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    Old 10-18-2008, 03:55 PM   #1
    Masta
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    Question I'm new to all of this... and I dont understand my labs

    Hell everyone. This is my first posting on this board. Iím trying to figure out whatís wrong with me. Recently was diagnosed with fibromyalgia and chronic fatigue syndrome. I feel that there may be a different diagnosis out there other than my doctor putting me on more anti depressants and now a stimulant to give me more energy. I went to an internist with a list of blood tests I wanted done after some research.

    i have got the results back but donít know what any of it means yet I go back to the internist end of this month
    .
    Theres are all of them I just asked the lab over the phone to give me a few of them that were out of the normal range

    Rheumatoid Factor Serum range 0-14 mine is 7 (does this mean I have arthritis?) my mom has RA
    ANA is negative
    HSCRP is range 9.9 (elevated, I know this means Iím suffering with some sort of inflammatory condition)
    ESR is 25 also elevated
    ALT is below normal 6
    AST is elevated 51
    CMP is elevated 110
    Wondering if it may be lupus or some sort of other inflammatory problem?

    My health history: im a chronic asthmatic on advair and albuterol. on depression meds wellbutrin and lexapro. On topamax for severe migraines. My body aches really bad and my body creaks or pops a lot all over when I move, and I have no energy. So I fit the symptoms for fibro and chronic fatigue.

    Im in the process of finding out of I have a thyroid problem have an apt next month with an endo specialist. My hormones are all over the place and my TSH is 4.58. I suffer with pcos.

    Any of you out there with advice please help. If there are blood tests that you could suggest I ask my internist to do to rule out arthritis or RA that would be great. Or should I just get a referral to see specialist that deals with arthritis?

     
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    Old 10-19-2008, 04:49 AM   #2
    AuntieLeela
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    Re: I'm new to all of this... and I dont understand my labs

    Your rheumatoid factor is within normal range, so it's negative. That doesn't rule out RA, 20% or more of people with RA are RF-.

    CMP usually stands for "Comprehensive Metabolic Panel", a panel of 14 different blood tests each with their own value. I'm not sure which test you're referring to here. ALT and AST are part of CMP as well as glucose, calcium, albumin, total protein, four tests for electrolytes, two tests for kidney function and four liver tests ALP, ALT, AST and Bilirubin.

    ALT and AST are often used in ratio to each other, but I don't know the math or values involved. ALT is more specific to liver disease and I don't think being below normal is a bad thing, but I don't really know. AST is elevated in liver diseases (usually with an increase in ALT too) but also post heart attack. It might be elevated due to one or more of your medications.

    Your ESR or SED rate is elevated at 25 but not wildly high. It's a non-specific test for inflammation.

    HSCRP, High Sensitivity C Reactive Protein is a screening tool for cardiovascular disease. Anything higher than 3 is considered VERY HIGH, the actual measurement cuts of at 10. In RA they use the plain CRP test, the HSCRP test is too sensitive for chronic inflammatory conditions. Maybe with your asthma and possible inflammatory arthritic condition (whatever it is) caused a super high false positive. 9.9 is crazy high.

    I would suggest you see a rheumatologist, they're used to "diagnostic detective work"

    Last edited by AuntieLeela; 10-19-2008 at 04:52 AM.

     
    Old 10-19-2008, 03:19 PM   #3
    Masta
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    Re: I'm new to all of this... and I dont understand my labs

    Thanks for the reply Aunti Leela. the cmp high level was chloride.

    im going to call my internist tomorrow and see if he can give me a refferal to a rheumatologist.

    how often does a false negative happen?

    Masta

     
    Old 10-20-2008, 07:43 AM   #4
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    Re: I'm new to all of this... and I dont understand my labs

    Let me rephrase . . . 9.9 is crazy high for a healthy person but it's LOW for someone with a serious chronic inflammatory condition.

    HSCRP tests the range 0 to 10. It has to be super sensitive to test in this low range.

    CRP tests 10 to 1000. It's used to test for the high inflammation you'd see in chronic inflammatory diseases like Asthma, RA, Lupus, SLE or Crohns disease. (among others)

    It's why those of us with chronic inflammatory disease are at greater risk than the general public for cardiovascular disease.

    High inflammation in our bodies isn't just bad for our joints or lungs - it's bad allover. Once we get the disease, whichever one it is, under control our CV risks diminish.

    Last edited by AuntieLeela; 10-20-2008 at 07:47 AM.

