6 Month Bloodwork

I got my 6 month bloodwork results this week.  I meet with my Dr. in 10 days - going out of town for business next week.  Can the experts out there help me interpret?   I have felt pretty low in energy, and suspected it was because of my iron.  My three month blood test, the iron and calcium were both low, but everything else was good.  This time, the good news is, calcium has improved, but iron seems to have gotten lower.  I am doing the Vitalady DS vitamin regimen, ordered through Vitalady, and have never missed a day of iron.  I always make sure to not have any food within two hours either side of the iron. I've listed the results, and what the normal ranges are for those areas that came up high or low.   Any input would be greatly appreciated!

 

CBC with Auto Diff

WBC  11.7  H  3.8-10.5
RBC   4.40

 

HGB 12.5 L  13.0-17.0

HCT  39.8
MCV  90.5
MCHC 31.4  L  32.0-36.0
RDW  17.0   H  10.3-14.5
PLT 236
Neut% 70.3
LYMPH% 19.7
Mono% 7.5
Bos %   1.7
Baso% 0.4
IMM Gran% 0.4
Neut#   8.2 H   1.8-7.4
Lymph # 2.3
Mono#  0.9
Bos# 0.2
Baso# 0.0

Iron  36  L  45-165
UIBC  177
TIBC  213 L  220-430
% Saturation, iron 17

all the CMP tests came out normal, including calcium serum - 9.5, which had been low at three months

Lipid Profile

Cholesterol  124
HDL Cholesterol   37  L  40-125
Triglyceride  98
LDL Cholesterol (calc) 67
Cholesterol/HDL ratio  3.4

Parathyroid Hormone Intact

Calcium  9.5
Parathyroid hormone  28
HGB AIC  4.6

Ferritin Serum

Ferritin 337

Vitamin B12    >2000  H  243-894

Vitamin D Hydroxy  42.9

Zinc Plasma  143  H  56-134

Vitamin B1  228.0  H  66.5-200.0

 

 

 

I think you're probably in pretty good shape if your ferritin is 337.  I don't understand why your iron serum and HGB are low but HCT is ok. Might be something to discuss with the doc or dietitian.

You probably can back on the B12. Maybe try 4 times a week rather than 7 days a week.

You want the calcium coming in around 9.2, D3 around 100 and PTH around 26. Your PTH is in good shape and your calcium pretty good too. It might take a little more time for the D3 to come up. 

You might cut your zinc back to 4 times a week.

If you're taking the B complex, time to stop. It may be elevating your B vitamins too high. You could go with 1 per wee****il you can retest all your B vitamins. B6 may be getting too high too. 

I think that's all I got.  : )   Oh! Protein serum, albumin and prealbumin?

--gina

Yes my ferritin's low despite mega supplementation.  Some DSers just don't absorb iron well and get iron infusions, or injections which sounds better to me.  This thread is worth a read before you see your doc http://www.obesityhelp.com/forums/ds/4485613/Which-iron-infu sion-is-best-Venofer-dextran-ferrlecit-infed/

BTW high B12 isn't dangerous, but your just flushing your money - I got the same result as you and have been cutting back for a few weeks now.  Vitaguy said 1,500-2,000 is a good number for a DSer.

I don't see copper.  You want to get that drawn as zinc and copper are like a seesaw so if your zinc's high your copper may be low.  You need to be on 2mg chelated copper until your bloodwork indicates otherwise.

Protein 7.5
Albumin 4.1
Bilirubin 0.4 
(Did not find prealbumin on test results)
Copper was also not on the test results, but I do take it daily 5 mg from the Vitalady plan

 

Thanks for the input, Major Mom and Huneypie, now I'm not panicking about these results.

