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What Do These HsCRP And DHEA Levels Indicate?
Question: Most of my recent blood results were good, but some are giving me a cause for concern. I would like to see if it's possible to put the pieces together. Some of the noteworthy results are:
hsCRP-1.61. Up from .96 in May, and had been near .60 previously.
DHEA-50. For this reading my GP said the norm should be 80. I have never been below normal before. (The testosterone was normal.)
For the above results, are they shouting out that something is amiss? The only symptoms I have are 1. significant upper abdominal bloating after eating, and 2. occasional daytime fatigue, most notably late in the day, but can occur at any time, (adrenal fatigue?) 3. and occasional malaise
Other results
LDH-161
ESR-3
PSA-3.6-I have been hovering between the low 3's and low 4's for 7 years
Free PSA-19%-this is up form the low to mid teens (and I no longer get up several times at night urinate and the almost never have the great urgency to urinate that I used to.
Looking at the whole picture are there any red flags? I would consider taking DHEA supplements, but that might be risky since my PSA panel is on the high side of normal.
My GP was not specific about the DHEA, if it was that or DHEAs. It was given over the phone, and he is mailing me the results.
The LDH range by the lab is 100-324, so I would think 161 is a low healthy result.
And finally, I did visit a urologist a few years ago with similar results. He did a DRE, which was, and always has been, normal. He did not think a biopsy was needed then, but I will investigate further.
hsCRP-1.61. Up from .96 in May, and had been near .60 previously.
DHEA-50. For this reading my GP said the norm should be 80. I have never been below normal before. (The testosterone was normal.)
For the above results, are they shouting out that something is amiss? The only symptoms I have are 1. significant upper abdominal bloating after eating, and 2. occasional daytime fatigue, most notably late in the day, but can occur at any time, (adrenal fatigue?) 3. and occasional malaise
Other results
LDH-161
ESR-3
PSA-3.6-I have been hovering between the low 3's and low 4's for 7 years
Free PSA-19%-this is up form the low to mid teens (and I no longer get up several times at night urinate and the almost never have the great urgency to urinate that I used to.
Looking at the whole picture are there any red flags? I would consider taking DHEA supplements, but that might be risky since my PSA panel is on the high side of normal.
My GP was not specific about the DHEA, if it was that or DHEAs. It was given over the phone, and he is mailing me the results.
The LDH range by the lab is 100-324, so I would think 161 is a low healthy result.
And finally, I did visit a urologist a few years ago with similar results. He did a DRE, which was, and always has been, normal. He did not think a biopsy was needed then, but I will investigate further.
Brief Answer:
the PSA requires further investigation
Detailed Answer:
Hello,
I've already answered to you about your hsCRP. The same answer applies. It's only used to estimate the risk of future cardiovascular events.
Regarding your DHEA. Interpretation depends on the units the lad uses to measure it. The most widely used reference range for a man at his 60s is 630-4700ng/L for DHEA. DHEA is not very useful test. A low DHEA does not mean much diagnostically! Since you've mentioned 80 as the lowest normal value, perhaps you're talking about DHEA-S? DHEA-S is the conjugated form of DHEA and may be lower than normal in Addison's disease or adrenal hypoplasia. This is not the main test to test for these conditions though and if you're symptom-free (besides fatigue, none of your symptoms may be related to the adrenals) and the rest of your tests (electrolytes for example) are normal then adrenal problems are not very likely. If you'd like to upload the full report, it will help me to get a better picture of your health condition.
Regarding your PSA levels. This is not a dangerously high PSA level but both this level of total PSA and your level of free PSA are associated with a 15-20% risk of prostate cancer. So a visit to a urologist should be scheduled. The symptoms you've mentioned are irrelevant. Prostate cancer rarely presents with symptoms and high PSA is not associated with benign prostatic hyperplasia which is the main cause of symptoms (waking you up at night to urinate, hesitation before starting to urinate, dribbling, etc). Some benign conditions like prostatic inflammation for example may cause the PSA levels to rise without cancer, so don't worry that much; just let the urologist do the necessary tests.
