Chiropractor/Bloodwork/Pre-Dr Crisler

[Kingneptune40]

After reading everything I could on this website and many others, I am getting ready to see Dr John on 6/8.........I am going to keep a journal to show my progress over the next 6 months and thought it would be good to post some of my blood levels from this spring..........Any comments from the board are much appreciated, as I enjoy learning from the "veterans" on this board..........

I am 40 year old Chiropractor, have been suffering from severe fatigue, digestive problems, and muscle weakness for the past 10 years..........I have been diagnosed by various "quacks" as having everything from depression, to MS, to CFS, to Myasthenia Gravis and everything in between.......Definitely not much consensus in the medical doctors I have seen........Nor have any of them thoroughly tested my hormone levels, as will be the case when I see Dr John...........Here are the blood levels from the spring, I can only post what they tested, as they did not do the complete testing of Dr John...........


In addition, I am 6', 240.......with a background in powerlifting and bodybuilding in my teens and 20's..........I did experiment with certain "supplements" (oral and injection) back in the my early 20's............

TSH.........5.9 (.5-2.0)
T3, free.....313...........(230-420)
T4, free......(.9)..........(.8-1.8)

DHEA Sulfate.........221 UG/UL


Total Test........252
Free Test.........64.6

Cholesterol.........129 (<200)
HDL Cholesterol....27 (>40)
LDL Cholesterol...71.....(<130)

Triglycerides......157......(<150)

Aldosterone.......5.0.......(10am)
Sodium.............140.......(135-140)
Potassium..........4.2........(3.5-5.3 MMOL)
Chloride.............108........(98-110 MMOL)
Carbon Dioxide.....26.........(21-33)
Calcium..............9.6.........(8.5-10.4mg/dl)
Alkaline Phos.......95..........(20-125 U/L)
AST...................15..........(3-50 U/L)
ALT....................23..........(3-60 U/L)
Bilirubin(total).......(.7)........(.2-1.5 mg/dl)
Glucose...............87...........(65-99 mg/dl)
Urea/Nitrogen.......21...........(7-25 mg/dl)
Creatine..............(.6).........(.5-1.4 mg/dl)
BUN/Creatine........35.9........(6-25)
Protein, total.........7.6..........(6-8.3 g/dl)
Albumin................4.7..........(3.7-5.1 g/dl)
Globulin................2.9..........(2.2-4.2 g/dl)


WBC...................7.9............(3.8-10.8)
RBC....................6.20...........(4.2-5.8 Mill/MCL)
Hemoglobin..........16.3............(13.2-17.1 g/dl)
Hematocrit...........47.5............(38.5-50)
MCV...................76.6.............(80-100)
MCH...................26.2.............(27-33)
MCHC..................34.2..............(32-36)
RDW....................15.1..............(11-15.0)
Platelet count........184...............(140-400 thous/MCL)

Iron......................88...............(40-190 mcg/dl)
TIBC.....................351..............(250-400 mcg/dl)
Saturation %..........25................(15-50 %)

Cardio CRP..............(.6)..............(1.0-10 mg/L)
Hemoglobin A1C........4.9..............(<6.0)

Insulin,serum............27...............(<17 MICRO IU/ML)

Vit B12, serum..........307.............(200-1100 PG/ML)

Ferritin....................66...............(20-345 NG/ML)
ESR........................2.................(0-15 MM/HR)

IGA,serum...............163...............(81-463 mg/dl)
IGG, serum...............987...............(694-1618)
IGM,serum...............64..................(48-271)

Folate, RBC..............449................(>280 NG/ML)

Cortisol, total............14.1...............about 10am

Homocysteine, CVD......18.5.............(<11.4 UMOL/L)
Lipoprotein A...............197.............(<75 nmol/L)

Mg, RBC.....................4.5................(4-6.4 mg/dl)

Angiotensin................25..................(9-67 U/L)

SHBG........................7....................(7-50 NMOL/L)

Pregnenolone..............16..................(10-200 NG/DL)

Hemoglobin Electrophoresis:
Hgb-A......................85.3.................(96.3-100)
Hgb-F......................9.9...................(0-2.0)
Hgb-A2....................4.8....................(0-3.7)



Any comments or suggestions are much appreciated.......I will be posting my bloodwork via Dr John next week and will continue to post my progress...........Per Dr John's rules........:type:

 

[JanSz]

After reading everything I could on this website and many others, I am getting ready to see Dr John on 6/8.........I am going to keep a journal to show my progress over the next 6 months and thought it would be good to post some of my blood levels from this spring..........Any comments from the board are much appreciated, as I enjoy learning from the "veterans" on this board..........

I am 40 year old Chiropractor, have been suffering from severe fatigue, digestive problems, and muscle weakness for the past 10 years..........I have been diagnosed by various "quacks" as having everything from depression, to MS, to CFS, to Myasthenia Gravis and everything in between.......Definitely not much consensus in the medical doctors I have seen........Nor have any of them thoroughly tested my hormone levels, as will be the case when I see Dr John...........Here are the blood levels from the spring, I can only post what they tested, as they did not do the complete testing of Dr John...........


