obesechess
Member
Hi Folks,
For the past two months or so I have been suffering from a number of odd symptoms, including extreme fatigue, brain fog, lack of motivation, shortness of breath, difficulty regulating my body temperature (sometimes very hot when cooking in an air-conditioned kitchen, or very cold despite wearing long sleeves on a 60 degree day), brain fog, light-headedness, and more.
I have a hormone panel booked tomorrow as part of my every-six-month checkup with my urologist for hypogonadism treatment, so I may get some answers there. In the meantime, my primary care provider ordered a battery of blood work the other day, all of which I have since been told is "normal." I already have a follow-up booked with a different doctor for a second opinion, but more information can't hurt. There are a few things that look abnormal to me.
36M, 5'9", 175lbs, USA.
Current medications:
Trintellix 10mg/day, Vyvanse 30mg/day, HCG 350iu/wk, Arimidex 0.5mg/wk, Tirzepatide 5mg/wk.
I do not smoke or use recreational drugs, I drink comparatively little (I don't remember the last time I had more than three drinks, total, in one week). I do fairly heavy strength training three times per week and am trying to do more cardiovascular exercise, though the aforementioned symptoms have made this more difficult recently.
There was a very large battery of tests ordered and I don't think it's a productive use of anyone's time if I post everything, so if I say "normal" assume that the value is roughly in the middle of the reference range, though I am happy to post specifics if people have questions about specific numbers. I have bolded the things that I believe warrant more attention given my symptoms and have called out anything that's not quite "normal."
Vitamin D3, B12: Normal
WBC Count, RBC count: Normal.
Hemoglobin: Normal, slightly high (16.9 g/dL, reference range 13.2 - 17.1g/dL)
Hematocrit: High (53.5, reference range 38.5% - 50%)
MCV: almost High (99.8 fL, reference range 80 - 100fL)
MCHC: Low, (31.6 g/dL, reference range 32-26g/dL)
MCH: Normal
RDW: Normal
Platelet Count: Normal
MPV: Normal
Absolute Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils: Normal
Glucose: Normal, slightly high (I was not fasted, 97mg/dL, reference range 65-99mg/dL)
Urea Nitrogen: Normal
BUN: Normal
Creatinine: Normal
EGFR: Normal
Sodium, Potassium, Chloride, CO2, Calcium, Protein: Normal
Albumin: High (5.3, reference range 3.6 - 5.1 g/dL)
Globulin: Normal
Albumin/Globulin Ratio: Normal
Bilirubin: High
Alkaline Phosphatase: Normal
AST: High (41 U/L, reference range 10-40 U/L)
ALT: Very High (125 U/L, reference range 9-46 U/L)
Total Cholesterol: Normal, almost high (192 mg/dL, reference range <200mg/dL)
HDL: Normal
Triglycerides: Normal
LDL: High (121mg/dL, reference range <100mg/dL)
Chol/HDLC Ratio: Normal
Non-HDL Cholesterol: High (141, reference range <130mg/dL)
TSH w/Reflex T4: Normal (0.75mlU/L - reference range 0.40 - 4.5mlU/L)
Re: Liver enzymes, these have fluctuated wildly over the past few years, from as low as 51 g/dL up to 125 this week. I had an ultrasound and MRI done on my liver earlier this year and it looked perfectly healthy. I believe this is from the fact that the majority of the medications I take are metabolized in the liver. I am not worried about them at the moment.
Re: Lipids, I am in the process of losing weight - I have kept 100lbs off for over a decade and with the help of Tirzepatide I am finally losing the last bit of body fat. I thought I had more lean mass than I do (170 with more weight to lose feels bad) but I am trying to get below 20% body fat. But since I'm still a bit chubby, I think this explains the high lipid numbers. The lipid numbers have all steadily decreased as I've lost more weight.
What I am concerned about given my symptoms are the hemoglobin/hematocrit and the thyroid. Those hematocrit/MCHC numbers suggest an iron deficiency to me, though perhaps a mild one, and the Thyroid seems to be one of those tests like testosterone where the reference range gets much lower than most people actually feel healthy on. I also have a history of hypothyroid in the family. Iron deficiency or hypothyroid would explain my symptoms (assuming my blood work tomorrow doesn't tell me that my testosterone has just suddenly crashed through the floor after a decade of remaining stable).
So - with the caveats that I already have a follow-up appointment with a more thorough doctor booked - what does everyone else think? What else should I be looking at?