     
    Old 10-20-2008, 09:36 AM   #5
    Masta
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    Question New to the thyroid world and need help please...

    I’m a 36/f and new to the thyroid world. I am going to see an endocrinologist for the first time early next month. I have gone and gotten all my lab records.

    I have read that the normal OPTIMAL ranges for hypothyroid are Adult Range: 0.35-2.1 miliIU/L online somewhere. I know AACE new labs guidelines are 0.3 to 3.04 as of 2002. My labs guidelines are way off so of course I have never been diagnosed with anything.

    Because of researching and looking at my labs I made my doctor do the thyroid testing on 10/14/08.

    My labs have been:
    10/14/08 - Free T3 is 2.4. Free T4 is 0.82. TPO Ab is 0.3. TgAb is 0.0
    10/07/08 - TSH was 2.83.
    09/10/08 - TSH was 4.58. T3 was 96
    07/26/07 - TSH was 3.23.
    08/21/06 - TSH was 3.38
    07/09/03 - TSH was 2.87. DHEA was 171
    06/13/02 - TSH was 2.60
    08/23/00 - TSH was 2.73

    My on 10/14/08 my DHEA was 150 (optimal range 350 – 430), Testosterone Total Free was 5.5 (optimal range is 1.4-2.2)

    Meds I’m on: wellbutrin & lexapro (depression), topamax (migraines), advair and albuterol (asthma). Calcium and Omega 3’s. Use to suffer from pcos and use to take metformin. Doctors say I no longer need to take it. I know I still have hormone issues

    Have been told I have fibromyalgia and chronic fatigue syndrome (have all the symptoms for both). I think there is more to it then that.

    I don’t know if topamax has an effect on the TSH number at all, I was told it’s a dopamine drug and it could have an affect with your labs (don’t know if this is true or not).

    I have done a 24hr urine collection to check my adrenals waiting to hear back on the results.

    ****My question to all you experts out there is this…. Are there any other tests I should get? Based on my labs, do you think I have hypothyroidism, hashis or something else?****

    Last edited by Masta; 10-20-2008 at 06:51 PM. Reason: need some help

     
    Old 10-21-2008, 12:33 PM   #6
    Masta
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    please help me understand these labs.. new to this board.. scared

    I did a 24hr urine collection 10/15/08. My doctor hasnít called me back.

    urine volume 2450 mL
    urine creatinine 54 mg/dL
    24hr Ur Cr *1323
    urine free cortisol (raw data) *<1
    Cortisol ug/g crt * see note
    Free Urine Cortisol * see note

    *The urinary free cortisol result is less than 1.0 ug/L which is the limit of quantitation for the assay. Based upon the Creatinine of this sample, the Urinary Free Cortisol is less than 1.9 ug/g crt.
    *then is says right underneath it all in capital letters*
    Low levels may be consistent with adrenal insufficiency.
    Cortisol Free Urine Reference range: <45.0.
    Unit: ug/d

    *The urinary free cortisol result is less than 1.0 ug/L which is the limit of quantitation for the assay. Based on the total volume of this sample, the Urinary Free Cortisol is less than 2.5 ug/d.
    *then is says right underneath it all in capital letters*
    Low levels may be consistent with adrenal insufficiency.
    Cortisol Urine Free (Raw data) unit: ug/L
    Reference Range 700-1600
    Unit:mg/d

    I have an appointment with a endo early November. I think I am suffering from hypothyroidism and other health problems.

    Any advice is welcome.

     
    Old 10-21-2008, 12:37 PM   #7
    Masta
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    desperate for advice...

    Iím a 36/f and new to the thyroid world. I am going to see an endocrinologist for the first time early next month. I have gone and gotten all my lab records.

    I have read that the normal OPTIMAL ranges for hypothyroid are Adult Range: 0.35-2.1 miliIU/L online somewhere. I know **** new labs guidelines are 0.3 to 3.04 as of 2002. My labs guidelines are way off so of course I have never been diagnosed with anything.

    Because of researching and looking at my labs I made my doctor do the thyroid testing on 10/14/08.

