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jhcakilmer
11-27-2007, 10:13 AM
I have been feeling fatigued lately, so I went in and had a CBC, with Thyroid Panel. Got the results back, and there wasn't anything unusual, except my Hematocrit and Hemaglobin levels were high. My PCP asked if I smoked or had any respiratory issues, which I don't. I also had a below normal Plasma Volume, of 7.0, which isn't really low, but strange considering my other values.

I guess the only thing that potential worries me is the HCT, and Hb levels being so high. I know of some pathological conditions such as erythroid hyperplasia, or polycythemia, but does anyone else have an ideal, or is it normal.

My PCP didn't seem concerned, but I'm just wondering what some other trainers or physicians think. I know the reference values can vary, and that each lab is different. I just might getting another panel in a few months.

Thoughts?

Too Tall
11-27-2007, 10:28 AM
Are you chronically dehydrated?

Kurt
11-27-2007, 10:28 AM
I have been feeling fatigued lately, so I went in and had a CBC, with Thyroid Panel. Got the results back, and there wasn't anything unusual, except my Hematocrit and Hemaglobin levels were high. My PCP asked if I smoked or had any respiratory issues, which I don't. I also had a below normal Plasma Volume, of 7.0, which isn't really low, but strange considering my other values.

I guess the only thing that potential worries me is the HCT, and Hb levels being so high. I know of some pathological conditions such as erythroid hyperplasia, or polycythemia, but does anyone else have an ideal, or is it normal.

My PCP didn't seem concerned, but I'm just wondering what some other trainers or physicians think. I know the reference values can vary, and that each lab is different. I just might getting another panel in a few months.

Thoughts?

Is your pcp an internist? Christ, you live in PA with one of the best med schools in the country, it might take you like a minute to get a referral and then grab your lab results and go to an expert – my dr is a hematologist and an oncologist, I think that is a good combo to look for. If you have something out of whack with you why screw with the internet, with a co-pay you might be closer to the real solution. Health is everything, you already know this.

jhcakilmer
11-27-2007, 10:34 AM
No, I'm not dehydrated....I did think of that. I usually drink 3-4 liters, plus what ever else I drink during workouts.

I am considering a hematologist referral, but not sure if it's really necessary. I checked my last blood test, about 2 years ago, and it was basically the same.

My HCT was 53, and Hb was 18......obviously not extremely high, but a little unusual.

Fixed
11-27-2007, 10:43 AM
bro sorry to hear there is a lot of stuff they can find but can't do anything about it . don't let it get you down ..i never have a good blood test but i'm still here after 20 years .
cheers

Kurt
11-27-2007, 11:10 AM
No, I'm not dehydrated....I did think of that. I usually drink 3-4 liters, plus what ever else I drink during workouts.

I am considering a hematologist referral, but not sure if it's really necessary. I checked my last blood test, about 2 years ago, and it was basically the same.

My HCT was 53, and Hb was 18......obviously not extremely high, but a little unusual.

I am not suggesting a hema, that is just who I have as my pcp. I am suggesting just another good dr in the loop. if you don't feel like where you should be you have to continue in your journey. I have a friend/client that has had fatigue issues along with many other symptoms for years – he has had ever test known to man, been to drs all over the country and they cannot find what is wrong with him – it is clear that something is wrong, that everyone agrees on, but no solution – they don’t know everything yet. You have to have a sharp internist, that is the first step. Good luck.

swoop
11-27-2007, 11:15 AM
just do a simple symptom test for depression/dysthymia too. .. oftentimes folks show physical symptoms before emotional ones. look on a credible site like webmd for a symptom tree or mention it to your doc.

Ginger
11-27-2007, 11:17 AM
As we all have our own little worlds, have your doc run a ferritin (stored iron) test along with a TIBC (total iron binding capacity).

And I always suggest, if you're having blood tests run, you're having fatigue, have your doc run a gluten panel. Doesn't hurt. Well...only a little. You'd rather not be celiac, but I'll tell you...if I'd known what I had when I was 17 instead of finding out when I was 35, I'd have had a much different life. (And while celiac is inherited, you may not show symptoms until a major medical/stress event)

My odd blood test result is that my MCV is above the normal range and has increased all year long and nobody seems to mind...

oh...and I'm vitamin D deficient. Go figure. (That's the celiac...)

