Am I overthinking these lab results?
August 30, 2013 1:23 PM Subscribe
I've been seeing an internal med doc for the past year and a half to figure out what's going on with me, and my blood work seems to indicate some kind of inflammation/autoimmune issues. My doc doesn't seem to be concerned, but I have the feeling he may not be looking at everything in totality. Should I just go ahead and see a specialist? More details inside.
posted by Taystee to health & fitness (11 answers total) 2 users marked this as a favorite
I have constant fatigue. I'm 80 pounds overweight, and it's all concentrated in my abdominal area. Losing weight is an impossible proposition -- cutting back to 1,200-1,500 quality calories a day and regular exercise doesn't budge the scale. I also have irregular periods, which swing from being on a normal cycle for a few months to going several months with no period at all. I'm currently taking levothyroxine, sertraline, singulair, vitamin D and necon (birth control).
As far as my labs are concerned, my a1c is 5, my fasting glucose is 86, my TSH is 1.5, my free T3 is 2.4 (on the very low end, but since it's still inside the normal range, the doc won't adjust my meds). My cholesterol is also high. What worries me is that my HS-CRP was 21.40 in January. When he tested it again in June, it went down to 8.90, but it's still very high. My sed rate was 39 in January and 29 in August.
I had a bad case of poison ivy in June, which a 12-day round of prednisone eventually cleared up. In early August, I suddenly developed a rash that started on my chest in an upside down U shape on my cleavage and under my right eye. Two days later, my eye was almost swollen shut and the rash had spread down my cheek. I thought it was poison ivy again and went in for more steroids. The doc was concerned because I hadn't been around poison ivy this time and it was presenting in an unusual way. He ordered more blood work, including an anti-nuclear antibody test. It came back positive , 1:640 and finely speckled. The DNA, SSA, SSB, SM, RNP tests came back negative, although the SSA was a 16, SSB 9, SM 10 and RNP 20. His only note was to discuss on return; my next scheduled appointment is in January. The rash cleared up after six days of prednisone.
In addition, my MCH numbers in August was 31.3, and my MCHC was 35.5. My red blood count was 4.57; in January it was 5.14. My ferritin level over the past year and a half has ranged from 202-322, whether I'm having my period or not.
I showed these results to a family practice doc, and her recommendation was to see a rheumatologist. I called my internal med doc, and he said he wasn't concerned because only the ANA came back positive and the rash cleared up with the medication.
I feel like he's not looking at all of these various parts of labs in totality. I know you are not a doctor or my doctor, but am I overthinking this? Should I go see a rheumatologist anyway? My health plan doesn't require a referral to see a specialist.