In addition, I am 6', 240.......with a background in powerlifting and bodybuilding in my teens and 20's..........I did experiment with certain "supplements" (oral and injection) back in the my early 20's............

TSH.........5.9 (.5-2.0)
T3, free.....313...........(230-420)
T4, free......(.9)..........(.8-1.8)

DHEA Sulfate.........221 UG/UL


Total Test........252
Free Test.........64.6

Cholesterol.........129 (<200)
HDL Cholesterol....27 (>40)
LDL Cholesterol...71.....(<130)

Triglycerides......157......(<150)

Aldosterone.......5.0.......(10am)
Sodium.............140.......(135-140)
Potassium..........4.2........(3.5-5.3 MMOL)
Chloride.............108........(98-110 MMOL)
Carbon Dioxide.....26.........(21-33)
Calcium..............9.6.........(8.5-10.4mg/dl)
Alkaline Phos.......95..........(20-125 U/L)
AST...................15..........(3-50 U/L)
ALT....................23..........(3-60 U/L)
Bilirubin(total).......(.7)........(.2-1.5 mg/dl)
Glucose...............87...........(65-99 mg/dl)
Urea/Nitrogen.......21...........(7-25 mg/dl)
Creatine..............(.6).........(.5-1.4 mg/dl)
BUN/Creatine........35.9........(6-25)
Protein, total.........7.6..........(6-8.3 g/dl)
Albumin................4.7..........(3.7-5.1 g/dl)
Globulin................2.9..........(2.2-4.2 g/dl)


WBC...................7.9............(3.8-10.8)
RBC....................6.20...........(4.2-5.8 Mill/MCL)
Hemoglobin..........16.3............(13.2-17.1 g/dl)
Hematocrit...........47.5............(38.5-50)
MCV...................76.6.............(80-100)
MCH...................26.2.............(27-33)
MCHC..................34.2..............(32-36)
RDW....................15.1..............(11-15.0)
Platelet count........184...............(140-400 thous/MCL)

Iron......................88...............(40-190 mcg/dl)
TIBC.....................351..............(250-400 mcg/dl)
Saturation %..........25................(15-50 %)

Cardio CRP..............(.6)..............(1.0-10 mg/L)
Hemoglobin A1C........4.9..............(<6.0)

Insulin,serum............27...............(<17 MICRO IU/ML)

Vit B12, serum..........307.............(200-1100 PG/ML)

Ferritin....................66...............(20-345 NG/ML)
ESR........................2.................(0-15 MM/HR)

IGA,serum...............163...............(81-463 mg/dl)
IGG, serum...............987...............(694-1618)
IGM,serum...............64..................(48-271)

Folate, RBC..............449................(>280 NG/ML)

Cortisol, total............14.1...............about 10am

Homocysteine, CVD......18.5.............(<11.4 UMOL/L)
Lipoprotein A...............197.............(<75 nmol/L)

Mg, RBC.....................4.5................(4-6.4 mg/dl)

Angiotensin................25..................(9-67 U/L)

SHBG........................7....................(7-50 NMOL/L)

Pregnenolone..............16..................(10-200 NG/DL)

Hemoglobin Electrophoresis:
Hgb-A......................85.3.................(96.3-100)
Hgb-F......................9.9...................(0-2.0)
Hgb-A2....................4.8....................(0-3.7)



Any comments or suggestions are much appreciated.......I will be posting my bloodwork via Dr John next week and will continue to post my progress...........Per Dr John's rules........:type:

You may want to go to lef.org
and do search on the red items.
You may want to check my blood test, post #1
http://anabolicminds.com/forum/male-anti-aging/66268-jans-bloodtest-april13.html#post827550
Have it printed and ask Dr John to add to it.
Whatewer you are currently on, supplements vise and medicins vise, make sure you stay on that routine for more than one month before drawing blood. You need to stabilized for the test.
Do test in Quest Diagnostics, blood drawn in Quest.
Special timing (as described by Dr John) when on Testosterone supplementation.
Off hand your first to address are:
insuline
SHBG
cholesterol
FT4
==========================================
My list may not have some valuable items contained in list here:
http://forum.mesomorphosis.com/mens-health-forum/bare-essentials-when-getting-134253139.html#post546430
mostly
total iron-binding capacity
urinalysis
and some items from his:
CBC w/ diff
Chem panel
liver panel
kidney panel
metabolic panel
lipid panel