Oh, and Kurt, has your guy been tested for celiac? :)

bnewt07
11-27-2007, 11:39 AM
Simple thing first-repeat the test.

Then I'd suggest you consult a doc not a bike forum. They can take all the relevant information and review your records, examine you, plan further investigations etc

Ginger
11-27-2007, 11:44 AM
Simple thing first-repeat the test.

Then I'd suggest you consult a doc not a bike forum. They can take all the relevant information and review your records, examine you, plan further investigations etc



Yep. There is that. If I get an odd test result, I have it retested a month later before I worry too much about it.
(I do some research in between and I find out if there's anything related to the odd test and ask the doc about it while I'm there. Sometimes that discussion creates more tests, sometimes it doesn't. You have to be your own advocate.)

thwart
11-27-2007, 09:46 PM
Yep. There is that. If I get an odd test result, I have it retested a month later before I worry too much about it. Generally good advice.

I would hydrate even more than you do now, especially if your plasma volume was down (although not the only cause).

Stay in touch with your doc. If you feel like you can't ask questions, you need a different physician.

gasman
11-27-2007, 10:28 PM
A Hct of 53 in a young healthy male isn't a big deal especially if you are dehydrated and probably not the cause of any fatigue. I used to run in the 50-52 range when I was in my mid-20's in med school. I now run around 46-47 at age 53. I still suck at racing.
There is a huge differential for fatigue, it just depends on how far you want to pursue it and if you have a doc that will join you on the journey. There are some good ideas presented here. i would think this time of year seasonal affective disorder (SAD) would be high on the list. It's much harder to recognize mild depression (SAD) in guys but it is fairly common, at least here in Oregon.

Louis
11-27-2007, 11:39 PM
How much quality sleep have you been getting? Do you try to "catch up" on the weekends? If so, you're not getting enough during the week. If you're also not getting enough during the weekends, then that's really bad.

jhcakilmer
11-28-2007, 01:05 AM
Thanks for all your suggestions. I really don't think I could drink much more, due to my frequency of urination, and concentration. Overall, my average intake is probably 5 liters a day.

Also, my fatigue was primarily psychological, I just wanted to make sure nothing else was wrong. I'm in medical school, raising two boys, and my father was killed a month ago, so I'm just really emotionally drained. Basically, I'm just hanging on until christmas break! It takes every ounce of energy to just function.

My average amount of sleep is 7-8 hours of sleep, but lately it's been anywhere from 4-8, with no consistent pattern. It's been a little more regular lately though.

I was pretty confident that my HCT, and Hb had no pathological connection. I guess I just wanted to see if it seemed that unusual to anyone else. I guess it means I should be faster, but that would mean I would need to train, and that requires time, and energy...

Fixed
11-28-2007, 10:28 AM
sorry about your dad I hope you feel better hang in there bro
cheers

ejh
11-28-2007, 11:48 AM
I went through that 10 years ago, had all kinds of blood work RBC 53% platlets 450,000 and low plasma. Checked passed blood work and normal for me. No other problems the doctor told me it was stress. I hope you get feeling better soon. Eric

jhcakilmer
11-28-2007, 06:55 PM
sorry about your dad I hope you feel better hang in there bro
cheers


Thanks, I'm keeping my head above water.

swoop
11-28-2007, 07:07 PM
.

ecl2k
11-28-2007, 07:41 PM
You should cut back on the EPO, lance

besides that

drink about 2L water/fluids per day, repeat test in a week or so

you're probably just relatively dehydrated or the sample wasn't obtained/processed properly

If the repeat value is high, then I think official polycythemia is HCT >60% (significantly increased risk of clotting) which may be due to bone marrow making too many red blood cells (analogous to leukemia), this condition can be genetic as well (any family history?), or it could be that you have lung or heart disease or live at high altitude. You can differentiate between the two by checking your endogenous EPO level - if its low its your bone marrow if its high its your heart or lungs or environment. What meds are you on? some meds can affect bone marrow production.

good luck with that but you're probably a-ok