Questions about some lab work...

[brookiepete]

I have been having some health problems the past couple of years, but all of my symptoms have seemed very mild, until, the past year, when I unexpectedly gained around 40lbs in less than a year.  I suppose I might have been taking in some extra calories, but not such a significant amount to warrant that weight gain (in my opinion).  I'm a 25 year old female,and I went to see a bariatric specialist and found out my bmi is around 32, making me clinically obese. The DR ordered quite a bit of lab work, and when we got the results he didn't seem to be concerned by some abnormalities that were marked and told me if I was concerned to see my primary care doctor (I don't have one). I just wanted to see what others thought about some of these to ease my concerns as I feel a bit at a loss.

WBC: 11.3 x 1000 (12/31/13)     5.7 x 1000 (05/09/2012)     10.8 x 1000 (08/29/2011)

Platelet Count: 456 x 1000 (12/31/13)   361 x 1000 (05/09/2012)   403 x 1000 (08/29/2011)

MPV:  6.7 fL (12/31/13)     7.2fL (05/09/2012)     7.2fL (08/29/2011)

Pyridoxal 5-Phosphate: 3 mcg/L  (12/31/13)

25-Hydroxy D Total: 12.4 ng/mL   (12/31/13)

Trig: 213     Chol: 251    HDL: 47    LDL: 161.4  (12/31/13)

S-TSH: 7.80 mIU/L (12/31/2013)     3.75 mIU/L  (05/09/2012)     2.91 mIU/L  (08/29/2011)

T4 Free: 0.9 ng/dL (12/31/2013)     0.8 ng/dL  (05/09/2012)

T3 Free: 3.5 pg/mL (12/31/2013)

Estradiol, Serum: 257 pg/mL (05/09/2012)

Progesterone S:  0.78 ng/mL (05/09/2012)

Free Testos: 0.3 ng/dL (08/29/2011)

Urinalysis:

U Leuk Est: MODERATE (12/31/13)     SMALL (05/09/2012)

U Prot Qual: TRACE  (12/31/13)      NEG (05/09/2012)

My metabolic test results came back 1860, so all good there. My symptoms include: exhaustion, sudden weight gain, foggy thinking, depression, chest pains ( tightness, pressure, and sometimes a twisting feeling going towards left arm bit and arm), chronic bronchial cough that has shown up every so often past three months following a serious case of bronchitis (inhaler helps when my lungs feel constricted and it's hard to breath, but I've never been diagnosed with asthma), brittle hair/nails, dry skin, psoriasis flare ups, particularly on cheeks and bridge of nose as well as scalp, diarrhea aprox 3x a week mostly in morning, lack of tendon reflex response in knee, and a consistent dull pain in my lower left pelvic region that occasionally travels up left side of abdomen which I have had for the past 2 years.

I'm most concerned about my thyroid levels, but the DR said it could be due to having an infection. I'm also greatly concerned about my cholesterol.  I've been a vegetarian for 16 years, do not eat fried foods or fast foods, and really don't eat many saturated fats.

The only thing being currently treated is the Vitamin D, and I'm also seeing a nutritionist for weight loss. I have a ton of other results but all were within normal range (can provide ranges if needed) although I noticed some neared towards either the low end or high end of the range (particularly in the chem panel).

[mkh9]

BTW, the low MCV Is probably due to iron deficiency. If you haven't had your iron, total iron binding capacity, and ferritin done you should. You probably have been low for a while. You hemoglobin doesn't go down unless you are in third stage anemia so you can still be anemic and/or have low iron but not have your Iron be off. What is your RDW? This will be seen on your CBC results? It isn't MPV it is MCV just for your info. Ok. I'm off to the dentist to get a crown replaced.
mkh9

[mkh9]

Regarding diet that is ok, it is up to you. It just worked so well for us that I wanted to let you know about it. As for you lab results and what the doctors said that is ridiculous. I am a clinical lab scientist (microbiologist) and so I understand the lab work and the leukocyte esterase if positive is a sign of a urinary tract infection.  That coupled with a slightly high WBC is typical. They didn't do a culture I assume? Yes we all have normal skin flora in our urine and sometimes to be frank some of the fecal flora can get wiped in there too (LOL). But men don't have this because the urine comes from deeper inside. So, when you take the urine sample they give you a towelette you are supposed wipe a certain way with and they give you directions and it should be some what of a good sample but not perfect. We know how to read this in the clinical lab if we get a culture. So if the lab does a dipstick and sees the leukocytes esterase or nitrates positive they are supposed to do a culture automatically. So they may have done one and it may have come up negative. At least that is the way it is done in the U.S. Sometimes the doctor asks for a microscopic analysis too and if it does have a lot of bacteria it won't be specific. You have to have a large number of one type or two types of bacteria (and certain types) for it to be called positive. I can only go by the limited info I have. which shows a slightly high WBC count and positive LE test. Do you still have pain when you urinate? Or kidney pain? If not I wouldn't worry about it. That is ridiculous about the only way to get a good sample is by catheter! clean catch samples are done all the time and we know how to read them. Unbelievable! Of course it is a better sample to have a catheter sample but this just isn't possible. The thyroid is off and you don't have to go to an endocrinologist like many people think. I was treated by my family practice doctor and I feel great now. He tested me for the TSH and hasimotos every 3 months while I took Synthroid and now it is 2.5 and I feel so much more energetic and I am finally starting to lose a few pounds. Finally. I stopped all the other symptoms for the most part too. It takes a while so be patient. I would just ignore the jibber jabber you have heard as I have read a whole lot about this and go see your FP doctor and get treated and be patient and kind to yourself. You can go on a statin drug like Crestor if you want to get your cholesterol down. It is up to you and probably a good idea for a while until things settle down at home. Also, if you do go on the statin and feel any muscle aches or muscle fatigue call your doctor right away as you may have to get off of it. Otherwise, most people have no problem with them.
mkh9

