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Low WBC & platelets, normal RBC, low iron, gastro issues


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Old 03-04-2013, 01:48 PM   #1
L2308S
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Low WBC & platelets, normal RBC, low iron, gastro issues

Hello,
I am looking for direction for any additional areas of testing which I can pursue.
(posted this under general health by accident so apologize for repeat post)

Bloodwork shows:
  • Low WBC (-neutrophils)
  • Low platelets (-high MPV)
  • Normal RBC (-high RDW - normal hemoglobin, hematocrit, MCV, MCH)
  • Very low iron

Symptoms:
  • Persistent gastrointestinal issues and more recently chest pain in the sternum area.

Background:
  • Gastrointestinal issues for ~ 8 years. Colonoscopy ~7 yrs ago - no issues.
  • Ultrasound completed recently due to onset of abdominal pain - no issues.
  • Platelets & WBC persistently low.
  • Onset of low iron within past year. Consume ample iron through diet so suspect it is due to malabsorption/gastro issues. Currently taking 1200mg ferrous glutinate daily - still within low iron range despite taking 1200mg for ~5 months.
  • Was borderline on B12 but took sublingually and now on very high side so no issues with sublingual absorption of B12. (Again, suspect gastro issues).
  • TSH hovers on lower end, but within range.
  • Digestive enzymes greatly relieve gastro symptoms.
  • Doctors are saying that it is stress related (for 8 years??) - unlikely to me given time and not feeling stressed
  • Waiting on results of FOBT, parasite/bacteria testing, and at recommendation of doctor trying food intolerance testing next.

Health Background:
  • Personal history of focal myositis and family history of hairy cell leukemia.

Last edited by L2308S; 03-04-2013 at 01:51 PM.

 
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Old 03-04-2013, 02:17 PM   #2
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

I hope my response won't be overwhelming to you, but you have several things suggestive of gluten intolerance and perhaps pernicious anemia. Let me explain-gluten intolerance, if it is causing celiac disease, causes malabsorption of iron from the small intestine, as well as other nutrients. It also causes many GI symptoms, ranging from nausea, bloating after meals, GERD, diarrhea or constipation, cramping, etc. Often diagnosed as IBS by mistake. There are antibody tests for celiac disease, and endoscopy with small bowel biopsy is diagnostic. B12 deficiency can occur when your GI tract lacks intrinsic factor, also an autoimmune process, and requires supplementation or anemia and many neurological symptoms can develop. I would bet that you are Vit D deficient as well, and would get that tested too. Your low WBC and platelets also suggest a possible autoimmune disorder, perhaps lupus, and sometimes several AI disorders co-exist in one person. So not inconceivable to have celiac disease, lupus, and pernicious anemia simultaneously. I am not saying that is what this is, I am just saying there are some clues here that could be followed in that direction. (Sorry you asked that question?) Lupus can also cause iron deficiency anemia, so a test for that would be reasonable, especially if you have other symptoms. You can see a list of common symptoms on the lupus board sticky notes at the top of page or research it online to see if anything else fits. In a nutshell, here are some things worth checking: urinalysis, ANA, sed rate, CRP, Chemistry panel, CPK-all for lupus screening/myositis, and transglutaminase and endomysial antibodies for celiac disease. Then add a Vit D and folate level (malabsorption) and consider intrinsic factor and/or antiparietal cell antibodies for the pernicious anemia possibility. If any more clues come up, to be followed by more specific testing. Myositis can be a symptom of autoimmune diseases as well. Your PCP MAY be willing to do all these, or some, and the GI Dr could do some as well, with follow up to a rheum if autoimmune screenings look positive. Like I said, I hope this isn't too much to hear, but if you've been told for 8 years you are stressed, UMMM..., someone hasn't been thinking, trying, or knowledgeable enough to look further. Pernicious anemia is associated with lack of HCL in stomach, called achlorhydric gastritis, which may explain why your digestive enzymes help some.

Last edited by ladybud; 03-04-2013 at 02:21 PM. Reason: added last sentence

 
Old 03-04-2013, 02:35 PM   #3
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

On a more positive note, now that I clobbered you with a boulder, all these tests are simply blood tests except urine and biopsy, of course, and all these things are treatable. Knowing exactly what is wrong will get you specific treatment so you feel better! Some things are easy to treat, like the vitamin deficiencies, some a little harder and take more time, effort, but all with the goal of feeling better and having better health overall. Please post back your thoughts and follow-up results when you get them. Hope your Dr is not reluctant to consider these ideas.

Last edited by ladybud; 03-04-2013 at 02:36 PM. Reason: left out a word

 
Old 03-04-2013, 02:55 PM   #4
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

Wow! Thank you very much for the thorough reply. I am so happy to have so many suggestions. I will certainly see if I am able to run through those tests that you indicated with my doctor.