    My labs have been:
    10/14/08 - Free T3 is 2.4. Free T4 is 0.82. TPO Ab is 0.3. TgAb is 0.0
    10/07/08 - TSH was 2.83.
    09/10/08 - TSH was 4.58. T3 was 96
    07/26/07 - TSH was 3.23.
    08/21/06 - TSH was 3.38
    07/09/03 - TSH was 2.87. DHEA was 171
    06/13/02 - TSH was 2.60
    08/23/00 - TSH was 2.73

    My on 10/14/08 my DHEA was 150 (optimal range 350 Ė 430), Testosterone Total Free was 5.5 (optimal range is 1.4-2.2)

    Meds Iím on: wellbutrin & lexapro (depression), topamax (migraines), advair and albuterol (asthma). Calcium and Omega 3ís. Use to suffer from pcos and use to take metformin. Doctors say I no longer need to take it. I know I still have hormone issues

    Have been told I have fibromyalgia and chronic fatigue syndrome (have all the symptoms for both). I think there is more to it then that.

    I donít know if topamax has an effect on the TSH number at all, I was told itís a dopamine drug and it could have an affect with your labs (donít know if this is true or not).

    I have done a 24hr urine collection to check my adrenals waiting to hear back on the results.

    ****My question to all you experts out there is thisÖ. Are there any other tests I should get? Based on my labs, do you think I have hypothyroidism, hashis or something else?****

    I did a 24hr urine collection 10/15/08. My doctor hasnít called me back.

    urine volume 2450 mL
    urine creatinine 54 mg/dL
    24hr Ur Cr *1323
    urine free cortisol (raw data) *<1
    Cortisol ug/g crt * see note
    Free Urine Cortisol * see note

    *The urinary free cortisol result is less than 1.0 ug/L which is the limit of quantitation for the assay. Based upon the Creatinine of this sample, the Urinary Free Cortisol is less than 1.9 ug/g crt.
    *then is says right underneath it all in capital letters*
    Low levels may be consistent with adrenal insufficiency.
    Cortisol Free Urine Reference range: <45.0.
    Unit: ug/d

    *The urinary free cortisol result is less than 1.0 ug/L which is the limit of quantitation for the assay. Based on the total volume of this sample, the Urinary Free Cortisol is less than 2.5 ug/d.
    *then is says right underneath it all in capital letters*
    Low levels may be consistent with adrenal insufficiency.
    Cortisol Urine Free (Raw data) unit: ug/L
    Reference Range 700-1600
    Unit:mg/d

    I have an appointment with a endo early November. I think I am suffering from hypothyroidism and other health problems. Any advice is welcome.

     
    Old 10-21-2008, 05:30 PM   #8
    pinkpixies
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    Re: please help me understand these labs.. new to this board.. scared

    I don't know anything about those tests...but you peed lots! LOL I only did 1800 ml on my 24 hour and I thought that was a lot. hehe When I was really dehydrated and in the hospital I was only doing 400 ml a day and I didn't really understand how little that was. >.<

     
    Old 10-21-2008, 08:32 PM   #9
    Masta
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    Re: please help me understand these labs.. new to this board.. scared

    i was thirsty that day!! hehehe....

    whatever i drink, it comes right out like like im on duirectics, but im not. weird eh.

    i wish my doctor would give me the time of day. my back is aching like no other.

    blood test showed:
    HSCRP is range 9.9 (elevated, I know this means Iím suffering with some sort of inflammatory condition)
    ESR is 25 also elevated
    ALT is below normal 6
    AST is elevated 51
    CMP (chloride) is elevated 110

    if anyone knows how to interpret the urine test please let me know so i can stop worrying. Thanks

     
    Old 10-22-2008, 07:59 AM   #10
    Masta
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    Exclamation Do i have AI? im desperate for answers

    I did a 24hr urine collection 10/15/08. My doctor hasnít called me back.

    urine volume 2450 mL
    urine creatinine 54 mg/dL
    24hr Ur Cr *1323
    urine free cortisol (raw data) *<1
    Cortisol ug/g crt * see note
    Free Urine Cortisol * see note

    *The urinary free cortisol result is less than 1.0 ug/L which is the limit of quantitation for the assay. Based upon the Creatinine of this sample, the Urinary Free Cortisol is less than 1.9 ug/g crt.
    *then is says right underneath it all in capital letters*
    Low levels may be consistent with adrenal insufficiency.
    Cortisol Free Urine Reference range: <45.0.
    Unit: ug/d

    *The urinary free cortisol result is less than 1.0 ug/L which is the limit of quantitation for the assay. Based on the total volume of this sample, the Urinary Free Cortisol is less than 2.5 ug/d.
    *then is says right underneath it all in capital letters*
    Low levels may be consistent with adrenal insufficiency.
    Cortisol Urine Free (Raw data) unit: ug/L
    Reference Range 700-1600
    Unit:mg/d

    ALT is below normal 6
    AST is elevated 51
    CMP is elevated 110
    Have had an MRI Ct scan on brain all looks ok.

