Update FFC Denver Worried Please Review...Thanks!

Discussion in 'Fibromyalgia Main Forum' started by ImDigNiT, Sep 19, 2005.

  1. ImDigNiT

    ImDigNiT New Member

    I just received my first lab results (35 vials) and had more lab work today.

    Here are some of the results:

    Iron Binding Capacity out of range at 423 (high)
    Hemoglobin out of range at 16.3(high)
    MCH out of range at 33.4 (high)
    Cholesterol out of range 298 (Highh)
    Triglycerides out of range at 204 (high)
    LDL out of range 208 (high)
    Coronary Risk Ratio out of range at 6.1 (High)
    Homocysteine (Cardiovascular) out of range 12.2 (High)
    Lipoprotien out of range 31 (high)
    Cardio CRP out of range 8.4 (High)
    NR Cell Activity out of range at 17.40 (Low)
    Vitamain D, 25-Dihydroxy 12 (Low)
    Thyroid in the low range

    I am concerned about all of it but extremely concerned about the NR Cell Activity. My adrenal glands are not fighting infections and viruses and such.

    Can someone remind of the site that explains your lab work please?

    Has anyone else had simiular results and if so how are you now and what did you do to get better?

    I am leaving Denver in the morning and will be back in Florida by Wed. or Thursday. I will take my lab work to my Dr and my attorney when I get back.

    The blood work today was for viruses including Lymes etc.

    Any input would be greatly appreciated.


    Peaceful mind and body to all.

    Marcia
  2. rileyearl

    rileyearl New Member

    Hi Marcia,

    I will be getting lab results on Wednesday and will report in. I'm going to the Seattle FFC.

    I have a question. Why are you taking your lab results to your attorney. Please excuse me if I missed something in an earlier post.

    Have a safe trip home! Talk to you soon!

    Francie
  3. kbak

    kbak Member

    Don't freak. My results were pretty poor. I have gone to Denver also. I have gotten so much better since I first went last March.

    It's always hard to hear your a lot sicker than you thought you were. With treatment I think you'll do well. Who is going to treat you? Denver, or a doc in FL?
  4. fibromaster

    fibromaster New Member

    Glucose: This is a measure of the sugar level in your blood. High values are associated with eating before the test, and diabetes.

    The normal range for a fasting glucose is 60 -109 mg/dl. According the the 1999 ADA criteria, diabetes is diagnosed with a *fasting* plasma glucose of 126 or more. A precursor, Impaired Fasting Glucose (IFG) is defined as reading of fasting glucose levels of 110 - 125. Sometimes a glucose tolerance test, which involves giving you a sugary drink followed by several blood glucose tests, is necessary to properly sort out normal from IFG from diabetes.

    Be aware that variations in lab normals exist. Also, Europeans tend to use a 2 hour after eating definition of diabetes rather than a fasting glucose. Using the European standards tends to increase the number of people who are classified as having diabetes.

    Electrolytes: These are your potassium, sodium, chloride, and CO2 levels.

    Potassium is controlled very carefully by the kidneys. It is important for the proper functioning of the nerves and muscles, particularly the heart. Any value outside the expected range, high or low, requires medical evaluation. This is especially important if you are taking a diuretic (water pill) or heart pill (Digitalis, Lanoxin, etc.).

    Sodium is also regulated by the kidneys and adrenal glands. There are numerous causes of high and low sodium levels, but the most common causes of low sodium are diuretic usage, diabetes drugs like chlorpropamide, and excessive water intake in patients with heart or liver disease.

    CO2 reflects the acid status of your blood. Low CO2 levels can be due to either to increased acidity from uncontrolled diabetes, kidney disease, metabolic disorders, or low CO2 can be due to chronic hyperventilation.

    Waste products:

    Blood Urea Nitrogen (BUN) is a waste product produced in the liver and excreted by the kidneys. High values may mean that the kidneys are not working as well as they should. BUN is also affected by high protein diets and/or strenuous exercise which raise levels, and by pregnancy which lowers it.

    Creatinine is a waste product largely from muscle breakdown. High values, especially with high BUN levels, may indicate problems with the kidneys..

    Uric Acid is normally excreted in urine. High values are associated with gout, arthritis, kidney problems and the use of some diuretics.