 

You have awesome protein markers!  : )

--g

Hello,

I hardly ever post on here these days, I don't check back a whole lot anymore as life has gone on.  I'm now 4.5 years post-DS and quite healthy!  The reason I'm responding to you is to let you know that my blood work in terms of abnormal blood cell differentials and "weird" iron panel was actually pretty similar to yours at one point.  I want to preface this by saying that my experience is not necessarily your experience, but I do think you should get some f/u testing done.  I argued with my doctors about getting more testing done by the fact that my vitamin panels were pretty normal and that it was not normal to have the values of the CBC and iron panel that I had just b/c I was a DSer. 

In short, abnormal CBC and the iron panel you have can indicate disease of some type.  I ended up having Hodgkin's Lymphoma.  I actually pulled my old blood work papers to look at my numbers b/c what you wrote was so similar to what I remember.  At my annual vitamin check-up, these were some of my values:

WBC = high, 11.3

RBC = normal, 4.11

HBG = low, 9.9

Hematocrit, MCV, MCH, MCHC, = all low

RDW & platelet count = high

 

Iron, total = low, 19

TIBC = low, 216

% saturation = 9

Ferritin = high, 470

 

Read some information on anemia sub-types.  I was given 5 rounds of IV iron and my HBG decreased, the iron panel remained the same and my ferritin was over 2,000.  All that iron was simply bound to ferritin (a protein) & stored in my liver.  For me, my body knew an "invader" (cancer) was present, which can use iron to grow and so it didn't matter how much iron I gave it, it stored it away so that the amount circulating was only the amount for essential normal functions.  This process is associated with long-term anemia from disease and is called Anemia of Chronic Disease. 

For Hodgkin's Lymphoma, WBC's increase because your body recognizes it as a type of infection.  The values never go "sky-high", they just hang around a little elevated.

What I would recommend:

Get an ESR (erythrosedimendation rate) & LDH (sorry don't remember what that one means) blood test.  They are pretty cheap.  ESR is a "non-specifc" inflammatory marker - it measures inflammation in the body, but it's just a general marker of inflammation and is not specific to lymphomas.  LDH is also an inflammatory marker but is tied to lymphomas, but not all lymphomas and it's not always high even if one should have it (I was diagnosed as advanced stage & my LDH was normal). 

There's enough abnormality in your blood work that's NOT related to vitamins to warrant it, so insurance should pay.  One of the possible problems is finding a physician who will not simply automatically think it must just be from your DS and actually do f/u blood work.  This was a major hurdle for me.  By the way, RDW = high . . . this is your red blood cell distribution width.  What it means is the amount of variability in terms of size of your red blood cells across a specific amount of time.  If I remember right, it's two weeks.  A high RDW therefore means that your blood cell size is changing.  The fact that most of the measures of the size of your red blood cells is low indicates that your body is making smaller red blood cells.  They get smaller in the presence of long-term (chronic) anemia.

BTW - I had been feeling pretty low in energy for months leading up to it and also suspected I was anemic.  I didn't go to the doctor sooner because I didn't have insurance.  I was right in having anemia, just not from the WLS.  When us DSers get anemia due to the surgery, it is called Iron-Deficiency Anemia.  When that happens your TIBC is normal and your ferritin is low.  Your low TIBC actually reflects/ supports your high ferritin level - here's why.  Like I said, ferritin is an iron that binds excess iron and stores it in your liver.  The TIBC = Total Iron Binding Capacity.  This number indicates the level that your body can easily bind to excess iron in your blood stream (hence the name).  When TIBC is low, it means that your body's ability to easily/ readily store excess iron is low . . . it's low because your body has already bound & stored so much excess iron as ferritin.  The cutoff value for normal ferritin is around 150.

I want to stress again, my diagnosis of Hodgkin's Lymphoma was my experience with these values.  There could be different diseases that also are consistent with these values. What I STRONGLY encourage you to not do is simply assume 1)  your doctor is always right; 2) it must be due to your DS.  We all have different health possibilities.

Best of luck.

Lisa

Great catch and good info. Thanks for posting, Lisa.

--gina

Hi Gina, I'm glad you saw Lisey's repl. I bookmarked it for reference as catching things early is preferable.