    Donít know if I have a thyroid problem

    Iím a 36/f and new to the thyroid world. I have gone and gotten all my lab records.

    I have read that the normal OPTIMAL ranges for hypothyroid are Adult Range: 0.35-2.1 miliIU/L online somewhere. I know AACE new labs guidelines are 0.3 to 3.04 as of 2002. My labs guidelines are way off so of course I have never been diagnosed with anything.

    Because of researching and looking at my labs I made my doctor do the thyroid testing on 10/14/08.

    My labs have been:
    10/14/08 - Free T3 is 2.4. Free T4 is 0.82. TPO Ab is 0.3. TgAb is 0.0. DHEA 150
    10/07/08 - TSH was 2.83.
    09/10/08 - TSH was 4.58. T3 was 96
    07/26/07 - TSH was 3.23.
    08/21/06 - TSH was 3.38
    07/09/03 - TSH was 2.87. DHEA was 171
    06/13/02 - TSH was 2.60
    08/23/00 - TSH was 2.73

    My on 10/14/08 my DHEA was 150 (optimal range 350 Ė 430), Testosterone Total Free was 5.5 (optimal range is 1.4-2.2)

    Meds Iím on: wellbutrin & lexapro (depression), topamax (migraines), advair and albuterol (asthma). Calcium and Omega 3ís. Use to suffer from pcos and use to take metformin. Doctors say I no longer need to take it. I know I still have hormone issues

    Have been told I have fibromyalgia and chronic fatigue syndrome (have all the symptoms for both). I think there is more to it then that.

    I donít know if topamax has an effect on the TSH number at all, I was told itís a dopamine drug and it could have an affect with your labs (donít know if this is true or not)?

    I have an appointment with an endo November 10, but going back to internist next monday.

    Do I look like I am AI with hypothyroidism?
    Should I request any other tests to be done before I go to the endo (she is a hard doc to get into and want all the results I can possibly have so she can diagnose)

    Any advice is welcome.

     
    Old 10-29-2008, 04:28 AM   #11
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    Re: Do i have AI? im desperate for answers

    Hi,
    I know little about Addisons and am new to this whole thing too with many abnormal results and symtoms, but I also have Lyme disease.

    Maybe I can offer a little advice that I hope helps??? As far as desired lab values, I've been told and seen as I get all, and keep copies of all my rusults too (good for you-smart!) the 'normal' values differ with each lab! It makes things confusing I know!

    Although you may have a great Internal Med. Dr., the Endocrine system is not their specialty! I know this only from being a nurse for 15 years. I know how frusterating it is to wait to see the Endo. as I had to wait over 3 months too---Aarrhg! Unfortuneitly, you need the specialist. I'm sorry that you have to wait.

    Also, I would research your meds. I don't know about the other meds., but I do know that your meds. for Asthma can affect some results.

    Also, so MANY that are diagnosed with F.M. and C.F. actually have an underlying desease!!! Have you ever been tested for Lyme??? Not a regular lab, it must be done at I-GeneX. Just a thought.

    Praying all the best for you!

     
    Old 10-30-2008, 07:47 AM   #12
    Masta
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    Re: Do i have AI? im desperate for answers

    jk44 i have not been tested for lymes disease. i dont have the regular symptoms red dot/bullseye marking anywhere, nor have i seen or found a tick on me.

    i dont know if you have to have a bullís-eye mark in order for a doctor to warrant any sort of lyme disease testing. lymes symptoms seem very similar to thyroid/addisions.

    i will keep plugging away by going from one doctor to the next to try and get an answer. my internist this week was frustrated with me. it was my 2nd visit to him and he did not want to run anymore tests. he said he wishes he could do a bunch of labs on himself. he also said looking for answers by running all sorts of labs is not the way he does medicine and he likes to rule stuff out by thinking about problems.

