500 - 7800
BASOPHILS 0.4 Normal
EOSINOPHILS 1.5 Normal
HEMATOCRIT 33.8 Low Normal is 35.0 - 45.0
HEMOGLOBIN 10.4 Low Normal 11.7-15.5

LYMPHOCYTES 28.7 Normal
MCH 20.6 Low Normal is 27 - 33
MCHC 30.8 Low Normal is 32.0-36.0
MCV 66.8 Low Normal is 80.0-100.0

MONOCYTES 7.7 Normal
NEUTROPHILS 61.7 Normal
PLATELET COUNT 349 Normal Normal is 140-400
RDW 20.7 High Normal is 11.0-15.0
RED BLOOD CELL COUNT 5.06 Normal Normal is 3.80-5.10
WHITE BLOOD CELL COUNT 9.8 Normal Normal is 3.8-10.8
COMMENT(S): Red blood cell agglutination present.
ALBUMIN 4.2 Normal Normal is 3.6-5.1
ALBUMIN/GLOBULIN RATIO 1.6 Normal Normal is 1.0-2.5
ALKALINE PHOSPHATASE 69 Normal Normal is 33-115
ALT 15 Normal Normal is 6-29
AST 14 Normal Normal is 10-30
BILIRUBIN, TOTAL 0.3 Normal Normal is 0.2-1.2
BUN/CREATININE RATIO NOT APPLICABLE 6-22
CALCIUM 9.5 Normal Normal is 8.6-10.2
CARBON DIOXIDE 25 Normal Normal is 19-30
CHLORIDE 106 Normal Normal is 98-110
CREATININE 0.75 Normal Normal is 0.50-1.10
eGFR AFRICAN AMERICAN 118 N > OR = 60
eGFR NON-AFR. AMERICAN 102 N > OR = 60
GLOBULIN 2.7 Normal Normal is 1.9-3.7
GLUCOSE 94 Normal Normal is 65-99
POTASSIUM 3.9 Normal Normal is 3.5-5.3
PROTEIN, TOTAL 6.9 Normal Normal is 6.1-8.1
SODIUM 141 Normal Normal is 135-146
UREA NITROGEN (BUN) 8 Normal Normal is 7-25
IRON BINDING CAPACITY 465 High Normal is 250-450
IRON, TOTAL 26 Low Normal is 40-175

 
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Old 07-28-2013, 08:14 PM   #2
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Re: Help understanding test results?

I have iron deficiency anemia also. Your numbers are very similar to mine. (I'll include the relevant ones below.) My doctor referred to my anemia as "mild." Since I'm male and the averages for men are higher than for women, my numbers are slightly further off from the average than yours are. Thus, your anemia is most certainly mild, too. I was also put on an iron and vitamin C supplement.

Your anemia could easily be a consequence of menstruation. Because I'm male, my doctor immediately sent me to an oncologist. After eliminating all the bad possibilities, mine seems likely to be runner's anemia. I run 52 miles a week. You do have a lot more symptoms than I do, however. Fatigue was my only symptom and is what landed me in my doctor's office.

My white blood cell count is different from yours. Mine is on the lower end of normal and yours is on the higher end of normal. I don't know if that's significant.

My doctor believes the iron supplement will correct my anemia. Hopefully it will correct yours, too! I am to have further blood work in 1-2 months. Good luck!

IRON 24
TOTAL IRON BINDING CAPACITY 380
FERRITIN 5.6
RBC, AUTO 4.52
HGB 10.6
HEMATOCRIT 34.2
MCV 75.6
MCH 23.5
MCHC 31.0
RDW, BLOOD 18.0
PLATELETS, AUTOMATED COUNT 206

Last edited by Erik2K13; 07-28-2013 at 08:30 PM.

 
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Old 07-31-2013, 09:48 AM   #3
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Re: Help understanding test results?

34me you also need to get further thyroid testing. Your TSH is a bit high. You need Ft4 and Ft3 test. Do not expect your doctor to know this are where it should be in the range. Being low thyroid can keep you from hanging on to iron.

I have had this problem for a year trying to get my iron up and it is because of my low Ft3.

Please get this tested there are so many with undiagnosed thyroid problems.
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Old 07-31-2013, 11:11 PM   #4
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Re: Help understanding test results?

Thanks for the thoughts.

How would I approach my doctor about the thyroid stuff? I don't really want to go and say, "I looked it up on the internet and I think that you are wrong, I need to have more thyroid tests done." KWIM?

I had half way expected there to be a problem with my thyroid as quite a few of my family members have thyroid problems.

 
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Old 08-01-2013, 08:48 AM   #5
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Re: Help understanding test results?

I understand what you mean 34me. I just ask my NP what I want tested and she writes it on the lab sheet.
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Old 08-03-2013, 04:32 PM   #6
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Re: Help understanding test results?

34me ask your doctor for a second opinion.

Also even at the lower range of the "normal" levels you wouldn't have enough iron.

The National Blood Transfusion Service in the UK will not take blood from any women with a HB lower than 12, and tricologists regularly see women with hair thinning and loss who have ferritin levels lower than 40.

One of my SIL has heavy periods and is on iron tablets for life. Her level hovers between 10 and 11. As long as you can cope with the side effects of both you will be fine.

In regards to whether your anemia is mild or not when I was aneamic I had a higher iron level than one of my friends' but I had more servere side effects. Unfortunately if you have another illness as well even if it's not linked to the anaemia, then your symptoms can be a lot worse than someone with a lower level.

 
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Old 08-03-2013, 08:57 PM   #7
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Re: Help understanding test results?

Your blood results are very consistent with iron deficiency anemia, and that should improve with the iron replacement. Your fatigue and restless leg syndrome are related to the anemia, but I agree that TSH is higher than ideal, and that could be part of the fatigue problem too. Since your heartburn is so bad, I wonder if you have an ulcer that is bleeding and contributing to the anemia. That can be checked by a stool test for hidden blood or a scope. Have you ever been on a stomach med stronger than Zantac, a PPI, like Nexium, Protonix, omeprazole? That might be more effective for the heartburn. In addition to the free T3 and T4, I would ask for antithyroid antibodies to be checked.

 
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Old 08-03-2013, 10:52 PM   #8
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Re: Help understanding test results?

For a while my GI doctor had me on Rx Zantac and one other one, I can't remember which one. At this point Zantac has been able to control it (though a high dose) though, so that is all that I have been on for about the last year.

I'll talk to the doctor next week. Thanks for all of the advice.

 
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