figure out missing items and add to my list


========================================
for ease of printing my list is:
Calcium
Carbon dioxide
Chloride
Copper, serum
Ferritin
Magnesium
Potasium
Selenium
Sodium
Zinc
Alkaline phosphase
ALT
AST
BUN/creatinine ratio
Creatinine
Globulin, calculated
Protein Total
Urea nitrogen
Bilirubin, Total
Bilirubin, Direct
EGFR non afr american
RPR W/Titer & Conf RFX RPR screen
C-reactive protein CRP
Fibrinogen
Hematocrit
Hemoglobin A1C
Homocysteine, cardio
Lipoprotein (A) Lp(A)
Folate, Serum
Cholesterol, Total
HDL cholesterol
cholesterol/HDL ratio
LDL chol, calculated
Triglycirides
VLDL
Vitamin A
Vitamin B12, serum
Vitamin D, 25-OH, Total
Vitamin D, 25-OH, D3
Vitamin D, 25-OH, D2
T3 Free
T3 uptake
T3,Total
T4,Free
T4,Total
TSH
Glucose, Fasting
Insuline, serum
PSA, Total
PSA, Total
PSA, %, free
IGF Binding protein-3
IGF-1
Aldosterone
Cortisol AM/PM
DHEA sulfate
Prolactin
FSH
LH
Progesterone
Pregnenolone
Estradiol, Bioavailable
Estradiol, Free
Estradiol, Fractionated, serum
Estradiol, Ultra-sensitive (to play safe, actually it is part of fractionated)
Estrogens, Total, Serum
Testosterone, Free, Bio/Tot
Dihydrotestosterone DHT

============================================
Keep us posted of your progress.
Good luck.

 

[KSman]

Serum glucose looks ok, but insulin is high and suggests insulin resistance/syndrome-x/metabolic_disorder. That condition often has elevated E and low T. You really need an E2 level.

The T and thyroid are high priority items. The thyroid will rob you of energy.

 

[JanSz]

Serum glucose looks ok, but insulin is high and suggests insulin resistance/syndrome-x/metabolic_disorder. That condition often has elevated E and low T. You really need an E2 level.

The T and thyroid are high priority items. The thyroid will rob you of energy.

How do you approach insulin resistance/syndrome-x/metabolic_disorder.

 

[KSman]

How do you approach insulin resistance/syndrome-x/metabolic_disorder.

I thought that LEF.org used to have a good article on this, but I can't find it now.

There is a vicious circle of declining LT and T, increasing E and increasing body fat with the loss of lean tissue mass. The fat is often in 'apple shaped body patterns'. Along with the fat, insulin resistance increases and many become pre-diabetic. Increased blood sugars cause accelerated aging, damage to the arteries and increased blood pressure. I think that re balancing hormones would be the best way to get out of this situation.

With higher levels of body fat, natural GH release is reduced, well beyond the natural decline that occurs with age. With E out of balance, it becomes almost impossible for some to loose weight. When put on HGH, the fat loss occurs very nicely for many. So that illustrates the problem with fat leading to greater declines of one's HG.

Part of insulin resistance is related to reduced cell wall permeability. And mitochondrial function can be a problem too. Fish oils, general supplements are useful and acetyl-l-carnitine and lipoic acid help with mitochondrial function. Mitochondria also need anti-oxidants. CoQ10 is important, all the more so if statin drugs are used.

 

[wildfox]

Looks like insulin resistance/pre-diabetes. Your HDL is low, and insulin is high. Testosterone increases insulin sensitivity, and you definitely need more T. Homocysteine, and Lipoprotein are also high.

Dr. Crisler can help you with the T, and hopefully that will help other things, but you need to find an endocrinologist that can help you with your dyslipidemia.

KSman gives good advice here by the way. Very much like what my endocrinologist recommended for my insulin resistance situation.

Good luck!

 

[JanSz]

http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=5416&query=fibrinogen A1C&hiword=A1C FIBRINOGENIC FIBRINOGENS fibrinogen

What follows are the 10 most important blood tests one should have at least once a year to evaluate cardiac health:

C-reactive protein
Triglycerides
Fibrinogen
Free Testosterone
Hemoglobin A1C
Homocysteine
Total Cholesterol
LDL
Fasting Glucose
HDL

 

[Kingneptune40]

JanSZ, KSman, Wildfox............Just wanted to thank you guys for taking the time to respond to my post..........Not to mention I enjoyed reading the rest of your posts on this board, as I have read every thread on this board since February.............You guys should all get "honorary doctor" degrees in my opinion..........