    Enzymes

    AST, ALT, SGOT, SGPT, and GGT and Alkaline Phosphatase are abbreviations for proteins called enzymes which help all the chemical activities within cells to take place. Injury to cells release these enzymes into the blood. They are found in muscles, the liver and heart. Damage from alcohol and a number of diseases are reflected in high values.

    Alkaline phosphatase is an enzyme found primarily in bones and the liver. Expected values are higher for those who are growing (children and pregnant women) or when damage to bones or liver has occurred or with gallstones. Low values are probably not significant.

    GGT is also elevated in liver disease, particularly with obstruction of bile ducts. Unlike the alkaline phosphatase it is not elevated with bone growth or damage.

    AST/SGOT , ALT/ SGPT are also liver and muscle enzymes. They may be elevated from liver problems, hepatitis, excess alcohol ingestion, muscle injury and recent heart attack.

    LDH is the enzyme present in all the cells in the body. Anything which damages cells, including blood drawing itself, will raise amounts in the blood. If blood is not processed promptly and properly, high levels may occur. If all values except LDH are within expected ranges, it is probably a processing error and does not require further evaluation.

    Bilirubin: is a pigment removed from the blood by the liver. Low values are of no concern. If slightly elevated above the expected ranges, but with all other enzymes (LDH, GOT, GPT, GGT) within expected values, it is probably a condition known as Gilbert’s syndrome and is not significant

    CPK is an enzyme which is very useful for diagnosing diseases of the heart and skeletal muscle. This enzyme is the first to be elevated after a heart attack (3 to 4 hours). If CPK is high in the absence of heart muscle injury, this is a strong indication of skeletal muscle disease.

    Proteins

    Albumin and Globulin measure the amount and type of protein in your blood. They are a general index of overall health and nutrition. Globulin is the "antibody" protein important for fighting disease.

    A/G Ratio is the mathematical relationship between the above.

    Blood Fats

    Cholesterol is a fat-like substance in the blood which, if elevated has been associated with heart disease.

    Total Cholesterol: A high cholesterol in the blood is a major risk factor for heart and blood vessel disease. Cholesterol in itself is not all bad, in fact, our bodies need a certain amount of this substance to function properly. However, when the level gets too high, vascular disease can result. A total cholesterol of less than 200, and an LDL Cholesterol of 100 or less is considered optimal by the National Heart, Lung, and Blood Institute. The levels that your doctor will recommend depend upon whether you are at high risk for cardiovascular disease.

    As the level of blood cholesterol increases, so does the possibility of plugging the arteries due to cholesterol plaque build-up. Such a disease process is called "hardening of the arteries" or atherosclerosis. When the arteries feeding the heart become plugged, a heart attack may occur. If the arteries that go to the brain are affected, then the result is a stroke.

    There are three major kinds of cholesterol, High Density Lipoprotein (HDL) , Low Density Lipoprotein (LDL), and Very Low Density Lipoprotein (VLDL).

    LDL Cholesterol is considered "bad cholesterol" because cholesterol deposits form in the arteries when LDL levels are high. An LDL level of less than 130 is recommended, 100 is optimal, values greater than 160 are considered high risk and should be followed up by your physician. Those persons who have established coronary or vascular disease may be instructed by their doctor to get their LDL Cholesterol well below 100. You should ask your doctor which LDL target he or she wants for you. There are two ways to report LDL. The most common is simply an estimate calculated from the Total Cholesterol, HDL, and triglycerides results. This may say "LDL Calc" . A directly measured LDL Cholesterol is usually more accurate, but more expensive and may require that your doctor specify the direct LDL.

    HDL cholesterol is a ‘good cholesterol’ as it protects against heart disease by helping remove excess cholesterol deposited in the arteries. High levels seem to be associated with low incidence of coronary heart disease.

    Triglyceride is fat in the blood which, if elevated, has been associated with heart disease, especially if over 500 mg. High triglycerides are also associated with pancreatitis. Triglyceride levels over 150 mg/dl may be associated with problems other than heart disease. Ways to lower triglycerides: 1) weight reduction, if overweight; 2) reduce animal fats in the diet: eat more fish; 3) take certain medications your physician can prescribe; 4) get regular aerobic exercise; 5) decrease alcohol and sugar consumption—alcohol and sugar are not fats, but the body can convert them into fats then dump those fats into your blood stream 6) restrict calories - carbohydrates are converted to triglycerides when eaten to excess.

