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What Does This Blood Report Indicate?
Question: Please if an HEPATOLOGIST DR can answer this question : I've been suffering anxiety and depression for around 5 years now. I have been running all kind of tests and discovered the following abnormal results (all the rest is normal) :
1) Anti-TPO 467 (which clearly means hashimoto's disease, but my TSH is 4.4 and it's still mild to treat...it has always been 2.4-4 these last years)
2) Hemoglobin 17-18 and Hematocrit 50-53 [please explain what further test i need to perform]
3) Ceruloplasmin 187 and Urinary Copper 14 [lab range 15-50]. PLEASE EXPLAIN. DO I HAVE COPPER DEFICIENCY? Is copper not well eliminated and thus accumulationg in my central nervous system causing my nervousity?
1) Anti-TPO 467 (which clearly means hashimoto's disease, but my TSH is 4.4 and it's still mild to treat...it has always been 2.4-4 these last years)
2) Hemoglobin 17-18 and Hematocrit 50-53 [please explain what further test i need to perform]
3) Ceruloplasmin 187 and Urinary Copper 14 [lab range 15-50]. PLEASE EXPLAIN. DO I HAVE COPPER DEFICIENCY? Is copper not well eliminated and thus accumulationg in my central nervous system causing my nervousity?
Brief Answer:
Repeat your TSH after 3 months.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
(1) Your anti TPO level is high and you have hashimotos thyroiditis. But your TSH level is not high. Moreover you don't have symptoms of hypothyroidism. So no need of thyroid supplement.
In future your TSH will increased and you have to take thyroid supplement like thyroxin.
But right now it is not needed.
In my opinion you should repeat your TSH and free T4 level after 3 months. And then if needed start medication accordingly.
(2) Your Hemoglobin and hematocrit values are high. But single high value is not significant. It can be due to dehydration or some other cause.
So you should repeat your hemoglobin and hematocrit 2 to 3 times at monthly interval.
If it remains persistent high then further investigation like Serum Epo level is needed.
(3) Your copper level is low normal. Your ceruloplasmin level is high. It can be seen in some infection or inflammation. So don't worry about that. Check your CRP level and search for any inflammatory cause.
Your depression and anxiety has no relation with your copper. So don't worry about that. Consult your psychiatrist for that.
Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you very good health.
Repeat your TSH after 3 months.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
(1) Your anti TPO level is high and you have hashimotos thyroiditis. But your TSH level is not high. Moreover you don't have symptoms of hypothyroidism. So no need of thyroid supplement.
In future your TSH will increased and you have to take thyroid supplement like thyroxin.
But right now it is not needed.
In my opinion you should repeat your TSH and free T4 level after 3 months. And then if needed start medication accordingly.
(2) Your Hemoglobin and hematocrit values are high. But single high value is not significant. It can be due to dehydration or some other cause.
So you should repeat your hemoglobin and hematocrit 2 to 3 times at monthly interval.
If it remains persistent high then further investigation like Serum Epo level is needed.
(3) Your copper level is low normal. Your ceruloplasmin level is high. It can be seen in some infection or inflammation. So don't worry about that. Check your CRP level and search for any inflammatory cause.
Your depression and anxiety has no relation with your copper. So don't worry about that. Consult your psychiatrist for that.
Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you very good health.
Above answer was peer-reviewed by :
Dr. Priyanka G Raj
Dear Doctor,
1) Thank you.
2) Concerning the hemoglobin and hematocrit, i have always performed repetitive tests, and hemoglobin has always been [17-18] and hematocrit [49-53.5].
3)Concerning the ceruloplasmin, the lab range is [200-400] i guess, so my level of 124 (which i performed again 2 weeks later and been 187) is low, not high!
The copper level is 861 [lab range 700-1400]
The URINARY COPPER level (24 hours urine) is 14 [Lab range 15-50].
1) Thank you.
2) Concerning the hemoglobin and hematocrit, i have always performed repetitive tests, and hemoglobin has always been [17-18] and hematocrit [49-53.5].
3)Concerning the ceruloplasmin, the lab range is [200-400] i guess, so my level of 124 (which i performed again 2 weeks later and been 187) is low, not high!
The copper level is 861 [lab range 700-1400]
The URINARY COPPER level (24 hours urine) is 14 [Lab range 15-50].
Brief Answer:
Go for serum epo level.
Detailed Answer:
Hi, dear
Welcome back.
I have gone through your question.
I can understand your concern.
Your laboratory range for ceruloplasmin is 200 to 400 so it may be in different unit. I thought it was in mg/DL and normal range is 22-58mg/DL.
But any way you mentioned normal range 200-400 so definitely it is low.
Your serum copper is not low. So not to worry. But check your liver functions test once and if there is high liver enzymes then liver biopsy should be performed. But wait for that.
In my opinion repeat copper level after 3 months is sufficient.
If your hematocrit and hemoglobin levels are persistently high then you should go for serum Epo level.
High epo level suggest secondary polycythemia. Low epo level suggest primary polycythemia due to bone marrow disease.
Give me follow up with your serum Epo level.
Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you very good health.
Go for serum epo level.
Detailed Answer:
Hi, dear
Welcome back.
I have gone through your question.
I can understand your concern.
Your laboratory range for ceruloplasmin is 200 to 400 so it may be in different unit. I thought it was in mg/DL and normal range is 22-58mg/DL.
But any way you mentioned normal range 200-400 so definitely it is low.
Your serum copper is not low. So not to worry. But check your liver functions test once and if there is high liver enzymes then liver biopsy should be performed. But wait for that.
In my opinion repeat copper level after 3 months is sufficient.
If your hematocrit and hemoglobin levels are persistently high then you should go for serum Epo level.
High epo level suggest secondary polycythemia. Low epo level suggest primary polycythemia due to bone marrow disease.
Give me follow up with your serum Epo level.
Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you very good health.
Above answer was peer-reviewed by :
Dr. Veerisetty Shyamkumar
Thanks doctor...
1) is epo level needs to be done at a specific time of the journey and under a specific condition?
2) is there another test to do to compelte the diagnosis? (Someone told me go also for a serum viscosity test).
What do you think?
1) is epo level needs to be done at a specific time of the journey and under a specific condition?
2) is there another test to do to compelte the diagnosis? (Someone told me go also for a serum viscosity test).
What do you think?
Brief Answer:
You can test anytime.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
You can go for epo testing at anytime.
If epo level is low then jak 2 mutation and bone marrow testing should be done. But its not required right now.
Go for Epo level first.
Serum viscosity test is not much helpful.
Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you very good health.
You can test anytime.
Detailed Answer:
Hi, dear
I have gone through your question.
I can understand your concern.
You can go for epo testing at anytime.
If epo level is low then jak 2 mutation and bone marrow testing should be done. But its not required right now.
Go for Epo level first.
Serum viscosity test is not much helpful.
Hope I have answered your question. If you have any doubts then feel free to ask me.
I will be happy to answer.
Thanks for using health care magic.
Wish you very good health.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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