I agree with everything you guys wrote, I just needed to get some feedback from the veterans like yourself..........My testosterone has been in the "crapper" since my "cycles" back in the mid to late 80's, due to the fact that I was an amateur and was following advice of fellow lifters..........I dont think my Test. levels were ever normal after the 4 cycles and of course, I did not do any PCT or anything during the cycles to keep my Estrogen in check...........With age comes wisdom........Looking back, having a bench press of 500lbs was not worth the damage I have done to my body, but I thought I was invincible.........LOL

My thyroid has been in the crapper too, but most doctors I have seen gave me the infamous, "you're within normal limits" routine..........What a joke.......You dont treat the "numbers", you treat the patient............Not to mention that in 2003, the "Board of Endocrinologists" changed the "normal range" from .5-5.0 to .5-2.0 and most doctors dont even know that???? I had to explain it to 2 or 3 myself..........When I tried some T4 and bio-identical hormones a year ago, I was unable to handle the anxiety and panic attacks.......even at low doses..........Which leads me to believe that my adrenals need to be addressed before I start the Armour thyroid, per "Stopthethyroidmadness" website...........I am sure my adrenals are "shot" due to the low Test. and low thyroid and the stress over the past 10 years...........Thank god I am going to see Dr John..........

Personally, I think I have been battling CFS or Syndrome X/Metabolic Disorder...........My insulin resistance really concerns me, I had a doctor tell me the same back in 2003, but he was not much help to me..........I will talk to Dr John about seeing an endocrinologist, if needed and go from there........... KSman, thanks for the info on insulin resistance, I am starting to read LEF.org in recent weeks and will continue to follow up their advice, per your recommendations...........You are very correct, I have a horrible time losing weight, partly due to the inability to work out, which leaves me bed-ridden for days..........(Post-exertional fatigue)..........AKA-no hormones.............I did lose over 110 pounds 2 years ago, eating a 100% "Raw Diet", going from 335 to 220 within about 10 months........I basically ate salads, fruits, vegetables and nuts for a year, did not eat any cooked food...........I have kept the weight off and now added fresh fish, shrimp, occasional chicken/beef and I have added fish oils recently.............

I currently only take Klonopin (.5mg) for sleep, but no longer take any anti-depressants, pain pills, or anything else, for the past 2 years............I am going to start taking supplements per this boards advice, once I start seeing Dr John and come up with a game plan............I will discuss this with you guys once I get started on my treatment in mid-June.........

Thanks again guys, I will post my blood work from Quest after I get it back...........Peace

 

[Kingneptune40]

Thanks again JanSz, great information as usual...........I will read that article you posted..........Once again, I appreciate your time...........Peace

 

[KSman]

When on your diet, were you avoiding all fats to an extreme? That alone can create problems of this nature. Your colesterol may be too low. Any explaination for that?

 

[Kingneptune40]

KSman...............Good point, I think from my previous blood tests in my 20's and 30's, even when my bodyweight was 275-290, I had chronic low cholesterol levels............Definitely did not correlate with my bodyweight or unhealthy eating habits of my late 20's and early 30's, before I cleaned up my act.......

On my "raw diet", the year before my bloodtests, I ate lots of natural fats, including olive oil, raw nuts, lots of flax seed, lots of avocado's, and nutritional bars called "Lara Bars", which contained alot of fat content........I did not count any calories, ate every 3 hours and ate until I was stuffed........Definitely did not restrict calories or fat, but I did not eat any animal fats or proteins...........

I was very happy with the 100 pound weight loss over the 1 year period, but I could tell my body was needing to add some animal products............It really helped me get back to my weightlifting "mindset" where I could listen to my body to determine what I needed to ingest.........

What are you thinking about the chronic cholesterol problems I have had KSman????? Do you think it could be from the "cycles" I did in my early 20's without the proper bloodwork and PCT???? I am definitely curious what you think????

 

[JanSz]

Cholesterol.........129 (<200)
HDL Cholesterol....27 (>40)
LDL Cholesterol...71.....(<130)
Triglycerides......157......(<150)
Insulin,serum............27...............(<17 MICRO IU/ML)

ARE YOU AT RISK FOR METABOLIC SYNDROME?
Having your fasting insulin, triglycerides, and HDL checked can help you determine whether you are at risk for insulin resistance.

The following values indicate that you are at risk for insulin resistance and metabolic syndrome:1

Fasting insulin >= 15 µU/mL

Triglycerides >= 130 mg/dL

Triglycerides:HDL ratio >= 3.0.

Vitamin E (Synthetic), 300 Grams Powder
EDITED link below

LE Magazine July 2006

Metabolic Syndrome
The Twenty-First Century Epidemic

By Steven V. Joyal, MD



Le Magazine, July 2006 - Report: Metabolic Syndrome

Print Friendly
============================================================
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LifeExtensionRx
Metformin 500mg
LEF $9.50
Walgreens $38.29
Drugstore.com $56.65

 

[KSman]

KSman...............Good point, I think from my previous blood tests in my 20's and 30's, even when my bodyweight was 275-290, I had chronic low cholesterol levels............Definitely did not correlate with my bodyweight or unhealthy eating habits of my late 20's and early 30's, before I cleaned up my act.......

On my "raw diet", the year before my bloodtests, I ate lots of natural fats, including olive oil, raw nuts, lots of flax seed, lots of avocado's, and nutritional bars called "Lara Bars", which contained alot of fat content........I did not count any calories, ate every 3 hours and ate until I was stuffed........Definitely did not restrict calories or fat, but I did not eat any animal fats or proteins...........

