What Do My Lab Test Reports Indicate?
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Detailed Answer:
Hello,
Welcome and thanks for your query.
I agree with you that an unintentional loss of weight of 15 kgs over a period of 3 weeks is concerning. Your poor appetite and nausea and hence the poor food intake are factors. But one has to look for other causes. The drop of iron saturation form 33 to 20 would call for searching for conditions of blood loss from the GI tract. Stool test for occult blood , if not done, is a simple way.
Diabetes and hyperthyroidism are conditions that also lead to weight loss which can be excluded through HbA1c and Thyroid function tests.
Malignancies and HIV infection are other causes and blood examination for tumor markers and HIV may be done if not done already.
I am not able to see your test results or treatments tried and would be helpful if you could upload them.
Do get back to me with your input.
Iron now 13.3 was in 7/04/15 23.6
Transferrin 2.72, 2.55
Saturation 20, 37
Ferritin 118. 108
Sodium 143 142
Potassium 4.5 4.4
Chloride 109, 109
Bicarbonate 27, 27
Urea 5.3, 5.2
Creatinine 75, 80
Egfr 90^
Urate 0.37
Calcium 2.38, 2.43
Adja 2.44, 2.38
Magnesium 0.86, 0.86
Phosphate 1.03, 1.08
T protein 69, 69
Albumin 40, 39
Alp 94, 88
Bilirubin 10, 14
Ggt 28, 23
Ast 21, 17
Alt 22, 18
Total cholesterol 5.8 5.4
Hdl 1.2 (2015)
Ldl 3.7 (2015)
Triglyceride 0.9, 1.2
Hdl / ladle ratio 3.1 (2015)
Chol / Hdl ratio 4.5 (2015)
Glucose 4.9, 4.9
Haemoglobin 167, 168
Rbc 5.14, 5.12
Pcv 0.47, 0.48
Mcv 94, 93
MCH 32.5, 32.8
McHc 346, 353
Rdw 13.2, 13.2
Wcc 7.9, 9.8 (was 11.8 late 2014)
Neutrophils 4.3, 6.3
Lymphocytes 2.8, 2.6
Monocytes 0.6, 0.8
Eosinophils 0.2, 0.2
Platelets 304, 317 (was above 350 late 2014)
Esr 2 (2015) (was up to 11 late 2014)
Vitamin B12 470, 323
Folate 24.2, 20.7
Urine current 7 ph
Weight loss was just after colonoscopy in 2014.
Also right ventricular valve in early 2014 just on cusp of being a problem but cholesterol was above 8
Only medication, apart from antibiotics in 2014 has been nexium.
Was offered statins and bp meds early 2014 but refused, preferring to exercise and diet. When feverish Bp can fall. It rises quite high in Arvos but normally sits around 133/88
No swelling in ankles but occasional and unexplained joint pain - some osteo arthritis in spine
Cannot think of anything else apart from faulty hemochromatosis gene but only 1 not 2
Could it be either staphylococcus infection or malaria (though test is negative for having had it) or a combination of small but significant things adding up to a medium problem?
Thanks
Discussion follows
Detailed Answer:
Thank you for the details.
Have you checked your temperature? Please let me know how high it reaches and whether there are rigors or sweating. These are common in fever due to malaria. When was the last time you were in an endemic area and when did you have the episode of malaria? Staphylococcus infection usually has a focus usually in the skin. With a staphylococcus blood infection, you would be very sick.
How recent is your urine examination? Urinary infection may mimic malaria in symptoms of rigors and sweating and burning while passing urine is not an essential feature. Was your stool tested for occult blood?This is different from the usual stool test.
Malaria no positive tests but did have a letter from Red Cross stopping me from giving blood as a batch that I had given blood to after, returned positive (I wasn't singled out). In PNG 2 weeks each 2001, 2002, 2004 and 2006. XXXXXXX Islands 8 months 2007. Symptoms fevers, nausea, loss of appetitive, aches and initially flu like symptom. Usually quite mild, 2-3 times year. Similar symptoms but accompanied by stomach pain and diarrhoea late 2014,
Faeces tests last year for occult blood
Urine test this week
If it wasn't for negative malaria tests I would swear that that was what it is.
Will purchase thermometer and monitor before this conversation expires
Thanks again, might get sti's tested again if you think warranted but don't think needed. I suspect the answer is obvious from the above but want to rule anything else out???
Please get back to me with your thoughts whilst I monitor temperature as I suspect that writing everything down may achieve clarity and direction - thanks heaps!
You are welcome
Detailed Answer:
Malaria vivax can remain in the liver in an asymptomatic state for variable periods but 2 years is a long time.
If you had loss of weight recently and as there is a drop in iron content, blood loss from the gut is a possibility and can be detected through stool occult blood.
Let us see what the temperature range is and how well it correlates with your symptoms.
I have enjoyed this conversation.
Do get back with your input.
Have a great day
And still no treatment. I was almost hospitalised in 2014 but was already on long service leave
What do you think?
Relax, it is probably not a serious illness.
Detailed Answer:
There can be upto 1 degree fluctuation in temperature normally and so this may not be fever.
If you contacted a serious infection it would show in the blood test as a high WBC count, high ESR and CRP.
EBV is a possibility if IgM antibodies are present. Malaria is less likely.
There is an entity called psychogenic fever which is also to be considered in the differential.
One thing I am sure is that it is not a dangerous illness and may go away if you look the other way.
Wish you good health
Right think to do
Detailed Answer:
I am glad that you have decided to live your life.
It was nice interacting with you and I shall be happy to be of any assistance if you have any queries in the future.
Best wishes
As soon as docs decide that it is in my head it is "look the other direction" but when you wake in a cold sweat vomitting 2 years down the track, for any of the above options, I deserve to be treated. NAPLAN results were good for my school and all my relationships a e great (both personal and professional) - not a cloud in the sky and yet last night I woke up sweating and vomitting
Discussion folllows
Detailed Answer:
Hello XXXXXXX
I understand your concern and empathize with you.
There are so many symptoms for which the exact cause is not clear and when the known organic causes are excluded the doctors have a tendency to call it functional or psychogenic. History has proven them wrong several times. A simple example is that of ulcers in the stomach. It used to be considered a psychosomatic disease but now we know that it is also caused by a bacterium called H.Pylori.
You may have an irritable bowel syndrome from the description and it may be due to several reasons. I have patient who developed diarrhea with Nexium.
Work in unison with a doctor with an open mind and together you would detect the cause and manage well.