What Does My Lab Test Results Indicate?

Question: I consulted with one of your doctors a couple of days ago. He tried to reassure me but I have been reading more and am still very concerned. The other specialist was a diabetologist. I had a complete blood workup as it had been 4 years. All my lipids had improved hdl 71 ldl 97 total cholesterol 179. What concerned me was a fasting glucose of 100, up from 80s and 90s in the past. But a1c of only 3.8! That's down from about 5.2. I was very stressed and taking antibiotics for a urinary infection when I had the blood draw which I'm told and have read would account for the slightly higher fbg. I also have been working on don't and exercise and some weight loss. My doctor thinks the 3.8 is just great but I'm reading studies that there's higher mortality rates with low levels and also that anything below 4.5 is associated with hemoglobin disorders. My blood work was normal. Cbc and blood panel etc. My hemoglobin is 15.6 and hematocrit 46. Everyone thinks that's great too but the internet doesn't. Could mean iron overload which also lowers a1c?! I'm really freakingout! I hope you can help me sort this all out. The other doctors on here said all was normal but then I read those frightening studies. I'm a 64 year old post menopausal female. I have been struggling this year with urinary infections and resultant antibiotics. Dr's suspect post menopausal changes. Don't know of this affects anything. Or did I just bring a1c down when I improved lipids. But so much? The lab did the test twice on the same sample. They're not concerned either.... Only me! They did say they would redraw and rerun if I want... Though they don't see a need. Thanks. Anxiously await your answer.

So even such a drop in a1c is not alarming? How would one know if their type of hemoglobin is abnormal and causing low results? Would something show up on cbc or blood panel to indicate possibility of abnormal type of red blood cells or hemoglobin( hemoglobinopathy ) that causes low a1c? Or is this present from birth? Also what about the studies linking low a1c to 3 times the risk of mortality? That's scary! It even said it may reflect abnormalities indicating early cancer or other illness. Really scary! Also liver problems. But liver enzymes and whole liver panel normal (except one type of bili was
.1 above range that's point 1, not 1. High something bili... Not bili itself. Doctor said meaningless. All enzymes normal.

Also I did have culture. They believe it's post menopausal and I am using bio identical estriol cream vaginally


It is the indirect bili that's above range at.5 instead of. 0to.4
trying to send reports. Also negative from c-reactive protein.

Sent 2 reports

One question I don't see specifically answered is, does a such a drop in a1c cause concern or could it be as a result of what I have been doing to improve lipid profile?
I have re photographed the labs. I think they are clearer now. Just wanted to know if you see anything. They're in range (except for high hdls and low cardiac risk, abnormalities I welcome!). But one lengthy study on the risks of low a1c said the MCV in the higher range, and their numbers considered mine high, was consistent with low a1c, high hemoglobin (over 14.7 also like mine) consistant with low a1c which is also "linked to 3 times the mortality from all causes including cancer"
They assert that as a1cs are becoming routine screenings and low values will be found, it may well be used as a marker of underlying disease including early cancers. Have you heard of any of this? My doctor and others I've asked seem to think my a1c is a good thing but a few studies don't.
I appreciate the time you are taking. You are a hemotoligist? You should be an expert then. I value your advice.
My husband is a cytologist so I understand the meanings of your specialty and sub specialities. He, by the way, tells me to get off the internet and forget it.


Should I take the lab up on their offer to redraw and rerun the a1c on fresh blood? As I said earlier, they did run it twice on the original sample to be sure of the finding. The lab tech said my a1c was 4.8 in 2008 and 5. something in 2012. She didn't think it was too strange. Bit they did offer to redraw at no charge just to satisfy me.

I believe I had gained weight in 2012. I've lost weight now. I was at a lower weight than now in 2008 but my ldl and hdl, though good, have never been as good as they are now. 20 years ago the hdls were only 35. Been raising them since.

I am 135 and 5'5 now. Plan to lose about 10 more pounds. Used to try and stay under 120 but thinking that's a bit low, from the feedback I get.

My doctor is not only not worried, he thinks it is "perfect" and that it's good not bad and seems to intimate that it goes with improved lipids. Would you agree? Do you see those drops in healthy non diabetics? Is there any concern with hypoglycemia? Would you consider my reading abnormal or low normal? And does it matter if it doesn't come back up? So in your experience, these readings aren't that unusual even considering the 100 fbg?

And suggestion to retest would be just for my own satisfaction? Otherwise would you tell someone else just normal annual and no cause for more frequent than usual testing?
Thankyou

Is it only current liver problems that associate with low a1c or also propensity for developing them? And you know of nothing that backs up cancer, CVD etc? Does my hemoglobin many years post menopause correlate with one usually in the fourteens up until now even when menstruating and pregnant? Doctors have always remarked favorably on this.

Any chance there's studies refuting these scary ones? Have you agreed with their methods etc? I think it's odd that they say those with low readings have better lipid profiles, less existing heart disease, lower BMI's and higher hemoglobin. Aren't these good things! ? And then more of them die?!

Maybe they worry and over think things and that gets them... Lol!

Is there actually a mechanism that leads to liver disease even when liver panel is normal? Have you seen this or is it just some study with no known correlation? What do you think? I don't drink or anything else I can think of as a risk for liver problems.
Also, why do you recommend retest earlier than the standard yearly if its not a concern? So if it stayed low or even went lower or atleast continued in low ranges... Would that be bad?

I'm almost afraid to ask what type of investigation would be needed if it decreased?
Does this mean my blood sugar is really low all the time? It's seems like I should feel pretty rotten. How do you figure mean blood sugar by a1c? Should I be doing something with my diet? With everything else improving so much, I hesitate to change. But I'm confused because my fbg makes me think I should cut back carbs and a1c makes me think I should eat more carbs....

So you're saying that you would, in the case of it lowering, you'd just want to be sure all is still normal? With my blood work as it is now, would you even expect changes in 6 months? Doesn't seem like that is very likely since there's nothing else even hinting towards a problem, right? Wouldn't other values look more suspicious or close to or even being abnormal if anything was moving in the wrong direction? In a post eating or glucose tolerance test, would you be looking for drops rather than high levels with a low a1c? I don't feel like it goes unduly low. I've always felt like I needed to snack before and after exercise and to eat breakfast at a reasonable time to keep from feeling shaky, but that is not a new thing and fbg has never been too low. Haven't had a glucose tolerance since pregnancy 29 years ago because no one ever thought there are as a need based on other tests. And I've asked, because of family history of diabetes.
Is there any connection to my having had the urinary tract infections this year and rounds of antibiotics? Haven't had any other colds, flus or anything.