I was very happy with the 100 pound weight loss over the 1 year period, but I could tell my body was needing to add some animal products............It really helped me get back to my weightlifting "mindset" where I could listen to my body to determine what I needed to ingest.........

What are you thinking about the chronic cholesterol problems I have had KSman????? Do you think it could be from the "cycles" I did in my early 20's without the proper bloodwork and post cycle therapy???? I am definitely curious what you think????

You were doing everything right. So no problem with EFAs or EFA ratios at all. Some have low cholesterol. The liver makes it. Low cholesterol can limit the creation of the pregnenolone, DHEA and others in the steroid cascade for some. Some who have high cholesterol who get that low by using static drugs can really get their hormones and sometimes immune systems in a bad state (even with large amounts if CoQ10). They stop the statins and then things return to normal.

One sign of low T is thin and in-elastic skin. If you pinch up the skin on the back of your hand, it might take a while to recover. That thin crinkly skin is something that we associate with advanced age. I had that. 6 weeks after starting TRT, my skin was thicker and elastic. Recovery from the pinch test was almost instant. That is a nice result, but speaks to the types of tissue changes that, unseen, might be occurring throughout the body.

Do you take DHEA? What are your levels without? If natural DHEA levels are ok, you might not have any concerns for limits in the cholesterol cascade.

 

[cpeil2]

RBC....................6.20...........(4.2-5.8 Mill/MCL)
Hemoglobin..........16.3............(13.2-17.1 g/dl)
Hematocrit...........47.5............(38.5-50)
MCV...................76.6.............(80-100)
MCH...................26.2.............(27-33)
MCHC..................34.2..............(32-36)
RDW....................15.1..............(11-15.0)

These values suggest iron-deficiency anemia.

 

[Kingneptune40]

KSman..........Thanks for the reply.........I think my DHEA-sulfate was 221 back in the fall, TSH was 5.91 and my testosterone was 241 I think...........I tried Androgel, but it did not work well for me, gave me irritability, bloating, and mood swings............I have thick skin, so maybe I dont absorb it well, not to mention I am sure my estrogen levels are not too good.........I always tend to bloat and get irritable when I did my "cycles" and when I tried the Androgel........The Androgel definitely made me stronger though and increased my endurance........... At 241, even my GP figured out I needed something to boost my test. levels, but he is in way over his head when it comes to TRT........Hence, I found this site and booked an appt with Dr. John immediately..........Of course, I get more info from you guys than my own "doctors", which is just pathetic.......You guys are awesome.......

I know my thyroid is not good too, (TSH-5.9), but when I tried some T4, it gave me bad panic attacks and anxiety........It definitely helped with energy though, and my muscles were not sore..........I only was able to use for about a month, due to anxiety........Then I researched "Stopthethyroidmadness" and realized that I need to treat my adrenals first, then address thyroid........I have the "classic" symptoms for thyroid and adrenals..........I appreciate your suggestions KSman, thanks buddy.........

JanSz, I read that article on Metabolic Syndrome, thanks for the link.........I am really concerned with my insulin levels as we discussed and I bet Dr John is going to address this ASAP...........I am not real sure of family history, I was adopted, but I have always had problems with hypoglycemia, processing starches and sugars, and I had high liver enzymes back in my 20's when all of my problems started.........I am sure my "cycles" did not help the situation.........nor the college drinking binges..........Thanks for posting that article JanSz, that was a real eye opener for me..........Definitely makes me want to keep eating healthy............

Cpeil2, you are right on my man..........I was recently diagnosed with iron deficient anemia this spring.........Which could be playing a huge role in my fatigue.........I am hoping that with Dr John's TRT, we can get my numbers back up and then see where I am at............I was anemic as a child, so sounds like this has followed me through life........Thanks for your input, much appreciated...........I am amazed at the lack of "follow-up" by my physicians, I feel like I have to tell them everything????? I am a chiropractor, not an endocrinologist.........Its very frustrating..........Maybe I will go back to school and become a "D.O." like Dr John.........They just seem to have more common sense than these freakin' MD's........they drive me crazy.........LOL

 

[JanSz]

These values suggest iron-deficiency anemia.

In the name of education.
I would appreciate walking me thru your thought process, using the tests that are quoted.

===========================================
Quote:
Originally Posted by Kingneptune40
RBC....................6.20...........(4.2-5.8 Mill/MCL)
Hemoglobin..........16.3............(13.2-17.1 g/dl)
Hematocrit...........47.5............(38.5-50)
MCV...................76.6.............(80-100)
MCH...................26.2.............(27-33)
MCHC..................34.2..............(32-36)
RDW....................15.1..............(11-15.0)

 

[cpeil2]

In the name of education.
I would appreciate walking me thru your thought process, using the tests that are quoted.