    VLDL (very low density lipoprotein) is another carrier of fat in the blood.

    Cardiac Risk Factors

    C Reactive Protein (CRP): This is a marker for inflammation. Traditionally it has been used to assess inflammation in response to infection. However we use a highly sensitive C Reactive Protein which is useful in predicting vascular disease, heart attack or stroke.. The best treatment for a high C reactive protein level has not yet been defined, however statin drugs, niacin, weight loss, quitting smoking, and exercise all appear to improve C- Reactive Protein

    Homocysteine: Homocysteine is an amino acid that is normally found in small amounts in the blood. Higher levels are associated with increased risk of heart attack and other vascular diseases. Homocysteine levels may be high due to a deficiency of folic acid or Vitamin B12, due to heredity, older age, kidney disease, or certain medications. Men tend to have higher levels. Our lab normals are 4 - 15 micromole/l , but if you have had previous vascular disease we may recommend medications to reduce it below 10. You can reduce your homocysteine level by eating more green leafy vegetables and fortified grain products or cereals. The usual treatment is folic acid with or without Vitamin B-12.

    Lipoprotein (a) or Lp(a) : Elevated lipoprotein(a) (Lp[a]) concentrations are associated with premature coronary heart disease (CHD). The exact mechanism is not yet clear, but it appears that there is a strong genetic component to elevated Lp(a) levels that correlates with coronary disease. Persons with diabetes and a high Lp(a) level appear to be at increased risk of asymptomatic coronary disease.

    Note that a few insurance companies refuse to pay for cardiac risk factor testing. As of this writing, Aetna stands out as a company that refuses to cover testing for homocysteine or Lp(a) on the basis that it is "experimental" or "investigational". We have asked for a comprehensive review of their policy since it deviates from the norm.

    Minerals

    Calcium is controlled in the blood by the parathyroid glands and the kidneys. Calcium is found mostly in bone and is important for proper blood clotting, nerve, and cell activity. An elevated calcium can be due to medications such as thiazide type diuretics, inherited disorders of calcium handling in the kidneys, or excess parathyroid gland activity or vitamin D. Low calcium can be due to certain metabolic disorders such as insufficient parathyroid hormone; or drugs like Fosamax or furosemide type diuretics.

    Calcium is bound to albumin in the blood, so a low albumin level will cause the total calcium level in the blood to drop. You doctor can easily determine if this is significant or not.

    Phosphorus is also largely stored in the bone. It is regulated by the kidneys, and high levels may be due to kidney disease. When low levels are seen with high calcium levels it suggests parathyroid disease, however there are other causes. A low phosphorus, in combination with a high calcium, may suggest an overactive parathyroid gland.

    Thyroid

    There are 2 types of thyroid hormones easily measurable in the blood, thyroxine (T4) and triiodothyronine (T3). For technical reasons, it is easier and less expensive to measure the T4 level, so T3 is usually not measured on screening tests.

    Please be clear on which test you are looking at. We continue to see a tremendous amount of confusion among doctors, nurses, lab techs, and patients on which test is which. In particular, the "Total T3", "Free T3" and "T3 Uptake tests" are very confusing, and are not the same test.

    Thyroxine (T4) . This shows the total amount of the T4. High levels may be due to hyperthyroidism, however technical artifact occurs when estrogen levels are higher from pregnancy, birth control pills or estrogen replacement therapy. A Free T4 (see below) can avoid this interference.

    T3 Resin Uptake or Thyroid Uptake. This is a test that confuses doctors, nurses, and patients. First, this is not a thyroid test, but a test on the proteins that carry thyroid around in your blood stream. Not only that, a high test number may indicate a low level of the protein! The method of reporting varies from lab to lab. The proper use of the test is to compute the free thyroxine index.

    Free Thyroxine Index (FTI or T7) : A mathematical computation allows the lab to estimate the free thyroxine index from the T4 and T3 Uptake tests. The results tell us how much thyroid hormone is free in the blood stream to work on the body. Unlike the T4 alone, it is not affected by estrogen levels.

