Concerning lab results. I need insight (please read)
Hi, I have some questions regarding lab work that I had done last month. I have not been diagnosed with liver disease, but I suspect that I am having problems. I can't get answers or insight anywhere, so I thought that maybe some of you have more knowledge in this area and might be of help.
I am 27 years old and have been a pretty heavy drinker on and off for 8 years, with this past year being the worst. Anyway, I recently started experiencing hair loss last October/early November. I just brushed it off and assumed it was due to drinking and not getting enough water and/or stress. I finally went in to see a doctor last month and got a complete blood count and metabolic panel done. Here were my results. My liver function was fine, but there are other areas of concern that are seen in liver disease or cirrhosis.
MCV - 103.4 (normal range: 81-99) *I know this can be a direct result from heavy drinking or it can indicate liver disease. My vitamin b-12 levels are good, so I know that's not the other possible cause.
Vitamin b-12 - 628 (normal range: 180-914) - so, this leaves the only causes for my macroblastic anemia being liver
disease or heavy drinking alone
Ferritin - 61 (normal range: 11-306.8)
Iron - 33 (normal range: 65-175)
Transferrin - 187 (normal range: 250-380) *this is especially concerning because I know that low transferrin can indicate anemia of a chronic disease, most likely liver disease. I can't really find any other explanation other than kidney problems or autoimmune disorders.
Liver function test:
AST - 26 (normal range: 8-40)
ALT - 29 (normal range: 7-35)
Alkaline Phosphatase - 36 (normal range: 38-126)
Bilirubin, total - 0.6 (normal range: 0.4-2.0)
Protein, total - 7.6 (normal range: 6.4-8.3)
Albumin - 4.7 (normal range: 3.5- 4.8)
Anyway, it seems like the results all point to liver problems, other than my liver function test. The doctor called me back and said that I am simply just iron deficient and need to take supplements. So, I was doing that until I received my lab results in the mail. After researching, I have found that with low transferrin, taking iron can be dangerous because you're at risk for an iron overload. So, I stopped taking iron. Normally, with low transferrin, iron and ferritin are high, but my levels are also low. And, I called the doctor because I was concerned about my MCV and transferrin.. That's not normal! He never even mentioned it and is now referring me to a hematologist.
Do these weird results indicate liver disease pretty strongly? I can't find anything else other than that. And, I know hair loss is a common symptom. I don't have any symptoms, other than that, really. But, I know that liver disease doesn't always affect liver function results, and you don't usually have initial symptoms. It just seems like the research I have done says those types of results are usually found in cirrhosis. Wouldn't that show something else if I had it to that extent? I don't know.. I haven't had a drink in 21 days now because I'm too terrified to drink anymore, and I plan on quitting for good because of this.. Any insight or thoughts would be greatly appreciated! Thanks so much.
It appears you do not understand how to read your blood tests as all of your blood tests are normal except MCV, Transferrin and iron. Any result with a number between the two normal range values is normal.
All liver tests are normal.
As your doctor said, it appears you have iron deficiency anemia.
If you don't take your iron treatment you will continue to have anemia.
You do not have anything causing injury to your liver and your liver is functioning normally according to the tests you provided. The way way to know if you have liver damage from drinking is to have a liver biopsy performed.
Thanks for taking the time to respond. No, I know how to read my results. I understand my liver function test is normal, as I indicated that in the beginning. My concerns are my MCV and transferrin, which are both commonly seen in liver disease (from what I have read). I can't find many other explanations for those two numbers other than liver problems. Normally, with low transferrin comes high iron, so I am afraid, from what I have read, that taking iron with those transferrin levels puts me at risk for an overload.. Anyway, because I realize that you can still have liver disease and a normal liver function test, I thought that I'd ask here, in hopes that some of you guys might have more knowledge or experience with MCV and transferrin, since the two are directly related to the liver. I don't know if I should be concerned that those numbers could be an indication of damage or scarring, but that's all I can find.. Just looking for insight on this because I'm really scared.
I also agree with Hector as usual. This was a reply I started composing But Hector had already replied. You can see it's very similar:
Hello KRob and welcome to MedHelp.
It is good to hear you have stopped drinking since you seem very concerned and in the case of liver disease immediate action is critical but not to worry you are doing fine. From looking at the labs you provided your liver is not irritated, and is functioning well. Your kidney function is also excellent. Since you are still concerned I imagine the hepatologist will set you up with an ultra sound and those results will reveal any evidence of liver disease.
Anemia (low Iron) can also cause low levels of Alkaline Phosphatase. Mean corpuscular volume (MCV), and the transferrin saturation are used in diagnosing iron deficiency anemia. Poor diet, malnutrition and blood loss are common causes. If you are hesitant to take the supplement then adjust your diet until you can see your hepatologist.
Thanks a lot for responding, Guys! I really appreciate it. That does help ease my mind a little for now. I am going to see a hematologist first. Hopefully I don't have anemia of a chronic disease, but we'll see. An ultrasound might be appropriate at this point, considering the amount I have drank over the years. I'm definitely staying away from alcohol now. I haven't willingly quit for this long in a long time, so maybe this finally a wakeup call for me. Again, thanks for taking the time to give feedback.
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