===========================================
Quote:
Originally Posted by Kingneptune40
RBC....................6.20...........(4.2-5.8 Mill/MCL)
Hemoglobin..........16.3............(13.2-17.1 g/dl)
Hematocrit...........47.5............(38.5-50)
MCV...................76.6.............(80-100)
MCH...................26.2.............(27-33)
MCHC..................34.2..............(32-36)
RDW....................15.1..............(11-15.0)

He is producing numerous RBC's that are smaller than normal. You can tell this because his RBC is elevated and MCV (mean cell volume) is below normal.
Additionally, RDW (red cell distribution width) which is an index of the size distribution of the red cells, is elevated, meaning there is more variation in the size of the red cells than normal. In view of the fact that his MCV is low, the increased RDW most probably comes from a large number of undersized cells.
MCHC (mean cell hemoglobin concentration) is within range. MCHC is a measure of the portion of the RBC that comprises hemoglobin. It is expressed as a percentage. His MCHC shows that on average, each RBC comprises 34% hemoglobin.


MCH (mean corpuscular hemoglobin) is low. MCH is a measure of the absolute quantity of hemoglobin in each RBC. The fact that the MCH is low, while the MCHC is normal means that the cells are smaller than normal, although each cell is adequately supplied with hemoglobin.

Having small RBC's is called microcytosis, which is characteristic of iron-deficiency anemia. The abnormalities are slight and his hct and hemoglobin are mid-range, so this may represent an early anemia or one that is resolving.


On the other hand, I am nothing more than a hematologist wannabe, so a doc may look at these values and say that they are nothing to worry about.

If only one of the RBC indices had been off, I doubt whether I would have commented on it. But when so many were off, I thought it was worth commenting on.

 

[JanSz]

He is producing numerous RBC's that are smaller than normal. You can tell this because his RBC is elevated and MCV (mean cell volume) is below normal.
Additionally, RDW (red cell distribution width) which is an index of the size distribution of the red cells, is elevated, meaning there is more variation in the size of the red cells than normal. In view of the fact that his MCV is low, the increased RDW most probably comes from a large number of undersized cells.
MCHC (mean cell hemoglobin concentration) is within range. MCHC is a measure of the portion of the RBC that comprises hemoglobin. It is expressed as a percentage. His MCHC shows that on average, each RBC comprises 34% hemoglobin.


MCH (mean corpuscular hemoglobin) is low. MCH is a measure of the absolute quantity of hemoglobin in each RBC. The fact that the MCH is low, while the MCHC is normal means that the cells are smaller than normal, although each cell is adequately supplied with hemoglobin.

Having small RBC's is called microcytosis, which is characteristic of iron-deficiency anemia. The abnormalities are slight and his hct and hemoglobin are mid-range, so this may represent an early anemia or one that is resolving.


On the other hand, I am nothing more than a hematologist wannabe, so a doc may look at these values and say that they are nothing to worry about.

If only one of the RBC indices had been off, I doubt whether I would have commented on it. But when so many were off, I thought it was worth commenting on.

I am so glad that you are here, thank you.

============================================
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===============

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Complete Blood Count (CBC) Test explanations on how to read it.

 

[Kingneptune40]

Cpeil2, are you sure you're not an endocrinologist?? You explained it the exact same way my doctor did back in the fall, I am impressed..........Personally, I had to look up the information in my Merck Manual before I could make sense of it...........

Since you are on a "roll" Cpeil2, did you check out my numbers on the "Hemoglobin Electrophoresis" test they had me do, following my RBC tests???? Here are the numbers from my original post in this thread........Tell me what you think???? If you feel like it.........

Hgb-A...........85.3...............(96.3-100)
Hgb-F...........9.9.................(0-2.0)
Hgb-A2..........4.8................(0-3.7)

The Pathologist wrote on the bottom of the blood work that "elevated HbA2 and Hbf may occur in beta-thalassemias........."

Any thoughts or comments..........

 

[cpeil2]

Cpeil2, are you sure you're not an endocrinologist?? You explained it the exact same way my doctor did back in the fall, I am impressed..........Personally, I had to look up the information in my Merck Manual before I could make sense of it...........

Since you are on a "roll" Cpeil2, did you check out my numbers on the "Hemoglobin Electrophoresis" test they had me do, following my RBC tests???? Here are the numbers from my original post in this thread........Tell me what you think???? If you feel like it.........

Hgb-A...........85.3...............(96.3-100)
Hgb-F...........9.9.................(0-2.0)
Hgb-A2..........4.8................(0-3.7)

The Pathologist wrote on the bottom of the blood work that "elevated HbA2 and Hbf may occur in beta-thalassemias........."

Any thoughts or comments..........

I think so. I suppose there is still a possiblity that it could be iron deficiency, but the HGB-f elevation is so pronounced.

