18 month labs

[newanatomy]

SURGERY DATE: 01/17/2014 Date Date Date Date Date
Ref range 2/28/2008 9/16/2013 8/14/2014 12/4/2014 6/26/2015
CALICUM RELATED
PTH, intact 15 -65 23 76.2
Calcium 8.7 - 10.2 9.7 8.8 8.9 9.6
Vitamin D, 25-hydroxy 30 - 100 130 70.1

IRON and TIBC
Iron Bind. Cap. (TIBC) 250 - 450 305 258
UIBC 150 - 375 217 189
Iron, Serum 35 - 155 88 69 62
Iron Saturation % 15 - 55 29 27


VITAMINS/MINERALS
Amylase 21-101
Copper 72 - 166 103 130
Magnesium 1.6 - 2.6 2.2 2.1
Ceruloplasmin 16.0 - 45.0 26.7 25
Selenium 79 - 326 214 163
Zinc, P 56 - 134 81 80

Vitamin A 38 - 98 72 57
Vitamin B1, Thiamine 78 - 185 229 154
Vitamin B6, plasma 2.1 - 21.7 84.2 19.7
Vitamin B12 200 - 1100 2000 1353 962
Folate >3.0 8.1 12.3 >20
Vitamin D, 25-hydroxy 30 - 100 130
Vitamin E 3.0 - 15.8
Vitamin K1 .28 - 1.78

LIPID PANEL
Cholesterol, total 130 - 200 217 238 124 110 128
Triglycerides 30 - 150 232 195 90 57 79
HDL cholesterol 40 - 60 35 54 40 48 54
VLDL cholesterol 5.0 - 40 18 11 16
LDL cholesterol 0 - 100 136 145 66 51 58
NON-HDL (5.1) 0.00 - 130.00 74
Coronary Risk (5.1) 0 - 4.0 2.4

RENAL PANEL
Glucose, Serum 65 - 99 85 98 84 84 82
Urea Nitrogen (BUN) 6. - 24 12 17 15
Creatinine, Serum .57 - 1.00 0.8 0.63 0.58 0.06
eGFR If NonAfrican American >59 109
eGFR If African American >59 126
BUN/Creatinine ratio 9.0 - 23 27 26 16
Sodium, Serum 134 - 144 140 145 143 142
Potassium, Serum 3.5 - 5.2 4.1 4.7 4.7 4.1
Chloride 97 - 108 107 106 105 102
Carbon Dioxide 18 - 29 25 27 28 29
Calcium, Serum 8.7 - 10.2 9.7 8.8 8.9 9.6
Albumin 3.5 - 5.5 4.4 4.7 4.2 4.7
Globulin 1.5 - 4.5 2 1.9 2.7
Albumin/Globulin ratio 1.1 - 2.5 2.4 2.2 1.7
Phosphorus 2.5 - 4.5 4.8

HEPATIC FUNCTION
Protein, total 6.0 - 8.5 7.8 6.7 6.1 7.4
Bilirubin, total 0.0 - 1.2 0.7 0.5 0.4 0.9
Alkaline Phosphotase (ALP) 39 - 117 98 98 71 80
AST (SGOT) 0 - 40 105 20 16 23
ALT (SGPT) 0 - 32 52 28 23 46

CBC
White blood cell count 3.4 - 10.8 9.1 5.6 5.6 5.9
Red blood cell count 3.77 - 5.28 5.02 4.4 4.04 4.34
Hemoglobin 11.7 - 15.9 15.1 12.6 12.3 13.1
Hematocrit 34.0 - 46.6 44.1 40.2 38 40.5
MCV 79 - 97 87.9 91 94 93
MCH 26.6 - 33.0 30.1 28.6 30.4 30.3
MCHC 31.5 - 35.7 34.2 31.3 32.4 32.5
RDW 12.3 - 15.4 14.3 13.7 13.3 13.6
Platelet count 150 - 379 296 264 244 240
MPV (mean platelet value) 7.8 - 11.0 12.7 8.2
Absolute neutrophils 1.4 - 7.0 3.1 3.2 3.3
Absolute Lymphcytes 0.7 - 3.1 1.9 1.8 2.1
Absolute Monocytes 0.1 - 0.9 0.4 0.4 0.3
Absolute Eosiniphils 0.0 - 0.4 0.1 0.1 0.1
Absolute Basophils 0.0 - 2.0 0.1 0.1 0.1
% Neutrophils 40 - 74 55 57 55.5
% Lymphocytes 22 - 44 2.1 35 33 35
% Monocytes 0 - 12 5.8 7 8 5
% Eosinophils 0 -7 2 1 1.9
% Basophils 0 -2 1 1 1.2

