My Recent Blood Work. Interpretation Request

[methylenewhite]

31 years, male, caucasian. The main question is necessity of iron supplements.

Result Ref range
Liver
AST (Aspartate Aminotransferase) 35,51 U/L <40
ALP (Alkaline Phosphatase Level) 134,48 U/L <115 U/L
ALT (Alanine aminotransferase / SGPT) 30,07 U/L <41
GGT (Gamma-Glutamyl Transpeptidase) 23,30 U/L <55,00 U/L
PT (Prothrombin time) 10,1 10,00 sec
PTT (Partial thromboplastin time) 25,20 24,30 - 35,00 sec
albumin 4,23 g/dL 3,5 - 5,0 g/dL
bilirubin 0,31 mg/dL 1,2 mg/dL
total protein 7,21 g/dL 6,4 - 8,3 g/dL
fibrinogen 185,00 mg/dL 200 - 393 mg/dL

Blood
CBC (complete blood count) This part is in Portuguese but it is understandable, sorry.
Hemácias em milhões/mm³....: 5,43 4,50 a 5,90
Hemoglobina em g/dL ...........: 15,20 13,50 a 17,50
Hamatócrito em %....................: 46,10 41,00 a 53,00
Vol. Glob. Médio em fL............: 84,90 80,00 a 100,00
Hem. Glob Médio em pg.........: 27,99 26,00 a 34,00
C.H. Glob Médio em g/dL......: 32,97 31,00 a 37,00
R.D.W %.....................................: 12,50 10,00 a 16,00


iron 74,49 µg/dL 65 - 175 µg/dL
Ferritin 41,8 ng/mL 23,9 - 336,2 ng/mL
transferrin 207,52 mg/dL 200 - 360 mg/dL
transferrin saturation 26,05 % 20 - 50%
copper 90,80 µg/dL 70,0 - 140,0 µg/dL
ceruloplasmin 32,00 mg/dL 22 - 58 mg/dL
TIBC 187,99 µg/dL 250 - 450 µg/dL


Cortisol saliva 9:00 am 0,240 ug/dL <0,736 ug/dL
Cortisol saliva 11:00pm (same day) <0,054 ug/dL <0,274 ug/dL

Insulin 9,30 uUI/mL 1,9 - 23,0 µUI/mL
Glucose 91,32 mg/dL 65,00 - 99,00 mg/dL
Hba1c 4,60 % <5,7%
Lactic acid 2,8 mmol/L 0,5 - 2,2 mmol/L
Sodium 143,45 mmol/L 136,00 - 146,00 mmol/L
Potassium 4,09 mmol/L 3,50 - 5,10 mmol/L

Triglycerides 498,79 mg/dL <150 mg/dL <<< borderline super high
Cholesterol 224,91 mg/dL <190 mg/dL <<<high
Uric Acid 6,37 mg/dL 3,50 - 7,20 mg/dL

 

[methylenewhite]

Up. Advice really needed. Am I anemic?

@tankasnowgod I believe you have sophisticated knowledge about iron. Could you comment please?

 

[AJC]

Anemic means red blood cells (hemoglobin and/or hematocrit) below normal range.

 

[shepherdgirl]

Hi @ methylenewhite
Sorry, I am not an expert on the CBC or a doctor. But here are my opinions on a few of the tests fwiw:
The low but in range transferrin saturation could indicate you are becoming iron deficient. Your ferritin is low but in range - from what I have read different people feel good at different levels of ferritin, so even if it is in range it can still be low for you. Your RDW is decently low - I think that can be an indication that you don't have certain types of anemia (including iron deficiency anemia). I remember hearing that anemia happens after the other iron deficiencies. So it's hard to use a test to tell if you are just starting to become deficient. Which of the Spanish tests measures MCV? I think hemoglobin is shown on the Spanish test as being in range.
How are you feeling? how are your heart rate, hair/nails, fatigue, tolerance to cold, cravings for ice, etc.
Are you donating blood, blocking iron absorption, eating a lot of calcium?
I am glad you are paying attention - anemia has a tendency to sneak up on people, and then it's too late to prevent it, of course. Best of luck with this!

 

[yerrag]

Alkaline phosphatase, TIBC, lactic acid, triglyceride - all very high. Your rbc is on the high side as optimal is 4.2 to 4.9, but hematocrit and hemoglobin are optimal though. Bilirubin high also. It suggests microscopic bleeding, and you may be losing some blood. Good to test your reticulocytes to see if it's higher than 1%.

Bilirubin is high because there could be a lot of dead read blood cells to process. Alkaline phosphatase being high indicates biliary obstruction. With some biliary issues, liver is affected and that could explian high triglyceride. Since liver is affected, your thyroid could be affected also and this could cause glycolysis as sugar metabolism pathway instead of oxidative metabolism.

 

[yerrag]

Your uric acid being on above optimal suggests some oxidative stress as well. What could be causing your red blood cells to die? Do you have some sort of NADPH oxidase deficiency I wonder.

 

[yerrag]

Or G6PD deficiency.

 

[golder]

I'm just getting some lab work done (thyroid, vit D and others) and I was looking for someone with a Ray Peat insight to help me decipher them. Could anyone help? Thanks so much guys!

 

[yerrag]

I'm just getting some lab work done (thyroid, vit D and others) and I was looking for someone with a Ray Peat insight to help me decipher them. Could anyone help? Thanks so much guys!

You can post your results in your own thread and we can try to interpret it.

 

[tankasnowgod]

Up. Advice really needed. Am I anemic?

@tankasnowgod I believe you have sophisticated knowledge about iron. Could you comment please?

Anemia refers to Hemoglobin mainly, and no, that is not anemic. Hemoglobin looks good. In my experience, any blood donation center would be happy to have you donate with a level of 15.2 13.0 is the minimum cutoff for males.

Ferritin and TSAT are in that near deficiency range. That's personally the range that I target. I would avoid any iron supplements, they aren't needed if iron is in range, and can cause a host of problems on their own (just look up the GI symptoms that very common).

 

[AJC]

Alkaline phosphatase, TIBC, lactic acid, triglyceride - all very high. Your rbc is on the high side as optimal is 4.2 to 4.9, but hematocrit and hemoglobin are optimal though. Bilirubin high also. It suggests microscopic bleeding, and you may be losing some blood. Good to test your reticulocytes to see if it's higher than 1%.

Bilirubin is high because there could be a lot of dead read blood cells to process. Alkaline phosphatase being high indicates biliary obstruction. With some biliary issues, liver is affected and that could explian high triglyceride. Since liver is affected, your thyroid could be affected also and this could cause glycolysis as sugar metabolism pathway instead of oxidative metabolism.

His bilirubin is 0.31---I don't think that's high. Looks like normal reference range is around <1.2.

 

[yerrag]

He gave two values:

bilirubin 0,31 mg/dL 1,2 mg/dL

I'm assuming he's referring to direct and indirect bilirubin, not total bilirubin.

If I'm right in my assumption, those values are above range.

 

[shepherdgirl]

TIBC is low which implies high iron, yet low ferritin and low transferrin saturation could mean a slight deficiency - am I interpreting that correctly? Can both be true?

 

[AJC]

He gave two values:



I'm assuming he's referring to direct and indirect bilirubin, not total bilirubin.

If I'm right in my assumption, those values are above range.

I think the first value is his blood level and the second number is the lab reference range. That seems to be the pattern for the other values he typed out (like insulin for example).

 

[yerrag]

and the second number is the lab reference range.

There is no range to speak of when there's only one value.

 

[methylenewhite]

He gave two values:



I'm assuming he's referring to direct and indirect bilirubin, not total bilirubin.

If I'm right in my assumption, those values are above range.

It should be like this bilirubin 0,31 mg/dL <1,2 mg/dL. Reference is lower then 1,2 mg/dl

 

[yerrag]

It should be like this bilirubin 0,31 mg/dL <1,2 mg/dL. Reference is lower then 1,2 mg/dl

Ok thanks for the clarification.

 

[Rafael Lao Wai]

31 years, male, caucasian. The main question is necessity of iron supplements.

Result Ref range
Liver
AST (Aspartate Aminotransferase) 35,51 U/L <40
ALP (Alkaline Phosphatase Level) 134,48 U/L <115 U/L
ALT (Alanine aminotransferase / SGPT) 30,07 U/L <41
GGT (Gamma-Glutamyl Transpeptidase) 23,30 U/L <55,00 U/L
PT (Prothrombin time) 10,1 10,00 sec
PTT (Partial thromboplastin time) 25,20 24,30 - 35,00 sec
albumin 4,23 g/dL 3,5 - 5,0 g/dL
bilirubin 0,31 mg/dL 1,2 mg/dL
total protein 7,21 g/dL 6,4 - 8,3 g/dL
fibrinogen 185,00 mg/dL 200 - 393 mg/dL

Blood
CBC (complete blood count) This part is in Portuguese but it is understandable, sorry.
Hemácias em milhões/mm³....: 5,43 4,50 a 5,90
Hemoglobina em g/dL ...........: 15,20 13,50 a 17,50
Hamatócrito em %....................: 46,10 41,00 a 53,00
Vol. Glob. Médio em fL............: 84,90 80,00 a 100,00
Hem. Glob Médio em pg.........: 27,99 26,00 a 34,00
C.H. Glob Médio em g/dL......: 32,97 31,00 a 37,00
R.D.W %.....................................: 12,50 10,00 a 16,00


iron 74,49 µg/dL 65 - 175 µg/dL
Ferritin 41,8 ng/mL 23,9 - 336,2 ng/mL
transferrin 207,52 mg/dL 200 - 360 mg/dL
transferrin saturation 26,05 % 20 - 50%
copper 90,80 µg/dL 70,0 - 140,0 µg/dL
ceruloplasmin 32,00 mg/dL 22 - 58 mg/dL
TIBC 187,99 µg/dL 250 - 450 µg/dL


Cortisol saliva 9:00 am 0,240 ug/dL <0,736 ug/dL
Cortisol saliva 11:00pm (same day) <0,054 ug/dL <0,274 ug/dL

Insulin 9,30 uUI/mL 1,9 - 23,0 µUI/mL
Glucose 91,32 mg/dL 65,00 - 99,00 mg/dL
Hba1c 4,60 % <5,7%
Lactic acid 2,8 mmol/L 0,5 - 2,2 mmol/L
Sodium 143,45 mmol/L 136,00 - 146,00 mmol/L
Potassium 4,09 mmol/L 3,50 - 5,10 mmol/L

Triglycerides 498,79 mg/dL <150 mg/dL <<< borderline super high
Cholesterol 224,91 mg/dL <190 mg/dL <<<high
Uric Acid 6,37 mg/dL 3,50 - 7,20 mg/dL

Per Peat standards, your cholesterol seems fine. Ray has said that it's beneficial to keep cholesterol at around 200 I believe he said. I try to find the interview where he said that.

The triglycerides does seem high. What's your diet like right now?

One study said that high ALP could be caused by vitamin D deficiency. Have you had it tested recently?