Do you know if celiac or lupus can take some time to properly show up in tests? About 7 years ago I got a full colonoscopy done and they said it should have picked up celiac. The doctors seem hesitant to redo this procedure again but I'm concerned that perhaps things might have been missed or it may take time to show up properly???

I believe they also tested me for lupus/rheumatoid arthritis during that time 7 years ago due to joint pain, which also came back negative - again, would this maybe be false negative in early stages?

Recently one of the dr's suggested pernicious anemia. They told me to take sublingual B12 which rapidly increased my b12 levels from borderline to VERY high so they now said it was unlikely to be pernicious anemia. Can you have pernicious anemia and still have success with b12 supplementation, or is this correct that it is unlikely due to success of supplementation?

 
Old 03-04-2013, 02:57 PM   #5
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

...and sorry right back for my long reply!!
Hope it's not too much to ask for the additional clarification.

 
Old 03-04-2013, 03:41 PM   #6
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

No problem-good questions! To paragraph 2 & 3 YES & YES. A colonoscopy does NOT pick up celiac disease. It is a small intestine disease, biopsies are done thru an upper endoscopy into the jejunum, first part of small intestine. A small bowel follow thru xray can diagnose celiac often without endoscopy, so that is possible, but I would get the blood tests first. Pernicous anemia is very treatable with B12 supplements either sublingual or injections. You just can't absorb B12 thru the stomach or small intestine with it, so the oral form doesn't help. SL is absorbed thru the membranes of the mouth, where intrinsic factor is not needed, so that was erroneous information. Good luck with all this. Don't curtail your gluten intake before your antibodies are tested-it could cause a false negative. It took 10 years for my lupus test to turn from negative to positive in spite of obvious symptoms. A little longer than most, so at seven years, worth retesting.

Last edited by ladybud; 03-04-2013 at 03:42 PM. Reason: correction

 
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Old 03-05-2013, 07:47 AM   #7
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

Thank you, and thank you again!
Very helpful. I will certainly be following up with my doctors with some of your suggestions when I go in for my next follow up appointment.

 
Old 03-05-2013, 07:54 AM   #8
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

Please give us some followup when you get to the bottom of this! We all learn from one another, one of the advantages of the boards.

 
Old 03-11-2013, 01:09 PM   #9
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

Well, this is a surprise! My ova & parasite test results came back indicating I have tested positive to 'dientamoeba fraglilis'.

Apparently this parasite can often be misdiagnosed as IBS (which a couple of doctor's suggested to me, but which I didn't really want to accept because IBS is a 'syndrome' or affect, not a 'cause').

Interestingly enough, many years back I was travelling through very remote regions of Central & South America so perhaps it was something that I picked up a very very long time ago. I'm unsure if it's possible to survive that long in someone, but given my symptoms have been ongoing for so long I wonder....

In a few weeks I will be able to tell if the treatment will resolve my issues.

I suspect that it is all correlated: parasite causes diarrhea/steatorrhea symptoms, because of my gastro issues nutrients/minerals are not properly absorbed, because nutrients are not absorbed you suffer from symptoms of malabsorption (low iron, blood counts etc).

Here is a description of the parasite:
{DELETED}

Last edited by Mod-S4; 03-15-2013 at 09:05 PM. Reason: This board is for your own writing only. Please don't post text from other sources. Thanks.

 
Old 03-14-2013, 06:40 PM   #10
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

I received my tests back and it appears that I have been host to a parasite called 'dientamoba fragillis' (dientamoeba fragilis).

According to what I've read there have been a lot of studies that link this particular parasite to IBS - like symptoms. In one study 35% of people diagnosed actually were host to this parasite! Historically it had been thought of as a non-pathogenic parasite, however, there seems to be enough research to indicate it can cause symptoms.

From my research the symptoms are as follows:
-chronic diarrhea and/or passing of mucus
-abdominal pain
-loss of appetite
-weight loss
-nausea
-chronic fatigue
-eosinophilia

Also can have side effects from malabsorption
-fatigue
-hair loss
-sometimes skin irritation or pain in the joints.

I am currently undergoing treatment with metronidozole (Flagy). I will provide an update if this seems to alleviate my issues.

 
Old 03-15-2013, 08:56 AM   #11
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

WOW, what a diagnosis! So happy you got an answer, are on treatment, and on your way to getting better! Thanks for posting your outcome. It will undoubtedly help others think of additional possibilities to consider, especially those with IBS.

 
Old 03-19-2013, 07:36 AM   #12
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Re: Low WBC & platelets, normal RBC, low iron, gastro issues

Right on the mark ladybud! Even if it isn't always the solution for those diagnosed with IBS, at least this may encourage others to persist and keep pushing to find an answer.

I will post another separate memo below outlining my entire list of symptoms, tests, etc which might help others with similar issues determine if it's at least an area for them to explore.

 
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