[brookiepete]

Thank you for the well-thought out and detailed response.  It really helps to know that other people have had similar symptoms.  I will look in to those diets you mentioned, but I'm not sure how drastic of a lifestyle change I can make at this moment ( a lot going on).  But I do follow a vegetarian lifestyle, and have started ensuring I have fruit or veg with each meal and replacing snacks with produce instead.  I want to be able to lower my cholesterol naturally by losing weight and eating right so I know I'll need to make some big changes but I'm doing this all gradually so I don't get frustrated and drop out of it.

As for my thyroid, the doctor I am seeing at mayo clinic does not think it looks like a problem and will not refer me to an endocrinologist.  But I do think hypothyroidism would explain a lot of my symptoms, when I first started reading about the illness I started crying because I was like "this is me!".  I feel so fatigued all the time, weak, and very depressed. It's made me almost impossible to be around, and I think the depression has contributed to eating poor foods, not exercising as much.  It's a catch 22 really.  

My mayo doctor also said I don't have a UTI, although there was bacteria in the urine sample, he said it was because the sample was not done via catheter so it was normal for bacteria to be present?  I don't know why I would have proteins and stuff in my urine then if I didn't have an infection?  I haven't had any antibiotics, and my primary care doctor has closed her office for the month so not sure who to go to.  

The range for the WBC is [3.5-10.5 x1000],  mine is 11.3 so very mild
MPV [7.4-10.9 fL], mine is 6.7 but has been below range for almost three years
S-TSH [0.30-5.00 mIU/L], mine is  7.8
T4 Free [0.6-1.6 ng/dL] mine has been .8 and .9
T3 (Triiodothyronine) Free Serum [2.0-3.5 pg/mL]  mine is 3.5 so just at high end of normal?

[mkh9]

Oh I just checked the range for the platelet and it goes up to 450,000 and that is normal. So, 456,000 I wouldn't worry about it. Check it again next time but it isn't that much of a variance from the normal and you tend to run high which is ok.
mkh9

[mkh9]

Can you send your labs ranges it would be helpful because every lab is a bit different. But the first thing I will say is that you had a urinary tract infection by the LE test being positive and that is what made your WBC count go up only a little (11,000). I would worry about that. Did you get antibiotics for it ? Are you feeling burning when you pee , kidney or back pain in the kidney area or anything now? If so you could get an antibiotic for it and/or drink lots of cranberry juice (if you are not diabetic), and it should go away over a few days. The TSH is way off. If you are not on Synthroid you should be and that may account for tiredness and weight gain. I was at 7.8 and could hardly get out of bed. I am not at 2.5 and am still somewhat tired but I'm in the normal range (<3.8). You should also get tested for Hashimotos antibodies.  The thyroid can cause a lot of problems cold hands , feeling cold, weight gain, fatigue, peeling fingernails, foggy thinking,  hairloss, so you have all the symptoms I had. The platelet count seems very high but I don't recall the range on that without looking it up. If it is high it could be due to a number of things. Let me know about those ranges and i'll get back to you on the platelet count. The vitamin D is extremely low. You need to take at least 1000 IU per day. Retest in a few months then if way low you may need a lot more. I was on 1000 IU and now I 'm on 4000 IU. I'm retesting in 4 months. I need to be at about 60 IU because I got osteoporosis at 51 years old and the vitamin D will help with calcium absorption. Obviously, your cholesterol and triglycerides and HDL need to change. The weight loss will take care of this. I do recommend a whole plant based diet if you are willing to change. It helped my husband and I. It is up to you it is not a diet as you won't feel hungry it is a lifestyle change as to what you eat. Look at the DVD Forks over Knives if you can or check out the website drmcdougall.com and or get his book the starch solution. It takes a while to get used to and if you don't want to that is ok. You will see though that instead of taking a lot of meds etc. It will drop your cholesterol , blood pressure, weight etc. I had a cholesterol at 200 and it dropped to 150. My husband couldn't lose weight on any diet and he was hypothyroid all his life and he finally went on this plant based diet and he lost weight and his bp went down and cholesterol is much better. So anyway it is an idea. The best bet is to read about it and see for yourself how well it works on the lab work etc. Ok. well, this is a start. I hope it helps.
mkh9

[brookiepete]

Other symptoms I forgot to add are cold fingers and toes (also kind of weird, the tips of my toes always turn white in the cold), and some hair loss.