As long as you're a heterozygote, there are worse things than beta-thalassemia. But if you're a homozygote . . . .

 

[JanSz]

I think so. I suppose there is still a possiblity that it could be iron deficiency, but the HGB-f elevation is so pronounced.

As long as you're a heterozygote, there are worse things than beta-thalassemia. But if you're a homozygote . . . .

If heterozygote there is always a possibility that his is either manifesting heterozygote or compound heterozygote.....

 

[cpeil2]

If heterozygote there is always a possibility that his is either manifesting heterozygote or compound heterozygote.....

Isn't a compound heterozygote extremely rare?

It seems that he is a manifesting heterozygote because he does have measurable blood abnormalities.


Kingneptune, do you have any overt symptoms of anemia?

 

[Kingneptune40]

Cpeil2...........anemia

Hey Cpeil2..............My major symptoms are fatigue, which is brutal, only able to work 15 hours a week, muscle weakness, and digestive problems...........I dont have any apparent skin pallor or problems with nails or skin..........In fact, didnt even realize I had anemia until last year and I thought it was from low levels of testosterone and thyroid that have been persistant probably for the past 10 years............I did find out this year that I had some "minor anemia" as a baby, per my mom, so maybe this has been an on-going thing for me........I have struggled with fatigue my whole life, even though I was always active in sports, 3 sport athlete in high school and played 2 years of college football..........But, I was always falling asleep in school and always had to take naps after school and was a "bear" to get up in the morning........Usually sleeping til noon on the weekends........Definitely not normal.......???

 

[Kingneptune40]

Hey KSman, thanks alot for PM'n the article to me..........I have not read that one, definitely another eye opener.......Need to read it again and I will get back with you.........What kind of Amino's do you take???? Thanks again my man...........Peace

 

[cpeil2]

Hey Cpeil2..............My major symptoms are fatigue, which is brutal, only able to work 15 hours a week, muscle weakness, and digestive problems...........I dont have any apparent skin pallor or problems with nails or skin..........In fact, didnt even realize I had anemia until last year and I thought it was from low levels of testosterone and thyroid that have been persistant probably for the past 10 years............I did find out this year that I had some "minor anemia" as a baby, per my mom, so maybe this has been an on-going thing for me........I have struggled with fatigue my whole life, even though I was always active in sports, 3 sport athlete in high school and played 2 years of college football..........But, I was always falling asleep in school and always had to take naps after school and was a "bear" to get up in the morning........Usually sleeping til noon on the weekends........Definitely not normal.......???

"An elevation of Hb A2 demonstrated by electrophoresis or column chromatography confirms the diagnosis of beta thalassemia trait.."

"The Hb A2 level in these patients usually is approximately 4-6%. "


This is from an emedicine article that you can find here.


Your Mentzer index is 12.35. You calculate the Mentzer index by dividing MCV by RBC--in your case 76.6/6.2=12.35. Mentzer index of less than 13 suggests beta thalassemia, 13 or more suggests iron-deficiency anemia.


Kingneptune - Labs certainly suggest beta thalassemia minor. I have read that people who are heterozygous for the trait experience no symptoms other than mild anemia. You have the mild anemia. In view of your lifelong problem with fatique, I guess they're wrong that carriers do not experience symptoms.

 

[Kingneptune40]

Once again Cpeil2, you are the man.........Some of you guys need to go to med school and start getting paid for your knowledge.........So per your research and the Pathologist's report that my Hgb electrophoresis indicates "Beta Thalassemia"............Where do I go from here????? My GP indicates that my "levels" are not severe enough to indicate blood transfusions, which I am not too hip on anyway, and I really dont know what to think at this point?????

Do you think some of this can resolve via TRT and other hormone balancing or is this an issue that will need more investigation down the road????? What do you think Dr Cpeil2............You give better advice than my doctors........

 

[Kingneptune40]

Just to follow up with you Cpeil2, the research I have done on "beta-thalassemia minor" , which is what the pathology report states, and agreed upon by you.............It seems that patient "help" sites, by patients with this condition, all seem to agree that the fatigue is many times very severe, even with the "minor" form.........Whereas the "official statement" of most medical/physician sites, seem to downplay the fatigue in the "minor" form, saying that thalassemia "major" is the only form to worry about????

To me, it sounds like the same "dog and pony show" that the medical community gives us about TRT and thyroid issues......."Well, your numbers are within normal limits, so I dont know why you are complaining"........Here, take some anti-depressants and have a great day.......(laughter in background)...........

I just have a feeling that if Dr John cant get this improved, then I am probably not going to find much help.........They act like "thalassemia minor" is like having the flu........???

 

[JanSz]

"An elevation of Hb A2 demonstrated by electrophoresis or column chromatography confirms the diagnosis of beta thalassemia trait.."

"The Hb A2 level in these patients usually is approximately 4-6%. "


This is from an emedicine article that you can find herehttp://www.emedicine.com/med/topic2260.htm.


