Help Interpreting 1-Year Followup Tests

[Edo]

Though I have been gluten free for over a year, I've been without health insurance until now, so have never had any tests done other than Enterolab. I got to finally see my doctor this Feb (so happy about that!), didn't have much time with her so didn't get to tell her all my unresolved symptoms and request all the followup tests I wanted, but I did get some of them.

If it helps, I am female, 25, 5'3", 118 lbs. My most noticeable unresolved symptoms include:

Constipation ever since a week-long round of antibiotics for a UTI 1.5 years ago. Along with the C comes general intestinal pain, queasiness, rarely sharp intestinal pain right after a bm.

Constant, severe lack of energy, muscle weakness, sometimes joint pain in legs when walking, exercise intolerance.

Occasional chest pains (can be upper left, lower left, and center, different types of pain for each).

Fast heart rate (might just be a normal genetic thing as several family members do too).

Sometimes pounding heart beat (which went away the day I went gluten free, but has been reappearing lately)

Dizziness and temporary blindness when standing up.

Cold hands and feet, and limbs fall asleep easily.

Signs of neuropathy and ataxia.

Practically all signs of anemia.

Many signs of (hyper)thyroid problems.

I could think of a lot more, but those are the major ones I notice daily.

And I am taking the following:

Probiotics - PB8, 4 per day

Digestive enzymes - 1 with each meal

Magnesium chelate - 500 mg per day

4000 IU vitamin D3 per day

Used to take a multi and b12 months ago, but went off them to see if it would make any difference. Not sure.

I was hoping someone could help me interpret the results of my tests to connect them with my symptoms. I was told over the phone that all the tests came back normal, but I went and got copies, and I'm not so sure about some. I've been researching the tests individually, but if anyone has their own insight on what these results could mean, or picks up on anything that might be helpful, please let me know.

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All Tests Fasting - Unintentionally, I ended up fasting around 16 hours by the time the blood was taken instead of the 10-12 I think they said. I was shaky from hunger, then weak the rest of the day.

Test result (Reference Range)

Red = Abnormal

Gray = Borderline Abnormal

Bear with me if I considered some things borderline that shouldn't be, or vice versa. Some were tough calls.

CBC Screen with Auto

WBC 4.9 K/mcL (3.8-11.0)

RBC 4.55 M/mcL (4.0-5.2)

HGB 14.3 g/dL (12.0-16.0)

HCT 42.1 % (36-46)

MCV 92.6 fl (80-100)

MCH 31.5 pg (26-34)

MCHC 34.1 g/dL (31-36)

RDW 10.5 % (10.5-13.5)

Platelet Count 277 K/mcL (150-450)

Neutrophils 57.2 % (44-70)

Lymphocytes 27.2 % (25-46)

Monocytes 12.9 % (1-12)

Eosinophils 1.9 % (0-8)

Basophils 0.7 % (0-2)

Absolute Neut Ct 2.8 K/mcL (1.8-7.7)

Absolute Lymphs 1.3 K/mcL (1.0-5.0)

Absolute Monos 0.6 K/mcL (0-0.8)

Absolute Eos 0.1 K/mcL (0-0.5)

Absolute Baso 0.0 K/mcL (0-0.2)

NRBC 0.0 /100 (0)

Comprehensive Metabolic Panel

Sodium 137 mmol/L (136-146)

Potassium 4.0 mmol/L (3.5-5.1)

Chloride 100 mmol/L (98-107)

Glucose 93 mg/dL (60-120, ADA recommends normal fasting 70-99)

CO2 28 mmol/L (22-32)

BUN 9 mg/dL (7-21)

Creatinine 0.6 mg/dL (0.6-1.0)

Calcium 9.3 mg/dL (8.4-10.3)

Albumin 4.8 g/dL (3.3-5.0)

AST 9 Units/L (15-37)

Protien, Total 7.7 g/dL (6.0-8.0)

Bilirubin, Total 0.6 mg/dL (0.1-1.2)

ALT 16 Units/L (12-78)

Alk Phos 54 Units/L (38-126)

GFR Calc, Non-African 131 mL/mn/1.73 (>60)

GFR Calc, African 158 mL/mn/1.73 (>60)

Osmo Calc 282 mOs/Kg H20 (280-305)

Lipid Panel

Cholesterol 157 mg/dL (<200)

Triglycerides 41 mg/dL (<150)

HDL 74 mg/dL (30-85, <40 low, >59 high)

LDL by calculation 75 mg/dL (<130)

TSH (3rd Generation)

Thyroid Stimulating Hormone 2.480 mcIU/mL (0.358-3.800)

VIT D 25-hydroxy

Vitamin D, 25-Hydroxy 40.5 ng/mL (30-80)

Tissue Transglutaminase ab, IgA

TTG ab, IgA 8 (0-19)

Celiac Disease Reflexive Panel

TTG ab, IgA 181 mg/dL (68-378)

Gliadin Peptide Ab IgA 3 (0-19)

Stool Culture

Enteric Pathogens No Salmonella, Shigella, Campylobacter, or significant amounts of Staphylococcus aureus or yeast isolated

Shiga Toxin Assay Negative for Shiga toxins 1 and 2

Fecal Leukocytes No PMN's seen

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I see my doctor again on March 3 for a physical and would like to ask for more tests that might explain my continuing symptoms. She is referring me to a gastroenterologist, though I don't know how long that will take. She also recommended a colonoscopy. I think they should look at my upper GI too because I get pain there also. For the constipation, she recommended I try increasing fiber, which I did. But after doing the calculations, I was already getting 25 grams of fiber per day minimum, usually more like in the 30's, and I am drinking 8x 8 oz glasses of water per day minimum and even more fluids from foods (tried drinking more also, but it felt unnatural and taxing on my system), so I just think there is something else at play here. I want to ask for:

Common vitamin/mineral deficiencies not yet tested for: all the B vitamins, iron, magnesium, zinc, vitamin K... any others?

More thyroid tests due to symptoms and family history.

ANA test to check for autoantibodies (for possible additional autoimmune diseases at work).

Test for low stomach acid due to poor carb/fat digestion.

More thorough tests for parasites/bacterial overgrowth/H. Pylori. I've heard it takes multiple stool samples to get an accurate result on certain things, and I'm not sure she even ordered the most applicable tests. Advice?

Bone health; just heard this is a common problem with Celiac.

If anyone can think of anything else or has any advice, I'd much appreciate it!

[Edo]

I came back from the doctor and she refused to do any further tests until after a heart ultrasound and wearing a heart monitor. I'm feeling kind of let down. She said there was no clinical reason to do the tests I asked for, that any possible deficiencies would've shown up somehow on the tests I already got. And that because I am following the gluten free diet successfully, any deficiencies should have corrected themselves by now. That doesn't seem right to me. I can't wait for a GI doc.

[rustycat]

Hi,

Your symptoms are very similar to mine. Even though I've been gluten free for 6 months, I can relate to many of your continuing issues.

I have been interested to see the list of symptoms for Hashimoto's Thyroid disease and it sounds a lot like what I have. You might want to search for that on this site. There is lots of interesting information.

Best wishes.