OTHER
Thyroid stimulating hormone (TSH) .450 - 4.500 2.6 2.56 0.19 low
Thyroxine (T4) Free, Direct S .82 - 1.77 1.33

Ferritin, Serum (Serial) 15 - 150 436 410 285
Notes on Ferritin
PreAlbumin 20 - 40
C Reactive Protein, Quant 0.0 - 4.9 1.1
Sedimentation Rate-Westergren 0 - 32 2

 

[southernlady]

NA, can you list what you currently take as far as vitamins and minerals, include brand and how much.

 

[newanatomy]

Vitamins
Sundown Naturals - Potassium Gluconate 595mg, 1 caplet
BioTech Dry Vitamin D3-50 50,000iu , 1 Capsule
NOW Dry E - 400 Iu Alpha Tocopheryl Succinate, 1 Capsule
Puritan's Pride - Chelated Zinc (Zinc Gluconate) 50 Mg, 1 tablet
Puritan's Pride - Chelated Copper 2mg , 1 Pill
Doctor's Best - Natural Vitamin K2 45 mcg, 1 capsule
Bio Tech - K1-1000 mcg, 1 capsule
NOW - Calcium Citrate 600 mg, 4 tablets
NOW - Selenium 100mcg, 1 tablet
Simply Right - Adults 50+ Multivitamin, 2 tablet
NOW - Potassium Citrate, 1 capsule
Jarrow S Probiotic, 1 tablet
NOW - Magnesium Citrate (200 Mg; Magnesium Citrate), 2 tablets
Simply Right - Biotin Extra Strength 5000 Mcg, 1 Tablet
Sundown Naturals - High Potency Perfect Iron, 3 Tablet
Equaline - Vitamin C 1000 Mg, 1 Tablet
Finest Natural - Magnesium - 250mg As Magnesium Oxide (67% Rdv), 4 Tablet

Medicines
Synthyroid - Levothyroxine 75 Mcg, 1 Tablet
Lansoprazole DR 30 MG capsule - 30 MG capsule per day, 1 capsule
Simply Right - stool softener, 4 capsules daily

 

[newanatomy]

Sorry about the lab results being so messy. I tried to pretty them up but, it kept getting messed up again and I had to leave for dinner. I think you can figure them out.

The concerning ones are:
PTH 76.2 when it was 23 in December
Vitamin D 70.1 when it was 130 in December
I am not sure what the Creatine, Serum does or why it dropped from .58 in December to .06. (I looked this up and on http://www.netdoctor.co.uk/ate/liverandkidney/203123.html, it said Having a low level of blood creatinine indicates nothing more than an efficient and effective pair of kidneys.)

Phosphorus is high at 4.8 (range is 2.5 - 4.5)

Hepatic Function: Alt (SGPT) (range 0 - 32) Was 23 in December now 46 From: http://www.surgeryencyclopedia.com/La-Pa/Liver-Function-Tests.html: ALT is an enzyme that transfers an amino group from the amino acid alanine to a ketoacid acceptor (oxaloacetate). The enzyme was formerly called serum glutamic pyruvic transaminase (SGPT) after the products formed by this reaction. Although ALT is present in other tissues besides liver, its concentration in liver is far greater than any other tissue, and blood levels in nonhepatic conditions rarely produce levels of a magnitude seen in liver disease. The enzyme is very sensitive to necrotic or inflammatory liver injury. Consequently, if ALT or direct bilirubin is increased, then some form of liver disease is likely. If both are normal, then liver disease is unlikely.

