Sujay

Discussion in 'Fibromyalgia Main Forum' started by CelticLadee, Jun 24, 2003.

  1. CelticLadee

    CelticLadee New Member

    Hello Sujay,
    I hope you don't mind I have been wanting to talk to you.
    I just got my blood test results and have some questions. In hindsight I have been battling CFIDS symptoms since spring 2001 but really notably since July 2002. My GP and naturopath have not diagnosed me and tend to skirt around it and just treat my symptoms. Here are my stats.
    CBC
    WBC 7.4 NORMAL
    RBC 4.59 NORMAL
    HEMOGLOBIN 12.1 NORMAL
    HEMATOCRIT 36.1 NORMAL
    MCV 79 NORMAL
    MCH 26.4 LOW (WHAT IS THIS? WHAT DOES IT MEAN LOW?)
    MCHC 33.6 NORMAL
    RDW 14.9 NORMAL
    PLT 316 NORMAL
    AUTO DIFF
    GRAN % 58 NORMAL
    LYMPH % 31 NORMAL
    MONO % 8 NORMAL
    EO % 2 NORMAL
    BA % 1 NORMAL
    NEUTROPHIL# 4.3 NORMAL
    LYMPH # 2.3 NORMAL
    MONO # 0.6 NORMAL
    EOS# 0.1 NORMAL
    BASO # 0.1 NORMAL
    SED RATE 7(a) NORMAL

    I also had the COMP MET PAN all is normal except GPT/ALT is slightily elevated to 48
    TIBC serum iron is low at 31 but TIBC high at 485 with % SATURATION at 6
    My THYROXINE (T4) was 7.7 and the TSH was at 2.43.

    Question: As far as hypercoagulation - does this indicate I don't have it or mycoplasma bacteria? or do I need another type blood test to know this?

    Question: What is this MCH 26.4 low reading all about? Is it significant or not?

    Question: Frequent test show my liver count keeps going up to 48 the past year. Does this indicate anything? Should I do anything to help my liver? I drink lots of water.

    Question: My naturopath gave me a prescription for Levoxyl 0.05 MG. After reading about it I don't like the idea of taking it. My reading of 2.43 isn't that high - can you give me a second opinion - what should I do? or not do? He wants it to be 2.00. Says my fatigue and cold hands and low morning temperatures would improve with Levoxyl.

    Question: Are there further tests I should have done or not?

    I thank you in advance for any help you can give me. This whole year has been so confusing for me trying to figure out what I need to do to get well. It seems to me reading your posts that you have a solid foundation in knowledge of this illness. If you could stir me in the right direction I would really appreciate it. Thank you very much.

    CelticLadee
  2. Shirl

    Shirl New Member

    Shalom, Shirl
  3. sujay

    sujay New Member

    I, too began struggling with CFIDS symptoms in spring 2001, though I first became ill in fall 2000. I understand why your GP and naturopath may be uncomfortable with diagnosing you. It's very frustrating to have to tell a patient that we don't have an approved battle plan to combat what's really wrong (or that we don't even really understand what it is). I'm glad, though to hear that they acknowledge and are willing to treat your symptoms.

    Your lab really doesn't look too bad, and the abnormalities appear to be mostly related to a low iron level. Iron supplementation might help some of your symptoms, but I can offer this as a suggestion only. There's no way my opinion can substitute for the judgment of the physicians who know you. That being said, I'll do the best I can to answer your questions.

    Question: As far as hypercoagulation - does this indicate I don't have it or mycoplasma bacteria? or do I need another type blood test to know this?

    Answer: There really is no substitue for the ISAC Panel to evaluate for hypercoagulation. We are really interested in looking for evidence of excess fibrin or prothrombin production (which we suspect leads to abnormal deposition and interferes with normal metabolic function of the cells, accounting for many of our symptoms). In addition to the tests you report we also look for signs of auto-immune disease (though this is less likely in your case with the low sed rate, which we often see with this disease). I have started checking for Hughes' Syndrome (the new name for Anti-phospholipid Antibody Syndrome, named in honor of the British rheumatologist who first described it a couple of decades ago). For that I test PT, PTT, D-dimer, Lupus Anticoagulant and Anti-cardiolipid Antibody. (These are the two most commonly positive anti-phospholipid antibodies. The ISAC Panel tests for evidence that others may have been activated by the immune system, and that's why we talk about a variant.) I do have a patient with Hughes' Syndrome who also tests positive on ISAC, and we are currently trying to see if adding heparin and looking for a pathogen will help ease some of the fatigue and other symptoms she still suffers despite getting excellent care from her primary care physician, neurologist and rheumatologist. I generally hold off on PCR testing (to look for mycoplasma, chlamydia and several viruses) until after we've seen some response (a worsening of symptoms) to heparin therapy. These critters are difficult to flush out of hiding, and the tests are expensive, so we try to maximize our chances for a positive result.

    Question: What is this MCH 26.4 low reading all about? Is it significant or not?

    Answer: Probably related to low iron stores.

    Question: Frequent test show my liver count keeps going up to 48 the past year. Does this indicate anything? Should I do anything to help my liver? I drink lots of water.

    Answer: Generally liver function tests increase due to inflammation of the liver, but toxins or even just too much fat can also cause problems. It needs to be looked at in its clinical context by the people in position to evaluate the whole picture, your physicians. I'd definitely avoid alcohol and exposure to chemicals (like those used for dry cleaning) while this is being evaluated.

    Question: My naturopath gave me a prescription for Levoxyl 0.05 MG. After reading about it I don't like the idea of taking it. My reading of 2.43 isn't that high - can you give me a second opinion - what should I do? or not do? He wants it to be 2.00. Says my fatigue and cold hands and low morning temperatures would improve with Levoxyl.

    Answer: He could be right, but I would be more comfortable if he had first checked Free T3 and Free T4 (because a lot of thyroid hormone tends to be bound to protein in patients who have been chronically ill for a long time. If both are in the lower half of the normal range you might do better with low doses of Armour Thyroid (or synthetic Thyrolar) because some of us may have difficulty converting T4 to the more active T3 in the peripheral tissues, where fine-tuning is normally done to meet local needs. This is really complicated; Madwolf could probably explain it far better than I, because he's had a lot more experience. (I'm learning at his knee.)

    Question: Are there further tests I should have done or not?

    Answer: Please see above. You might see if your doctor would talk to Dr. Berg. He is not a physician, but he talks to us all the time, and I have been very impressed with his grasp of many of the principles of clinical medicine. I'd also be happy to talk to your doctor if he's interested. I practice in Poulsbo, so that shouldn't be too difficult to arrange. (I can be contacted at mail4sujay at yahoo if you need more details on how he can get in touch with me.)

    You're certainly welcome for any help and encouragement I can provide. Good luck on your quest. I hope you will see steady improvement, despite all the ups and downs we have come to expect.

    Best wishes,

    Sujay