    Free T4 : This test directly measures the free T4 in the blood rather than estimating it like the FTI. It is a more reliable , but a little more expensive test. Some labs now do the Free T4 routinely rather than the Total T4.

    Total T3: This is usually not ordered as a screening test, but rather when thyroid disease is being evaluated. T3 is the more potent and shorter lived version of thyroid hormone. Some people with high thyroid levels secrete more T3 than T4. In these (overactive) hyperthyroid cases the T4 can be normal, the T3 high, and the TSH low. The Total T3 reports the total amount of T3 in the bloodstream, including T3 bound to carrier proteins plus freely circulating T3.

    Free T3: This test measures only the portion of thyroid hormone T3 that is "free", that is, not bound to carrier proteins.

    Thyroid Stimulating Hormone (TSH) : This protein hormone is secreted by the pituitary gland and regulates the thyroid gland. A high level suggests your thyroid is underactive, and a low level suggests your thyroid is overactive.

    Glycohemoglobin (Hemoglobin A1 or A1c, HbA1c) : Glycohemoglobin measures the amount of glucose chemically attached to your red blood cells. Since blood cells live about 3 months, it tells us your average glucose for the last 6 - 8 weeks. A high level suggests poor diabetes control. Standardization for glycohemoglobin from lab to lab is poor, and you cannot compare a test from different labs unless you can verify the technique for measuring glycohemoglobin is the same. The only exception is if your lab is standardized to the national DCCT referenced method. You can ask your lab if they use a DCCT referenced method.

    FYI, at Amarillo Medical Specialists we do use a test method that is DCCT referenced.

    Hormones

    Insulin : Insulin is secreted by the pancreas in response to eating or elevated blood sugar. It is deficient in persons with type 1 diabetes, and present at insufficient levels in persons with type 2 diabetes. The natural evolution of type 2 diabetes causes insulin levels to fall from high levels to low levels over a course of years. Thus insulin levels in persons with type 1 and type 2 diabetes overlap significantly, and insulin levels are not very useful in determining type 1 vs type 2. Insulin levels vary widely from person to person depending upon an individuals insulin sensitivity (or conversely, their insulin resistance.) Insulin levels also vary widely according to when the last meal occurred. Insulin resistance is a risk factor for coronary disease, thus assessing an individual's insulin resistance may have some value using the HOMA-IR calculation. Insulin levels are also elevated in patients with true hypoglycemia, however the interpretation of these levels is difficult. Insulin levels, when measured by itself at a random time is rarely useful.

    C-peptide : This is a fragment cleaved off of the precursor of insulin (pro-insulin) when insulin is manufactured in the pancreas. C-peptide levels usually correlate with the insulin levels, except when people take insulin injections. When a patient is hypoglycemic, this test may be useful to determine whether high insulin levels are due to excessive pancreatic release of insulin, or from an injection of insulin.

    Estradiol : This is the most commonly measured type of estrogen measured. In women it varies according to their age, and whether they are having normal menstrual cycles. Hormone levels are also changed when taking birth control pills or estrogen replacement.

    Complete Blood Count (CBC)

    The CBC typically has several parameters that are created from an automated cell counter. These are the most relevant:

    White Blood Count (WBC) is the number of white cells. High WBC can be a sign of infection. WBC is also increased in certain types of leukemia. Low white counts can be a sign of bone marrow diseases or an enlarged spleen. Low WBC is also found in HIV infection in some cases. (ed. note: The vast majority of low WBC counts in our population is NOT HIV related.)

    Hemoglobin (Hgb) and Hematocrit (Hct) : The hemoglobin is the amount of oxygen carrying protein contained within the red blood cells. The hematocrit is the percentage of the blood volume occupied by red blood cells. In most labs the Hgb is actually measured, while the Hct is computed using the RBC measurement and the MCV measurement. Thus purists prefer to use the Hgb measurement as more reliable. Low Hgb or Hct suggest an anemia. Anemia can be due to nutritional deficiencies, blood loss, destruction of blood cells internally, or failure to produce blood in the bone marrow. High Hgb can occur due to lung disease, living at high altitude, or excessive bone marrow production of blood cells.

