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reasons why hemoglobin would go up

My doctor was all happy because my ALT & AST are now normal, but hemoglobin is high rather than low??  Never heard anyone on here mention that.  Any opinions what that means?  It is 16.3.  My NP gave a rather vague answer like..it could be it is just diluted or something?  I have been really tired the last couple of days so expected it to be low.  Just curious if anyone knows of a reason for that.

Lauren
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233616 tn?1312787196
your WBC is not low for treaters...and it does mean you are absorbing the riba.

sometimes the WBC drops before the red.

I think your NP had it backwards....your blood being more diluted would give you a lower RBC.....however more concentrated, slightly dehydrated blood could read as higher than before.

Make sure you discontinue and duiretic drinks like cola and caffiene. They will strip you of fluids and minerals you badly need while treating.  Then try to get 1 liter per 100lbs of weight.

this was hard for me, but I worked out a system that worked, during the day I drink 3 tall glasses, and at night I line up 3 beside my bed. Late evening I slack off drinking water....
this allows me to sleep through half or 3/4 the night without needing to get up to pee.
then I start sipping water each time I wake up for the last 4 hrs of sleep (I usually wake up a few times then) and so by morning I have finished those 3....and only have to get up once during the night to pee.
A lot of folks give up on water because they get tired of getting up 5 times to pee....but it's all in the timing....just learn how long your kidneys take to start secreting, then adjust when you stop drinking in the evening to allow for an uninterrupted sleep.

mb
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Avatar universal
I am one of the lucky ones, geno 2.
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Avatar universal
Your doc has some reason for optimism based on the decline in enzymes but only the viral load test will tell for sure. If it turns out you're UND then I guess you're taking enough riba regardless of the hgb response which again is a crude barometer. However, if you're not UND, that would be the first thing I'd want to discuss -- upping the riba. From memory, 1200 mg/day is good up to around 200 lbs on the weight-based schemes. After that, they suggest 1400mg/day. The drop in WBC seems normal for treatment, so probably why no mention from your nurse.  Just means you got a good batch of interferon :) BTW what is your genotype?

- Jim

-- Jim
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Avatar universal
I am in week 3 of treatment.  Pre treatment my hemoglobin was 15.2.  Now 16.3.  I am just scrutinizing the result of my baseline compared to the one I just got a few days ago, and my WBC has dropped from 6.3 to 3.2.  Why didn't my NP mention it?  That seems kinda bad.  Suffice to say I am overweight, I take 6 pills.  The bottle just says the pill count not the dosage, but on the pills it has the number 200.  So 1200 mgs?  AST went from 55 to 20 and ALT went from 87 to 17, and that is what he focused on as really good news.  He was a bit concerned when he examined me and I jumped when he poked my liver.  Didn't hurt real bad, but he said he may order another ultra sound.  

I know this is very early in the game and I am sure I will have a clearer picture with the 4 week test for viral load on 11/7.  He didn't test for it this time.  He said he expects me to be undetected at week 4.  Is that really possible?

Well, I am going to email my doctor now and find out about that low WBC.

Thanks for the input.

Lauren
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233616 tn?1312787196
that is weird.  4 things...if you were really dehydrated comparative to the former draw it could seem to go up..though in reality that would only be because blood volume has dropped

or, you could be getting lousy riba absoption...take riba with some fat and no fiber.

or you could just have some really healthy bone marrow, that has already began it's own vigorous response to your red blood cells dropping...in which case count yourself lucky, but keep an eye on it, things can change in short order.

or fourth you might have gad an inacurrate test.
what was your hematocrit and has your WBC been dropping?
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Avatar universal
What week treatment are you in? Do you know your pre-treatment hemoglobin values and values for each test you've taken so far, and what week they were taken? How much do you weigh and how much ribavirin a day are you taking? Have you had a week 4 and week 12 viral load test? If so, what was the result and what was the sensitivity of the test?

-- Jim
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