Your Mentzer index is 12.35. You calculate the Mentzer index by dividing MCV by RBC--in your case 76.6/6.2=12.35. Mentzer index of less than 13 suggests beta thalassemia, 13 or more suggests iron-deficiency anemia.


Kingneptune - Labs certainly suggest beta thalassemia minor. I have read that people who are heterozygous for the trait experience no symptoms other than mild anemia. You have the mild anemia. In view of your lifelong problem with fatique, I guess they're wrong that carriers do not experience symptoms.

Quote:
Frequency:


In the US: The frequency of disease varies widely, depending on the ethnic population. Beta thalassemia is reported most commonly in Mediterranean, African, and Southeast Asian populations.
Internationally: The disease is found most commonly in the Mediterranean region, Africa, and Southeast Asia, presumably as an adaptive association to endemic malaria. The incidence may be as high as 10% in these areas.
==========================
Kingneptune, in view of the above, it would possibly help if you describe your ethnicity.

 

[Kingneptune40]

Thanks for your input Dr John, I will be seeing you on Friday...........at noon...............Maybe we will catch some lunch afterward, if time permits...........Talk soon........Peace

 

[Kingneptune40]

Thanks for the input JanSz, that is the question I have been pondering myself.........I am 50 percent German, probably 25-50 percent Irish, with a touch of Scotch..........add your joke here..........LOL Believe me, I am baffled........Dont know if my thalassemia has developed as a result of everything else going on, or if its basically a genetic condition that runs in my family.............Which I am adopted and know very little of my family history............??? Must have something going on in the family tree........LOL

 

[cpeil2]

Thanks for the input JanSz, that is the question I have been pondering myself.........I am 50 percent German, probably 25-50 percent Irish, with a touch of Scotch..........add your joke here..........LOL Believe me, I am baffled........Dont know if my thalassemia has developed as a result of everything else going on, or if its basically a genetic condition that runs in my family.............Which I am adopted and know very little of my family history............??? Must have something going on in the family tree........LOL

It's genetic. Thalassemia is most common in people of Asian and Mediterranean descent, somewhat common in people of African descent and uncommon in people of northern European descent. But people of any ethnicity can have it.

It would be extremely rare for someon of European descent to have Thalassemia major, because both parents would have to carry the trait. Since carriers are unusual enough among that population, the possibility of two carriers having a child and each of them passing on the trait to the child is pretty remote.

 

[Kingneptune40]

Thanks again Cpeil2, its great to have you guys filling in the blanks around here..........I guess we will soon find out whether my fatigue is mainly low test and thyroid, along with the adrenal problems I am having too.........or if the Beta-thalassemia is causing a low level fatigue issue with me.......

As I was saying before, everything I could find on medical websites or physician based websites, stated that there is no "significant" fatigue with the "minor" forms of beta thallasemia..........But when you look at message boards with other patients with B-T minor, they said they were having severe fatigue problems and most doctors were just dismissing them as complainers????? It just makes me wonder if its the same scenario most of us are getting from MD's who dont believe in TRT and think its normal to have test. numbers in the 200-300 range in our late 30's?????

I will let you guys know what Dr John says and I will be posting my recovery journal here for the next 6 months.........I see Dr J on Friday, so I will post some info this weekend.........Thanks again guys for taking time to help me figure all of this out..........Peace.......

 

[JanSz]

Thanks for the input JanSz, that is the question I have been pondering myself.........I am 50 percent German, probably 25-50 percent Irish, with a touch of Scotch..........add your joke here..........LOL Believe me, I am baffled........Dont know if my thalassemia has developed as a result of everything else going on, or if its basically a genetic condition that runs in my family.............Which I am adopted and know very little of my family history............??? Must have something going on in the family tree........LOL

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[cpeil2]

http://www.ancestrybydna.com/welcome/home/index.php

DNAPrint® Genomics offers a unique and economical process for families to genetically verify their ancestral origins. Continue on to explore your family’s hereditary links to the past.

You can get the same testing through National Geographic for 99.95

 

[Kingneptune40]

Cpeil2 and JanSz, thanks again guys, I really appreciate the info.........I will get on that when I get back in town........I am off to see Dr John, talk to you guys this weekend.......Peace........

 

[cpeil2]

As RBC's are released into the bloodstream in an immature state, elevated RDW mewans the body is producing a lot of new RBC's.

Thank you!!

 

[wildfox]

Cpeil2 and JanSz, thanks again guys, I really appreciate the info.........I will get on that when I get back in town........I am off to see Dr John, talk to you guys this weekend.......Peace........

Are you satisfied with your visit?

 

[Kingneptune40]

Back from the Man-Cave

Hey Guys,

Had a great 1st appointment with Dr John, I will post some more info this evening..........Highly suggest everyone make the visit to Lansing, worth the trip..........Peace:thumbsup: :thumbsup: