Results from my latest review

[JohnEGreen]

Had the results and am a little concerned not as I had hoped for.

HbA1c seems to have gone up now 41 mmol/mol

Total cholesterol and lipids on the high side.

Liver function tests
Serum alanine aminotransferase level 15 u/L [0.0 - 45.0]
Serum bilirubin level 6 umol/L [0.0 - 21.0]
Alkaline phosphatase level 41 u/L [30.0 - 130.0]
Serum albumin level 35 g/L [35.0 - 50.0]

Serum lipid levels

Serum cholesterol level 7.7 mmol/L
Serum triglyceride levels 1.96 mmol/L [0.4 - 1.8]
Above high reference limit
Serum HDL cholesterol level 1.5 mmol/L
Serum non high density lipoprotein cholesterol level 6.2 mmol/L
Serum LDL cholesterol level 5.3 mmol/L
NB the calculation of LDL is valid only for a
fasting sample.
Serum cholesterol/HDL ratio 5.1
Urea and electrolytes
Serum sodium level 141 mmol/L [133.0 - 146.0]
Serum potassium level 5.7 mmol/L [3.5 - 5.3]
Above high reference limit
Serum urea level 7.3 mmol/L [2.5 - 7.8]
Serum creatinine level 125 umol/L [70.0 - 120.0]
Above high reference limit

EGFR BY EPI
eGFR using creatinine (CKD-EPI) per 1.73 square metres 50 mL/min
GFR calculated by CKD-Epi formula (mL/min/1.73m2)
- for African-Caribbean multiply by 1.159. Not
valid in acute kidney injury, dialysis and
pregnancy. Please use Cockroft-Gault estimate
of creatinine clearance for drug dosing.
TOTAL PROTEIN ONLY
Serum total protein level 65 g/L [60.0 - 80.0]

Think I am going to have to change things a bit.

Edit to add blood count may be of interest.

Full blood count
Haemoglobin concentration 146 g/L [130.0 - 170.0]
Total white blood count 8.5 10*9/L [4.0 - 10.0]
Platelet count - observation 193 10*9/L [150.0 - 410.0]
Red blood cell count 4.46 10*12/L [4.5 - 5.5]
Below low reference limit
Haematocrit 0.437 L/L [0.4 - 0.5]
Mean cell volume 98 fL [83.0 - 101.0]
Mean cell haemoglobin level 32.7 pg [27.0 - 32.0]
Above high reference limit
Mean cell haemoglobin concentration 334 g/L [315.0 - 345.0]
Neutrophil count 6.5 10*9/L [2.0 - 7.0]
Lymphocyte count 1.2 10*9/L [1.0 - 3.0]
Monocyte count - observation 0.7 10*9/L [0.2 - 1.0]
Eosinophil count - observation 0.0 10*9/L [0.0 - 0.5]
Basophil count 0.1 10*9/L [0.0 - 0.1]
Nucleated red blood cell count 0.0 10*9/L

 

[Bluetit1802]

Have you discussed any of this with your nurse/GP? What have they had to say about it?

 

[JohnEGreen]

Appointment tomorrow not looking forward to it going to have some argumentation over statins I think at least

I'm not sure how too interpret some of the results though if you accept the hype over cholesterol levels it does not look to good.

And there are no appointments available with doctor for the next month or two.

At least the eGFR has not got any worse my Lymphocyte count is back up to normal range just but red blood cell count has dropped.

MCV is now down in normal range but Mean cell haemoglobin level seems to be up bit of a mixed bag realy not sure if cholesterol is very bad or just bad.

But A1c going up is not what I had anticipated at all.

Still see what the nurse makes of it all tomorrow.

 

[Bluetit1802]

Did you fast for this blood test and were you well hydrated?

High MCH levels can indicate macrocytic anemia, which can be caused by insufficient vitamin B12. Insufficient folic acid can be another cause of macrocytic anemia. If you are concerned you could ask for B12 and folate blood tests. My MCH levels are always above the standard range by a small amount. I asked for the B12 and folate tests, which came back totally normal so I am at a loss to know why, but my GP is unconcerned. However, all my other red blood cell markers are normal.

 

[JohnEGreen]

I fasted and was well hydrated. Have been taking folic acid for quite a while and last test gave B12 as normal Lymphocyte count was down to 0.2 previously of course it could be the prednisolone screwing every thing up doctor has put retest required for

Liver function tests
Serum lipid levels
Urea and electrolytes
EGFR BY EPI
TOTAL PROTEIN ONLY

Not sure what's going on.

Do I give in and take statins? I am so totally averse to that had sworn I never would again.

 

[hankjam]

Yes, I was going to ask about hydration as your salts do look a bit close to the "top".
That's a blizzard of numbers, I don't get anything like as comprehensive a list of stats, impressed.
I can understand you being a bit concerned. The discussion on statins is a definite, they don't seem to be able to discuss much else at the moment.
If the Doc don't want to see you for a couple of months.... dear lord, that's just poor.
I hope it goes well with Nurse tomorrow.
Best wishes
Hj

 

[JohnEGreen]

Yes, I was going to ask about hydration as your salts do look a bit close to the "top".
That's a blizzard of numbers, I don't get anything like as comprehensive a list of stats, impressed.
I can understand you being a bit concerned. The discussion on statins is a definite, they don't seem to be able to discuss much else at the moment.
If the Doc don't want to see you for a couple of months.... dear lord, that's just poor.
I hope it goes well with Nurse tomorrow.
Best wishes
Hj

I also got this for the full set.

MICROALBUMIN
Urine albumin/creatinine ratio < 2.0 mg/mmol [0.0 - 2.99]
Urine Albumin:Creatinine Ratio (Albuminuria
or ACR).
For the initial detection of proteinuria, if the
ACR is between 3 and 70 mg/mmol, this should be
confirmed by a subsequent early morning sample. If
the initial ACR is 70 mg/mmol or greater, a repeat
sample need not be tested.
Regard a confirmed ACR of 3mg/mmol or more as
clinically important proteinuria. [NICE CG182]
Urine creatinine level 6.4 mmol/L
Urine albumin level < 3.0 mg/L

Pretty comprehensive just a bit confusing.

 

[DCUKMod]

@JohnEGreen - some of my blood routinely run on the edges, of the assays quoted, and I always query with the Doc and she has now convinced me that for me, those edges are my norm, as there is nothing to join them firmly together, and they've always been that way.

If, bearing in mind your more complex medical history, your lipids concern you, then ask for a referral to an lipidologist, at the Lipids Clinic, or if that's not forthcoming ask your GP to take soecialist advice, via the email system.

GPs are able to make almost like a remote referral in situations like this where an examination or face to face meeting could be considered less simportant than the decent set of recent bloods. It's not completely ideal, but it can sure as heck cut down on the time waiting for appointments to be generated, and clinic waiting lists.

Where my GP has done tis for me, we allowed a couple of weeks for she and the Endo to get talking, and the second time, she had made the referral, based on a letter I wrote to her, in the lead up to a telephone consultation, where I was not at all comfortable with my blood results and the planned (in)action.

In my case, the e-referrals have been for Endo stuff, as opposed to haematological, or lipids directly.

The e-referral process (how my GP and I describe it; not necessarily the proper name!) really is a well-kept secret, but one to be used, where necessary.

Good luck John. It's very frustrating when things take a bit of a confounding turn.

 

[Tophat1900]

John, try running your numbers through the calculator. See what you get... http://www.hughcalc.org/chol-si.php

 

[Bluetit1802]

I fasted and was well hydrated. Have been taking folic acid for quite a while and last test gave B12 as normal Lymphocyte count was down to 0.2 previously of course it could be the prednisolone screwing every thing up doctor has put retest required for

Liver function tests
Serum lipid levels
Urea and electrolytes
EGFR BY EPI
TOTAL PROTEIN ONLY

Not sure what's going on.

Do I give in and take statins? I am so totally averse to that had sworn I never would again.

I imagine the doctor is ordering these repeat tests to confirm or otherwise the first lot. It looks like he is looking after you.

Has anything changed diet and medication wise since your previous tests? Could that be a reason?

 

[JohnEGreen]

Has anything changed diet and medication wise since your previous tests? Could that be a reason?

No change in diet particularly but as I have been reminded my prednisolone dose was upped for a while and that could be the cause of the higher A1c .

Got a repeat blood test booked for next week. So didn't get a lecture about lipids today I think they are waiting to see what the repeat shows.

And the nurse agreed with me that there is a difference between being a normal T2 and drug induced T3E so things are not so straight forward.

 

[JohnEGreen]

John, try running your numbers through the calculator. See what you get... http://www.hughcalc.org/chol-si.php

I am not overly concerned about raised lipids but would prefer them a bit lower nurse and doctor probably more worried about it than I.

But will run my figures through the calculator to see how bad the results are in the orthodox view, And to see if I need to make some real changes to diet to bring it back down.

Did so this is what I got.

Your Total Cholesterol of 7.70 is HIGH RISK
Your LDL of 5.30 is VERY HIGH RISK
Your HDL of 1.5 is NORMAL
Your Triglyceride level of 1.95 is BORDERLINE
RATIOS:
Your Total Cholesterol/HDL ratio is: 5.13 - (preferably under 5.0, ideally under 3.5) AT RISK
Your HDL/LDL ratio is: 0.283 - (preferably over 0.3, ideally over 0.4) AT RISK
Your triglycerides/HDL ratio is: 1.300 - (preferably under 1.74, ideally under 0.87) NORMAL

"but would prefer them a bit lower " well may be a lot lower.

Oops some changes required I think.

 

[Bluetit1802]

What were your previous lipid results? Have they all deteriorated?

 

[JohnEGreen]

What were your previous lipid results? Have they all deteriorated?

I have tried to access my previous test results but not been able to so far but I think they were not as high as they are now so yes mostly deterioration as of now. So will have to give this serious thought and try to get an appointment at surgery but all appointment slots for the next several weeks are taken.

It's ldl and triglycerides that seem to be the problem.

Nurse has has changed my review back to six monthly from annually.

 

[Bluetit1802]

You could do with getting your previous results for comparison. Have you asked for print outs for them? They will be on your records and available to you if you ask. Nothing on line? Before you see nurse or GP you need to be armed with all the information, especially for the statin discussion.

 

[Pinkorchid]

Appointment tomorrow not looking forward to it going to have some argumentation over statins I think at least

I'm not sure how too interpret some of the results though if you accept the hype over cholesterol levels it does not look to good.

And there are no appointments available with doctor for the next month or two.

At least the eGFR has not got any worse my Lymphocyte count is back up to normal range just but red blood cell count has dropped.

MCV is now down in normal range but Mean cell haemoglobin level seems to be up bit of a mixed bag realy not sure if cholesterol is very bad or just bad.

But A1c going up is not what I had anticipated at all.

Still see what the nurse makes of it all tomorrow.

That is really bad no appointments available for a month or two.. At my practise we can wait up to two weeks for an appointment if we want to see a certain doctor but sooner if we are willing to see any one of the doctors

 

[JohnEGreen]

Yes should be able to get them on line just have to search back till hit the correct date as have had so many different blood tests done over the last year or so they all blur into one.

I did say to the nurse I have so many problems that all vie for my attention that cholesterol is not any where near top of the list and she did not take issue with that.

 

[JohnEGreen]

That is really bad no appointments available for a month or two.. At my practise we can wait up to two weeks for an appointment if we want to see a certain doctor but sooner if we are willing to see any one of the doctors

I went on line to book an appointment and got no slots available that's for any doctor at our surgery you can't book ahead for more than I think 4 weeks

 

[bulkbiker]

I have tried to access my previous test results but not been able to so far but I think they were not as high as they are now so yes mostly deterioration as of now. So will have to give this serious thought and try to get an appointment at surgery but all appointment slots for the next several weeks are taken.

It's ldl and triglycerides that seem to be the problem.

Nurse has has changed my review back to six monthly from annually.

I'll just drop this off here for you
http://skimmed.cream.org/cholesterol-protective-in-elderly/
From Nick Mailer one of the smartest people I have come across..

 

[Mr_Pot]

I went on line to book an appointment and got no slots available that's for any doctor at our surgery you can't book ahead for more than I think 4 weeks

My local surgery only make about two weeks of appointments available on line, they keep some appointments in the next few days for people who phone in requiring an urgent consultation and they don't make a longer range available due to the number of people that don't turn up. So it is worth checking regularly in case the are cancellations or they make more days available. Last week they told me there were no appointments with my requested doctor for 3 weeks, the next day I booked an appointment with him on line for the following day.