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What issues could these blood test results point to?

I'm a 37 year old male. Never been overweight or had any major known health conditions. Fit and muscular. For a lot of my life, I've been tired and didn't know why. I suspect as far back as my pre-teen years. I had an in-lab sleep study at about 35 years old after realizing that I may have sleep issues. It showed a 4.7 Apnea-Hypopnea Index and an 18 Respiratory Disturbance Index, likely meaning a lesser-known condition called Upper Airway Resistance Syndrome. Unlike sleep apnea, UARS causes a bunch of arousals/RERAs that wake the brain up all night just enough to open the airway that has narrowed (instead of completely closed, like obstructive sleep apnea does).

Back in December of 2019, I was getting ready for bed one night and felt a cold feeling in my chest. My heart started pounding, my blood pressure shot up, I started shaking all over, I was full of adrenaline and felt like I could barely walk due to the shaking. ER did EKGs, tons of blood work for everything, etc. They couldn't find a reason even as I lay in the bed of their room with 173/100 blood pressure. I went to a Cardiologist and had a full Stress Echocardiogram where they looked at my heart with ultrasound, checked blood flow rates, etc. Very healthy and strong heart. Cardiologist wasn't sure about the blood pressure. He thought it was anxiety. GP doctor wanted to give Metoprolol for suppressing the symptoms.

This was months ago. I just created an account with LabCorp to see recent blood work and a bunch of my results popped up from previous blood work that I didn't know I could access.

In January 2018, someone did a full metabolic panel and all results were good, including a/g levels and alkaline phospatase.

In December 2010 my GP doc did blood work after my first ER visit and my a/g ratio was a 2.4 out of reference range of 1.2-2.2, so it was high. My alkaline phosphatase was 122 out of reference range of 39-117 IU/L, so it was also high. Albumin and bilirubin were normal.

Went back to that GP again January 7, 2020 after another alarming ER visit.  Metanephrines were 66 out of 0-62 range.

Another January 2020 blood test showed an a/g ratio of 2.3 out of 1.2-2.2. Triglycerides were 171 out of  Reference Range: 0-149 mg/dL.  HDL Cholesterol was 36 out of reference range: >39 mg/dL.

LDL Cholesterol Calc was high at 120 out of reference range of: 0-99 mg/dL

I'm about to start working with a new sleep doctor and also have found a new GP doctor.

Could I have any kind of issue going on in my body with these things? I've had an MRI of the abdomen and contrast CT scan of the abdomen and pelvis. They also checked my organs and found a few benign liver cysts. They checked all organs and also checked the kidneys for adrenal tumors.

Could this all be my sleep issues or is a health problem to blame? I woke up the other night feeling like I had a sleep seizure of some sort. I have had Gastritis (swollen stomach lining) for about 1.5 months now that I got after a stomach virus spread through my family in early February. I suspect that the Gastritis was aiding panic attacks. The UARS keeps my body in "fight or flight" mode.

I have located a new GP doctor and sleep doctor. My former GP doctor didn't tell me about any of those high results and searching for them brings up scary stuff.
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207091 tn?1337709493
Most of the time, a result that's close to the range - like your 2.4 - isn't considered alarming. A high a/g ratio usually indicates dehydration, and yours is just barely high, so that's not particularly concerning.

Your ALP was also slightly elevated, but not alarmingly so. Was this consistently elevated on your results, or just the one time?

The only one that is significantly out of range is your triglycerides and LDL, and that can be managed with diet, or if it remains that way with diet changes, maybe a statin. You can work with your doctor on that.

I agree with GuitarRox that if you drink alcohol, now is the time to work on stopping that, and that none of this is related to your sleep issues.

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20620809 tn?1504362969
Normally we don't feel anything with cholesterol changes.  You can bump your hdl up by adding in more exercise if your doctor allows you to exercise.  Are you a drinker or eat things like pasta a lot, white rice?  Those things tend to raise triglycerides. High triglycerides can raise your risk for heart issues and also be a sign of a metabolic syndrome. You are still borderline at 177!  They aren't considered high until over 199.  https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in-depth/triglycerides/art-20048186  If you exercise you will usually help your triglycerides and HDL both, pay attention to diet (cut out regular pasta, go wheat, eat brown rice, cut down on sugar and alcohol) can help too.  LDL cholesterol is also something to lower.  Guidelines are that they'd like you under 100, right?  So, your exercise, diet, losing some weight are all natural ways to lower that.  Or you may consider if it is time to start a statin for LDL.  They work well with few side effects but talk to your doctor about that.  But again, you don't 'feel' cholesterol issues.  By the way, high cholesterol is extremely common and often genetic.

Would guess this is entirely separate from your sleep issue.  
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Avatar universal
Correction to date: In December 2019 my GP doc did blood work after my first ER visit and my a/g ratio was a 2.4 out of reference range of 1.2-2.2, so it was high. My alkaline phosphatase was 122 out of reference range of 39-117 IU/L, so it was also high. Albumin and bilirubin were normal.
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