what would you say? anything suggestive?

Hello

I have posted here another thread some week ago about liver disease, my symptoms are fatigue, night awaking (between 1 and 3 am), headaches which come and go, coming and going RUQ pressure, bloating, soft and sometimes pale bowel movements, constipation, intermittent itching, skin colour changes (orangish, darker and some strange patches) , amenorrhoa and oligomenorrhea, low hormonal status, nausea, often hungry with normal blood sugar, feeling of weakness, intermittent impaired fasting glucose with other normal glucose parametes,easily feeling cold or hot, mild nerve pains in fingers

And now for some time I have also this gotten shortness of breath (think it is the worst symptome I have ever had), especially in the evenings (comes in attacks), blood pressure most of the time low-normal but heart rate often a bit fast

I am a female, 24y old, 5.6 ft, 110 lbs, rarely drinking alcohol, ex-smoker (smoked for 5 years), hep a b c negative

I have been checked some days ago for the possibility of a heart muscle problem, the result was that there was nothing abnormal on ultrasound and on ECG they only found a slightly elevated heartrate and a bit low blood pressure.Lung function was also okey.
I am quite glad about it that there is nothing wrong with my heart and heart muscle.

They also did a blood panel for anemia (cause of attacks of shortness of breath)

Here are the results:

ESR: 7 mm/h (females: 10-20 mm/h)  ** -but doc said it is often better below then up
CRP: <1 mg/L  (< 10 mg/L)

Hemoglobin: 14,5 mmol/l (females: 11,5-16 mmol/l
Hematocrit: 42,3 percent (females: 35-45 percent)

RBC: 4,7 mill/mm3  (females: 3,8-5,2 mill/mm3)
WBC: 9650  (4000-9500 mm3) **   (but I must say I have always been a bit in leucocytosis, but nobody really found out why)  My doc said it doesn`t fit to my ESR and CRP and is probably not caused by infections
THROMBO: 240 000 mm3  (150 000- 400 000)

MCH: 30.4 g/dl (27-33 g/dl)
MCHC: 34,6 g/dl (32-36 g/dl)
MCV: 95,7 fl (78-96) - this is very borderline..

Doc said this is 100 percent non-anemic and I think I would believe him to this point.

I know there are now liver enzyme tests done yet, but if my RUQ discomfort and some other issues (which is bit actuell at the moment again) would get worse or wouldn`t disappear I think I would aks my doc about LFTs and/or a liver ultrasound.

I think my blood platelet panel is rather good except of my borderline MCV but this would be difficult to interpret.

What do you think? I there anybody with knowledge in this field?

Thank you

[mandyT24]

Sorry I have looked that up the correct unit for hemoglobin was g/dl and not mm/l....

So I have a hb about 14,5 g/dl (range 11,5-16 for females)

[Paderla Anitha, DNB]

Hello and hope you are doing well.

It's unlikely that anemia is causing your symptoms. Did you mean you have pain in the right upper quadrant of the abdomen? Right upper quadrant pain and white stool could indicate disorders in the liver or gall bladder. If the pain is due to a problem from the liver like hepatitis, you should have associated symptoms like nausea and vomiting. The pain could be from the gall bladder too. It could be if there is a stone in the gall bladder or if its wall is inflamed.

Discuss these options with your consulting doctor, he may advise blood tests for liver function tests and maybe to do an abdominal ultrasonography to rule out hepatic enlargement or any stones in the gall bladder.

Hope this helped and do keep us posted.

[mandyT24]

Hello Anitha

Yes I have pale stools but not real diarrhea (yellowish and soft) but also constipation and normal bowel movements.
Pain in the right upper quadrant is not sharp, it feels like pressure and bloating and I have bloating also on the whole GI tract.

Vomting is not a symptom of mine, nausea from time to time.

And the symptoms above that I have listed  (many of them I have for years), don`t know about my gallbladder because I didn`t have CT.

My liver enzymes have  been normal when I did them more than a year ago, it was also because of RUQ pressure for a longer time. I also had hepatitis abc negative (has been tested too).
CRP`s  always that low (even when I have had a cold before) and ESR also low, doctor said no inflammation for a longer time.
He only said something about WBC and MCV but I very rarely drink alcohol.

What worries me a bit are my nails, they look like there is something wrong with liver, every person I see has "normal looking nails".

I don`t know if there are non-inflammative liver disease too?

I don`t like going to my dr so much because he doesn`t seem to find out.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Any disease which affects the liver will show changes in the liver function tests. Any structural abnormalities can be detected by an ultrasonography or CT scan. Diabetes Mellitus and Hypothyroidism could also cause the symptoms described by you. A simple blood test could help detect diabetes and hypothyroidism. Consult your primary care physician for these tests and repeat them if they have not been done recently.

Hope this helped and do keep us posted.

[mandyT24]

Hello Anitha

I was a time away...

I have borderline low thyroid tests for some years but without thyroid disease (?), also have amenorrhoe and oligomenorrhoe quite often but my doc says I dont seem to have PCO syndrome.
Also have no weight gain.

TSH, ft3 and ft4 are quite low-normal for some years now, the menstrual irregularities I had forever.

I have no diabetes, only isolated IFG from time to time  (100-115), very good glucose panel although, good OGTT and good measurements out of the blue.
Also often I have normal fasting values back (80-95)

Diidnt have CT from my liver and gallbladder and if you say my liver must be healthy I think I trust. I havent done tests now but when I did them with same symptoms more than a year ago they were within range.

At the moment I have fatigue and finger pain, tomorrow I see a rheuma doc and we do some tests.
The mild pains in the RUQ I also have sometimes but they come and go for days...


Thank you