My bilirubin is within range.

Ferritin range(15-150) was 436 then 410 in December now its 285

Thyroid stimulating hormone (TSH) (range .450-4.500) has been well controlled with drugs at 2.6 and 2.56 now it's 0.19

Everything else is within range except my total Cholesterol (range 130 - 200) which is low at 128

 

[DBmom23]

@newanatomy, your drop in creatinine could be a combination of being better hydrated than you were back in december and decreased muscle mass. It is not of concern on its own. Your phosphorus can be highly variable depending on your food intake. However, given your changes in PTH and Vitamin D, it is possible that it's high due to increased bone turnover. It seems like you need to increase your vitamin D and probably calcium. The increase in ALT is worth keeping an eye on but if AST is OK, then i wouldn't worry too much about it right now. Not sure why your TSH is suddenly low.

 

[southernlady]

I would add more D. maybe not every day but 2-3 times extra a week. That should also bring your PTH back down.

When are you taking your thyroid med? I take mine during a middle of the night potty run and that seems to hold me steady. I would also maybe ask to see an endo to find out what can help. You may need an adjustment upward.

 

[newanatomy]

I would add more D. maybe not every day but 2-3 times extra a week. That should also bring your PTH back down.

When are you taking your thyroid med? I take mine during a middle of the night potty run and that seems to hold me steady. I would also maybe ask to see an endo to find out what can help. You may need an adjustment upward.

Thanks, will do.

 

[DSRIGGS]

I would watch your ALT but I have seen that number bounce all over the place from read to read with Cameron, and myself and it hasn't ended up being anything...so hopefully this read was just an anomaly.

BTW, my creatinine is usually low too.

 

[newanatomy]

I would watch your ALT but I have seen that number bounce all over the place from read to read with Cameron, and myself and it hasn't ended up being anything...so hopefully this read was just an anomaly.

BTW, my creatinine is usually low too.

Thanks, I mostly need that PTH to come back down, I think. On second thought, my thyroid is a concern, too. Last time my thyroid went kaflooie, I lost a ton of hair. So much in fact, I had to change my part to cover a bald spot. That was pre-op.

 

[newanatomy]

Parathyroid hormone-vitamin D and FGF-23-endocrine axis

Dietary phosphorus is readily absorbed in the small intestine, and in healthy individuals, excess phosphorus is excreted by the kidneys under the regulatory action of the endocrine hormones: parathyroid hormone (PTH), vitamin D, and fibroblast growth factor-23 (FGF-23). The acute regulation of blood calcium and phosphorus concentrations is controlled through the actions of PTH and the active form of vitamin D. A slight drop in blood calcium levels (e.g., in the case of inadequate calcium intake) is sensed by the parathyroid glands, resulting in their increased secretion of PTH, which rapidly decreases urinary excretion of calcium but increases urinary excretion of phosphorus and stimulates bone resorption. This results in the release of bone mineral (calcium and phosphate)—actions that restore serum calcium concentrations. Although the action is not immediate, PTH also stimulates conversion of vitamin D to its active form (1,25-dihydroxyvitamin D; calcitriol) in the kidneys. Increased circulating 1,25-dihydroxyvitamin D in turn stimulates increased intestinal absorption of both calcium and phosphorus. A third hormone, FGF-23, plays a central role in phosphorus homeostasis. FGF-23 is secreted by bone-forming cells (osteoblasts/osteocytes) in response to increases in phosphorus intake. In a negative feedback loop, FGF-23 inhibits the production and stimulates the degradation of 1,25-dihydroxyvitamin D, as well as promotes an increase in urinary phosphorus excretion independently of PTH and 1,25-dihydroxyvitamin D (3).
http://lpi.oregonstate.edu/mic/minerals/phosphorus

I thought this was really interesting (even though it is a little over my head maybe, @DianaCox can explain it) because my PTH and phosphorus are both high and although my D was still in range it had dropped almost 50% over a 7 month period.