Your LDH (161) can be normal or high depending on the reference range used by this lab. I can't tell unless you upload the full report (or the reference range). A high LDH is associated with various conditions and is not diagnostic for any disease. Some examples include hemolysis (destruction of red blood cells), muscle injury, rhabdomyolysis (muscle cell destruction), hematologic malignancies, etc.
Low ESR has limited value. ESR is more useful when it's high or as a disease-activity index in certain disorders (autoimmune mostly).
Finally regarding your symptoms: the abdominal symptoms can be caused by a variety of diseases including gallbladder colic, irritable bowel syndrome, peptic ulcer, electrolyte disorders, etc. Adrenal insufficiency should be included in the list taking also into account the low DHEA (or DHEA-S). Other lab and clinical findings consistent with adrenal malfunction include hyponatremia (low sodium), hyperkalemia (high potassium), metabolic acidosis, hypoglycemia, low blood pressure, increased percentage of eosinophils in peripheral blood, anemia, etc.
Yes, the reference range suggests a normal result for LDH.
I suppose the urologist will repeat the DRE. Negative DRE with an unchanged PSA over a few years are reassuring enough.
I hope you find my comments helpful!
Please contact me again, if you'd like any clarification or further information.
Kind Regards!
the PSA requires further investigation
Detailed Answer:
Hello,
I've already answered to you about your hsCRP. The same answer applies. It's only used to estimate the risk of future cardiovascular events.
Regarding your DHEA. Interpretation depends on the units the lad uses to measure it. The most widely used reference range for a man at his 60s is 630-4700ng/L for DHEA. DHEA is not very useful test. A low DHEA does not mean much diagnostically! Since you've mentioned 80 as the lowest normal value, perhaps you're talking about DHEA-S? DHEA-S is the conjugated form of DHEA and may be lower than normal in Addison's disease or adrenal hypoplasia. This is not the main test to test for these conditions though and if you're symptom-free (besides fatigue, none of your symptoms may be related to the adrenals) and the rest of your tests (electrolytes for example) are normal then adrenal problems are not very likely. If you'd like to upload the full report, it will help me to get a better picture of your health condition.
Regarding your PSA levels. This is not a dangerously high PSA level but both this level of total PSA and your level of free PSA are associated with a 15-20% risk of prostate cancer. So a visit to a urologist should be scheduled. The symptoms you've mentioned are irrelevant. Prostate cancer rarely presents with symptoms and high PSA is not associated with benign prostatic hyperplasia which is the main cause of symptoms (waking you up at night to urinate, hesitation before starting to urinate, dribbling, etc). Some benign conditions like prostatic inflammation for example may cause the PSA levels to rise without cancer, so don't worry that much; just let the urologist do the necessary tests.
Your LDH (161) can be normal or high depending on the reference range used by this lab. I can't tell unless you upload the full report (or the reference range). A high LDH is associated with various conditions and is not diagnostic for any disease. Some examples include hemolysis (destruction of red blood cells), muscle injury, rhabdomyolysis (muscle cell destruction), hematologic malignancies, etc.
Low ESR has limited value. ESR is more useful when it's high or as a disease-activity index in certain disorders (autoimmune mostly).
Finally regarding your symptoms: the abdominal symptoms can be caused by a variety of diseases including gallbladder colic, irritable bowel syndrome, peptic ulcer, electrolyte disorders, etc. Adrenal insufficiency should be included in the list taking also into account the low DHEA (or DHEA-S). Other lab and clinical findings consistent with adrenal malfunction include hyponatremia (low sodium), hyperkalemia (high potassium), metabolic acidosis, hypoglycemia, low blood pressure, increased percentage of eosinophils in peripheral blood, anemia, etc.
Yes, the reference range suggests a normal result for LDH.
I suppose the urologist will repeat the DRE. Negative DRE with an unchanged PSA over a few years are reassuring enough.
I hope you find my comments helpful!
Please contact me again, if you'd like any clarification or further information.
Kind Regards!
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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