    Mean Corpuscular Volume (MCV) - This helps diagnose a cause of an anemia. Low values suggest iron deficiency, high values suggest either deficiencies of B12 or Folate, ineffective production in the bone marrow, or recent blood loss with replacement by newer (and larger) cells from the bone marrow.

    Platelet Count (PLT) : This is the number of cells that plug up holes in your blood vessels and prevent bleeding. High values can occur with bleeding, cigarette smoking or excess production by the bone marrow. Low values can occur from premature destruction states such as Immune Thrombocytopenia (ITP), acute blood loss, drug effects (such as heparin) , infections with sepsis, entrapment of platelets in an enlarged spleen, or bone marrow failure from diseases such as myelofibrosis or leukemia. Low platelets also can occur from clumping of the platelets in a lavender colored tube. You may need to repeat the test with a green top tube in that case.

    http://www.amarillomed.com/howto.htm
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    Thyroid hormones, notably triiodothyronine (T3), affect the heart directly and indirectly. They are closely linked with heart rate and heart output. T3 provides particular benefits by relaxing the smooth muscles of blood vessels, thus helping to keep them open so blood may flow smoothly through them. Hypothyroidism is associated with unhealthy cholesterol levels, mild high blood pressure, impaired heart muscle contraction, and heart failure in people with existing heart disease. There is some evidence that even subclinical hypothyroidism increases the rates of heart disease and heart attacks in older women.

    Cholesterol and Lipid Levels. Hypothyroidism is significantly associated with unhealthy lipid levels. (Lipids are fat molecules). Specifically, people with hypothyroidism and even subclinical hypothyroidism are at higher risk for high total and LDL -- the so-called bad -- cholesterol, triglycerides, and other lipids associated with heart disease. In fact, one 2000 study indicated that hypothyroidism is second only to poor dietary habits as a cause of high unhealthy cholesterol levels. Treating the thyroid condition can significantly reduce cholesterol levels. Among people with high cholesterol levels, between 1.3% and 2.8% have hypothyroidism and between 4.4% and 11.2% have subclinical hypothyroidism. Some experts are suggesting then that patients with high cholesterol should be assessed for thyroid function before they are given cholesterol-lowering agents. Research on whether the association between mild hypothyroidism and cholesterol levels has any significance is mixed, however.

    High Blood Pressure (Hypertension). Hypothyroidism may slow the heart rate to less than 60 beats per minute, reduce the heart’s pumping capacity, and increase the stiffness of blood vessel walls. All of these effect may lead to high blood pressure. Indeed, patients with hypothyroidism have a threefold increased risk of hypertension. Blood flow may even be affected in patients with subclinical hypothyroidism. All patients with chronic hypothyroidism, especially pregnant women, should have their blood pressures checked regularly.

    Homocysteine. Studies are also finding that hypothyroidism is associated with elevated levels of homocysteine, an amino acid that is increasingly becoming a major suspect in heart diseases. Vitamins B6, B12, and folic acid (another B vitamin) are important in protecting against elevated homocysteine levels. Supplements, then, may be important companions to thyroid replacement therapies.

    http://www.umm.edu/patiented/articles/how_serious_hypothyroidism_000038_6.htm
  5. ImDigNiT

    ImDigNiT New Member

    I just returned to Florida safely last night. Extremely long Ride and I am just worn plum out.

    Riley Earl- I am giving a copy to my attorney that I had to hire for my Long Term Disability Beneifits as I was rejuected initially.

    Kbak-I will be consulting with my GP on these results here is Florida. He is also a clinical Professor at the new Florida State University Medical School. If I continue going to the FFC, it will be in Atanta as it is only four hours or so from here.

    Fibromaster - Thanks so much for sharing your knowledge with me. You are the bomob!

    Next week I am scheduled to go to a Dr. my attorney scheduled to measure my ability to work. We will see how that goes.

    I am just really ill right now and I am trying to collect the LTD that I deserve. I tell you it is like trying to pull teeth.

    Please keep my in your thoughts as I feel like I am at the end of my ropes.

    Peaceful mind and body to all.

    Marcia