    Meanwhile my high sensitive CRP test came back higher then 2 weeks ago results. i have had a low grade fever for over 2 weeks. my periods have stopped and my internist said go talk to your gyno about all of that. i used to suffer from PCOS so i knew to ask for progesterone pills to bring my periods on and he said wait till you see your gyno.

    im thinking to myself why did i pay a copay to see this idiot. the doctor said Iíve spent more then enough time with you and if you would like to pay another copay .... then do so but i have other patients waiting. the waiting room had no-one in it when i left. He also said he doesnít want to waste valueable resource by running blood tests. Sheesh who pays my insurance premium him or me?

    before i left i made him run the second hscrp test came back higher at 12.2 (signs of inflammation or infection) because my previous labs said to retest me. he sent me to get a TB test (came back negative) and he tested me for lupus (anti-dna test) also negative.

    so yesterday i dropped of some copies of what a high hscrp meant and highlighted where it said to test the patient for infections or other inflammations. i gave those documents to his nurse to pass on to him. I also wrote please advise me on what I should be doing with these results. I havenít heard back from him. I knew I wouldnít so I made the secretary print off all my labs and I have decided not to go back to such a rude doctor. Im sure he thinks im a hypochondriac.

     
    Old 10-30-2008, 02:56 PM   #13
    jk44
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    Re: Do i have AI? im desperate for answers

    Masta,
    Do not ever go back to that Dr.!!!!!! Oh my word! Unfortunitly when you have any history of deppresion, most Dr.'s will contribute everything to that---not fair and very wrong to say the least!!!!!!
    You are absolutely right about your CRP!!!! The difference between this test and a sed-rate is that the CRP usally indicates inflamation from a musle, not always but usually. That along with an on-going fever, you do have some sort of infection going on so keep going 'til you get some answers!!!! As far as the test for Lupus----very unreliable!! It will only catch about 50%!
    Did he do an ANA OR RA/RH FACTOR??? How does you CBC w/diff. look??
    See the Endo, but you need a Rheumotologist and an Infection dis. specialist also. I noticed you mentioned a co-pay, does that mean that your insurance requires a referral????

    Now this is totally your disission--forgive my spelling!! When you find a new Dr., do not give him your previos Dr.'s name and do not tell him about your history of depression or the meds. for it, untill or unless he prescribes a new med. You don't want anything to interact with your current meds.

    Keep going dear!!!!!

     
    Old 10-31-2008, 08:24 AM   #14
    Masta
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    Re: Do i have AI? im desperate for answers

    jk44. i have found out my crazy motherinlaw who works in ICU has tainted the doctors point of view of me. she has admitted to other inlaws she often looks at family records while working as a nurse in the hospital. she has worked closely with many of the specialists i am about to go see.

    i dont know what she is telling these doctors but it is not good.

    my motherinlaw has serious mental health issues but does not show her colors while she is at work. so the doctors will believe anything she says. my motherinlaw has been abusive to her 8 kids their whole life. she has abused to her kids spouses. she doesnt have a relationship with anyone of her 24+ grandkids.

    so im about to report her to the hospital she is working at.

    ANA: negative
    TB test: negative
    anti DNA negative

    havent been tested for RA/RH factor

    CBC w/diff shows:
    WBC 10.4 (range 3.6-10.6) normal
    RBC 5.07 (range 4.00-5.20) normal
    Neut, Abs 6.8 (range 1.8-6.8) normal
    Neut Auto 65.6 (range 36.0-66.0) normal
    all the others normal too

    Comprehensive metabilic panel shows:
    ALT 6 (range 9-52) low
    AST 51 (range 16-50) High
    Chloride 110 (range 98-109) High
    everything else looks normal, but then again, what is normal?.... the labs have not updated the AACE finding of the TSH ranges so... i dont know if any of my labs are normal.

    i have never had any problems with CMP panels before or CBC this is the first time they have been out of whack.

    my cholestrol readings are all perfect yet the high sensite CRP is beyong elevated at 12.2 when anything above 3 is considered high risk for coronary heart disease. anything above a 10 is inflammation or infection.

    Last edited by Masta; 10-31-2008 at 08:39 AM. Reason: needed to add additional information

     
    Old 11-09-2008, 07:28 AM   #15
    jugina45
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    Re: Do i have AI? im desperate for answers

    ( removed ) not only is your in-law nasty but these charges are major HIPPA violations and should be reported to the Head of the Disciplinary Committee at the Hospital where she works. This is very serious..if she's doing it to family, she's most likely doing it to friends as well and this is against the law big time.

    Go speak to the head yourself, or make an appt and/or bring another family member with you..it can be done anonymously but this is just plain insane. Act now, please for your own sake. Good luck.

    Last edited by moderator2; 11-09-2008 at 09:01 AM. Reason: please go back and read the posting rules about professions

     
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