Blood Test Results

[LetsBeHappy2gether]

Let me start off by saying hello and thank you in advance for this forum, I have been reading it for the past few days and have decided to send in a question myself.  I am a 43 year old female who in the past few years has had several tests done, luckily none too bad.  I decided to take a more active role in my good health so have had blood tests taken.  I will list below the name the reference ranges then my results:

Total Protein      5.9-8.4     8.1
Albumin            3.2-5.2     4.2
Globulin           1.7-3.7 (h) 3.9
A/G Ratio          1.1-2.9 (l) 1.1
Glucose            70-109      85
Sodium             133-145     142
Potassium          3.5-5.3     3.9
Chloride           96-108      103
CO2                22-29       24
BUN                7-25        14
Creatinine         0.4-1.2     0.7
Bun/Creatinine     10-28       20
Calcium            8.4-10.4    9.8
Uric Acid          2.4-7.0     4.4
Iron               30-160      89
Cholesterol        <200        191
Triglycerides      <200        92
Total Bilirubin    0.0-1.0     0.4
LDH                94-250      144
Alk Phos.          39-120      119 (higher end of normal)
AST (SGOT)         <37         19
Phosphorus         2.6-4.5     3.2
ALT (SGPT)         <40         19
G-GTP              7-51        29
WBC                3.4-11.8    7.0
RBC                3.6-5.5     4.4 (lower end of normal)
HGB                11.5-15.6   12.3(lower end of normal)
HCT                36.3-49.9   38.4(lower end of normal)
MCV                79.2-104.1  87.7(lower end of normal)
MCH                25-34.1     28.1(lower end of normal)
MCHC               30-34.4     32.0
RDW                10.9-16.9   13.6
POLY               36-78       61%  (actual 4270)
LYMPH              12-48       30%  (actual  2100)
EOS                1-8         2    (actual 140)
BASO               0-2         0    (actual 70)
MONO               5-12        7    (actual 490
Platelet           144-400     238

                  Urinalysis
Not going to get into all of it, everything normal except PH was 8.5 the normal 5-9 (I know this means Alkaline and not acidic which I think is good, cause I read that you want it to be more alkaline because two things that must be active for cancer is Acidic and No oxygen) I had a Trace of protein, 1+ for Ketones and Moderate Epith.  Everything else was normal I even had my thyroid tested and all those were within normal ranges.  

I guess my question is this, my dad passed away of Bone Cancer when he was 49 and I have read that a HIGH ALKALINE PHOSPHATASE level can be indicative to bone disease, even cancer.  Since all my other LFT's are within normal ranges, I assume this means my ALK PHOS. is coming from Bone and NOT liver.  I injured my leg 4 years ago, now swollen above knee, shoulders hurt, hip hurts, Im getting a bit scared about bone cancer.  Can you give me some advice?  Much appreciated.  :)

[Kevin Pho, MD]

Although the alkaline phosphatase level is on the high end of normal, it is still within the normal range.  There are other causes of an elevated alkaline phosphastase.  Non liver causes can include the following:

Infiltrative diseases such as amyloidosis, sarcoidosis, hepatic abscesses, tuberculosis, and metastatic carcinoma.

Extrahepatic diseases such as myeloid metaplasia, peritonitis, diabetes mellitus, subacute thyroiditis, and uncomplicated gastric ulcer.

If bone cancer is truly a concern, a bone scan would be a reasonable first step for an evaluation.  This is not the most specific test - since other causes can give false positives (i.e. trauma etc.)  This can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[LetsBeHappy2gether]

Just me, I was reading further and found out that BLOOD CO2 that is low is consider Acidic and NOT Alkaline which means the PH is low, but how can this be low in the blood and high in the urine?  Is there something I can do to regulate BOTH, I read about O2 gases being done from your artery, but I truly dont wish to do something like this if it is not necessary.   Sorry to be throwing these questions around, but I keep coming up with different things that I am finding, and really wish to find out the best way to maintain good health.  Thank you again.

[LetsBeHappy2gether]

Thank you for the response, but I must say Im ever more afraid now then I was before.  None of the things you mentioned show a favorable prognosis.  I thought since all my other blood work was within normal ranges, I guess I was hoping, that what was going on would NOT be as severe as youve mentioned.  Im starting to panic now, I dont know what to do first.

[LetsBeHappy2gether]

First off I wish to apologize to Dr. Kevin.  I sounded somewhat accusatory when I made my statement earlier, you were only be thorough and honest and I wish to thank you.  I did go over this list of POSSIBLE conditions the increase in alkaline phosphatase could be.  (After my panic stricken moment that is)  :)  Anyway I notice that you listed Peritonitis which is  a swelling in the abdominal region, however, I did go to an oral surgeon several weeks ago and I am scheduled for surgery next month on my month, I have a mild form of periodonititis which is also the swellin of gums and oral tissues and could cause breakdown of bone, although my dentist assures me my bones are very strong but some of the pockets are quite deep, alot are 3 and some 6-7 which Im finding out is not really a good thing.  My gums do bleed, they are swollen and more red than pink.  I dont know if this has any bearing on the high Alk. Phos. but I thought I would mention it.  Also I was exposed last summer to someone whos boyfriend has TB but I have had lung x-rays during my course of routine physicals and have not found anything.  As for the subacute thyroiditis I did go to the doctor in May 03 for a sore throat and swollen glands (lymph-left side of neck) thats when all the bloodwork, mamos etc started, they found a 3mm nodule on my thyroid which I had checked again in Jan 04 with no change in size.  As for the Amyloidosis I dont think that is something I have considering my Creatinine and Bun are NOT elevated and within normal range, my urine does have a TRACE of protein but no Casts and my ECG was normal.  Im not overly concerned about Sarcoidosis since I do not have any of the symptoms for this particular disease and have had a chest x-ray in the past year.  My real concern at this point is Metastic carcinoma (which just means a type of cancer that has spread) so this can be anything and anywhere.  Based on my bloodtest and urine results would it be safe to say that I do NOT have anything life threatening at this point?  I have also read that a high alkaline phosphatase level alone is no indicative of any disease and may not be of any significance.  I would appreciate your opinion. I promise NOT to Yell at you this time  :)  Thank you  (Have to keep smiling)

[lrquest]

I just had my blood results sent to me from my doctor. After reading your post, I noticed that the normal range for "Alkaline Phosphatase" on my results was expanded a little more than yours (35 - 129).  I know its not much of a difference, but I thought it might make you a little more comfortable about your results.  May the good Lord guide your care. :)

[LetsBeHappy2gether]

Thank you IRQUEST for the post, I recently had another bloodtest done by a hematologist and the range was 30-125 there also and my alkaline phosphatase was 113 so it did go down a bit, but at the same time he informed me that I have what is known as Protein S Deficiency...Ugggggggggggggggghhhhhhhhhhhhhh  :)