For the past two months or so I have been suffering from a number of odd symptoms, including extreme fatigue, brain fog, lack of motivation, shortness of breath, difficulty regulating my body temperature (sometimes very hot when cooking in an air-conditioned kitchen, or very cold despite wearing long sleeves on a 60 degree day), brain fog, light-headedness, and more.
I have a hormone panel booked tomorrow as part of my every-six-month checkup with my urologist for hypogonadism treatment, so I may get some answers there. In the meantime, my primary care provider ordered a battery of blood work the other day, all of which I have since been told is "normal." I already have a follow-up booked with a different doctor for a second opinion, but more information can't hurt. There are a few things that look abnormal to me.
36M, 5'9", 175lbs, USA.
Current medications:
Trintellix 10mg/day, Vyvanse 30mg/day, HCG 350iu/wk, Arimidex 0.5mg/wk, Tirzepatide 5mg/wk.
I do not smoke or use recreational drugs, I drink comparatively little (I don't remember the last time I had more than three drinks, total, in one week). I do fairly heavy strength training three times per week and am trying to do more cardiovascular exercise, though the aforementioned symptoms have made this more difficult recently.
There was a very large battery of tests ordered and I don't think it's a productive use of anyone's time if I post everything, so if I say "normal" assume that the value is roughly in the middle of the reference range, though I am happy to post specifics if people have questions about specific numbers. I have bolded the things that I believe warrant more attention given my symptoms and have called out anything that's not quite "normal."
Vitamin D3, B12: Normal
WBC Count, RBC count: Normal.
Hemoglobin: Normal, slightly high (16.9 g/dL, reference range 13.2 - 17.1g/dL)
Hematocrit: High (53.5, reference range 38.5% - 50%)
MCV: almost High (99.8 fL, reference range 80 - 100fL)
MCHC: Low, (31.6 g/dL, reference range 32-26g/dL)
MCH: Normal
RDW: Normal
Platelet Count: Normal
MPV: Normal
Absolute Neutrophils, Lymphocytes, Monocytes, Eosinophils, Basophils: Normal
Glucose: Normal, slightly high (I was not fasted, 97mg/dL, reference range 65-99mg/dL)
Urea Nitrogen: Normal
BUN: Normal
Creatinine: Normal
EGFR: Normal
Sodium, Potassium, Chloride, CO2, Calcium, Protein: Normal
Albumin: High (5.3, reference range 3.6 - 5.1 g/dL)
Globulin: Normal
Albumin/Globulin Ratio: Normal
Bilirubin: High
Alkaline Phosphatase: Normal
AST: High (41 U/L, reference range 10-40 U/L)
ALT: Very High (125 U/L, reference range 9-46 U/L)
Total Cholesterol: Normal, almost high (192 mg/dL, reference range <200mg/dL)
HDL: Normal
Triglycerides: Normal
LDL: High (121mg/dL, reference range <100mg/dL)
Chol/HDLC Ratio: Normal
Non-HDL Cholesterol: High (141, reference range <130mg/dL)
TSH w/Reflex T4: Normal (0.75mlU/L - reference range 0.40 - 4.5mlU/L)
Re: Liver enzymes, these have fluctuated wildly over the past few years, from as low as 51 g/dL up to 125 this week. I had an ultrasound and MRI done on my liver earlier this year and it looked perfectly healthy. I believe this is from the fact that the majority of the medications I take are metabolized in the liver. I am not worried about them at the moment.
Re: Lipids, I am in the process of losing weight - I have kept 100lbs off for over a decade and with the help of Tirzepatide I am finally losing the last bit of body fat. I thought I had more lean mass than I do (170 with more weight to lose feels bad) but I am trying to get below 20% body fat. But since I'm still a bit chubby, I think this explains the high lipid numbers. The lipid numbers have all steadily decreased as I've lost more weight.
What I am concerned about given my symptoms are the hemoglobin/hematocrit and the thyroid. Those hematocrit/MCHC numbers suggest an iron deficiency to me, though perhaps a mild one, and the Thyroid seems to be one of those tests like testosterone where the reference range gets much lower than most people actually feel healthy on. I also have a history of hypothyroid in the family. Iron deficiency or hypothyroid would explain my symptoms (assuming my blood work tomorrow doesn't tell me that my testosterone has just suddenly crashed through the floor after a decade of remaining stable).
So - with the caveats that I already have a follow-up appointment with a more thorough doctor booked - what does everyone else think? What else should I be looking at?
