Hematology Visit

[stilltired07]

Hi all, thanks in advance.

To start off, I am a 25 year old Caucasian male.

My current health issues are Celiac Disease (diagnosed Nov 2009 by biopsy/anti-ttg positive blood tests), Addison's Disease (diagnosed in May 2011 by low cortisol and high ACTH), secondary hypogonadism (diagnosed by low free testosterone and low pituitary hormones LH/FSH).

Throughout the last couple years, my RBC/HB/HCT have been flip flopping from mildly low to borderline low. RBC range has been 3.5-4.5, HB range has been 119-141, HCT range has been 34-41. Basically it just seems to jump back and forth, never going higher than the bottom of normal. My absolute retic count throughout this time has ranged from severely low to mildly low. It is usually between 1-15 when normal is >25. It seems like every other test my levels bounce back and forth. Lately I've noticed my WBC starting to slide lower. It has always been between 5-7 and recently it has dropped into the 3's. I had been referred to a hematologist due to my bouncing counts and low b12/ferritin/folate.

Here is the blood work ran by the hematology department last week, it was taken one month after I was treated with B12 shots bi-weekly and oral ferritin/folate. I had a B12 shot 5 days before this test was taken. My B12 before treatment was 72 and my ferritin was 19. I have highlighted low results with red and borderline with orange.

The hematologist seems to be blowing me off, but my Gastro/Endo both believe it is something that needs to be investigated. My gasto mentioned a bone marrow biopsy, but the hematologist said not a chance. I am just worried as my health has not been good over the last couple years. Any advice or past experiences are appreciated. I understand nobody here is a doctor and others have much more severe issues, but I didn't know where else to ask. Thanks again to everyone!!

WBC: 3.1 (4-11)

ABS Neutro: 1.77 (2.0-6.5)

ABS Lymph: 0.79 (1.0 - 3.2)

ABS Mono: 0.32 (0.2 - 0.8)

ABS Eosin: 0.2 (0.04-0.40)

ABS Baso: 0.03 (0.00-0.10)

RBC: 4.1 (4.5-5.7)

HGB: 127 (140-170)

HCT: 36 (40-49)

MCV: 88 (82-97)

MCH: 31 (27-32)

MCHC: 352 (320-360)

RDW: 12.3 (11-15)

MPV: 8.3 (7-11)

PLT: 156 (150-400)

B12: 183 (110-800)

Homocysteine: 14.2 (3-15)

RBC Folate: 491 (normal >650)

Ferritin: 26 (30-280)

Total IRON: 11 (10-32)

TIBC: 50 (43-73)

Saturation %: 22 (20-50)

ESR: 1 (0-15)

CRP: <0.2 (0.0-5.0)

ALP: 41 (35-125)

AST: 30 (7-40)

ALT: 31 (10-45)

GGT: 9 (8-80)

[Gemini]

Hi all, thanks in advance.

To start off, I am a 25 year old Caucasian male.

My current health issues are Celiac Disease (diagnosed Nov 2009 by biopsy/anti-ttg positive blood tests), Addison's Disease (diagnosed in May 2011 by low cortisol and high ACTH), secondary hypogonadism (diagnosed by low free testosterone and low pituitary hormones LH/FSH).

Throughout the last couple years, my RBC/HB/HCT have been flip flopping from mildly low to borderline low. RBC range has been 3.5-4.5, HB range has been 119-141, HCT range has been 34-41. Basically it just seems to jump back and forth, never going higher than the bottom of normal. My absolute retic count throughout this time has ranged from severely low to mildly low. It is usually between 1-15 when normal is >25. It seems like every other test my levels bounce back and forth. Lately I've noticed my WBC starting to slide lower. It has always been between 5-7 and recently it has dropped into the 3's. I had been referred to a hematologist due to my bouncing counts and low b12/ferritin/folate.

Here is the blood work ran by the hematology department last week, it was taken one month after I was treated with B12 shots bi-weekly and oral ferritin/folate. I had a B12 shot 5 days before this test was taken. My B12 before treatment was 72 and my ferritin was 19. I have highlighted low results with red and borderline with orange.

The hematologist seems to be blowing me off, but my Gastro/Endo both believe it is something that needs to be investigated. My gasto mentioned a bone marrow biopsy, but the hematologist said not a chance. I am just worried as my health has not been good over the last couple years. Any advice or past experiences are appreciated. I understand nobody here is a doctor and others have much more severe issues, but I didn't know where else to ask. Thanks again to everyone!!

WBC: 3.1 (4-11)

ABS Neutro: 1.77 (2.0-6.5)

ABS Lymph: 0.79 (1.0 - 3.2)

ABS Mono: 0.32 (0.2 - 0.8)

ABS Eosin: 0.2 (0.04-0.40)

ABS Baso: 0.03 (0.00-0.10)

RBC: 4.1 (4.5-5.7)

HGB: 127 (140-170)

HCT: 36 (40-49)

MCV: 88 (82-97)

MCH: 31 (27-32)

MCHC: 352 (320-360)

RDW: 12.3 (11-15)

MPV: 8.3 (7-11)

PLT: 156 (150-400)

B12: 183 (110-800)

Homocysteine: 14.2 (3-15)

RBC Folate: 491 (normal >650)

Ferritin: 26 (30-280)

Total IRON: 11 (10-32)

TIBC: 50 (43-73)

Saturation %: 22 (20-50)

ESR: 1 (0-15)

CRP: <0.2 (0.0-5.0)

ALP: 41 (35-125)

AST: 30 (7-40)

ALT: 31 (10-45)

GGT: 9 (8-80)

Low white cell counts are common with people that have multiple autoimmune issues, which it looks like you have. I also have low white cell counts, which commonly dip into the mid 2's but I am rarely sick so do not worry about it. It is also common to have lower RBC's. I have found that even healed Celiacs have less than robust counts, including myself.

Havin Addison's Disease can influence you thyroid gland...they all work together in a feed back loop. If your thyroid gland is hypo, or low, that can cause anemia. Have you ever had your thyroid tested?

If you are getting sick a lot, then that would be reason to investigate further. Generally, doctors don't become concerned with low counts unless you are constantly sick. Has your health improved by going gluten-free?