Brief Answer:
The testing seems to point to Anemia

Detailed Answer:
Hi XXXXXXX thanks for coming to HealthCareMagic,

After having gone through the information you've provided, it seems like the only abnormality that has been detected so far is the Low Hematocrit and Low Red Blood Count. We will have to wait for the CT results of course.

Could you do me a favor and upload the results of the blood work so I can see how low the counts are?

A low 'crit and count can mean that you have anemia. Anemia is a fairly common disease which can present with the symptoms you've mentioned. Including fatigue and palpitations (heart speeding up). The neck and scalp pain can even be explained by Anemia.

Now, if my theory is right, the treatment is pretty easy. It all depends on what is causing the Anemia. To figure this out, you will need further testing. We have to check your Vitamin B levels, you Total Iron Binding Capacity (TIBC) and a few other things. Again, if you could upload your blood work, i'd be grateful as it would give me a place to start from.

So, our first job is to properly diagnose and treat the anemia that has bee suggested by the low 'crit and RBC.

Does that make sense? I look forward to your response.

Vinay

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Brief Answer:
Hemoglobin is borderline low.

Detailed Answer:
Hi, thanks for the upload, So i took a look at your labs. In the CBC section, your Hemoglobin level is also kind of borderline. For a young woman such as yourself, I would expect it to be higher for sure.

I would strongly suggest a deeper look into this. I think you may have Iron deficiency anemia. Can't be sure until some testing is done.

These are the tests I would suggest:

1) Serum Vitamin B levels
2) Serum Total Iron Binding Capacity (TIBC)
3) Peripheral Smear

To get these tests done though, you will need a prescription from your doctor. So you can discuss these things with your Primary. You could probably just call them and they woud send the prescription to the lab over the phone. I'm not so sure about that part though.. call them and see if you get lucky.

In the mean time, I would strongly suggest you try and get some more Iron and vitamins in your diet.. Green leafy vegetables and any veggie that is kind of crunchy when its uncooked is a good place to get Vitamin B and Iron.

You can also start taking an Over the Counter Vitamin Supplement. Pretty much any complete unbranded supplement will do.. so don't go buying something because of the advertising.

At the same time, concentrate on maintaining adequate hydration.. you can't absorb things from your gut very well if you are dehydrated.. caffeinated and sugary drinks don't count.. plain water is the absolute best. The rule of thumb is to drink enough water every day so that you have to relieve yourself at least 3 times a day and the urine is clear.

So start with the diet, the Vitamins and the Hydration, try and get the testing done and lets see where that testing takes us. Sound like a plan?

Let me know how else I can help,

Vin

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Brief Answer:
Tricky question, lets get the testing done to see...

Detailed Answer:
Hey there, Thanks for coming back.

Now that's a tricky question to answer. Iron supplements are freely available and are generally pretty safe to take. They do have side effects though. Most of the time they can cause some acidity and indigestion. Sometimes they can make you nauseous. So I don't normally recommend them unless there is a real need.

In the tests that you uploaded, your Hemoglobin is BORDERLINE, which seems to point at a mild iron deficiency. But I can't be sure. There could be other causes for that.

This is why testing is so important. Remember that TIBC test I mentioned in the last message? The Total Iron Binding capacity is a test of the bone marrows ability to bind iron absorbed from the gut. If your TIBC is high.. that means you are iron deficient and Iron supplements will definitely help and the side effects are worth it. On the other hand, if your TIBC is normal or low.. the Iron supplements would be a waste and the side effects wouldn't really be worth it.

There is another way to look at this as well. The whole borderline thing. Lets say that TIBC actually comes out to be high.. it can't be all that high.. otherwise your preliminary blood work would look much worse than it looks right now. So, the question becomes... whats the best way to address the deficiency of Iron. Well a high Iron diet.. with plenty of beans and greens is a MUCH better way to address iron deficiency than to take a supplement. Your body absorbs iron better from food than it does from pills. The concept i'm talking about is called "Bio-availability" and again the rule of thumb for the bioavail of any mineral or nutrient is simple to remember... natural foods have higher bioavail than pills.

So in treating this possible iron deficiency.. I wouldn't want to go for an Iron supplement until i'm very very sure the TIBC is high and even then.. i'd think long and hard about trying a dietary modification approach to treatment rather than supplementation.

Hope all that made some sense. Let me know how i can clarify things further.

Vinay

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Brief Answer:
D-dimer is a great screening test for PE... you're fine if negative...

Detailed Answer:
Hey there, Thanks for coming back,

D-Dimer is a test which is used as a screening test for Pulmonary embolisms. A screening test is a little different from a specific test.

A screening test is quick and if it turns out negative.. you're a hundred percent sure of the result...
On the other hand.. if it turns out positive... then you're not going to be so sure of the result.. You would still need another specific test to prove the diagnosis.

So a negative D-dimer RULES OUT PE just perfectly. So in your situation.. no worries.

IF the test had turned out positive back in January, then they would have had to get a Helical CT scan of the lungs to specifically prove the PE.

D-Dimers can sometime give a false positive result in situations like a recent surgery, certain infections and trauma But that's all academic. Lets not worry about all that.

In you're case.. the D-Dimer was negative.. so you can rest assured that you didn't have a PE back in January.

I hope that clears that up, let me know how else I can help you,

Vin

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