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911Doctor
911Doctor, Doctor
Category: Health
Satisfied Customers: 5094
Experience:  Board Certified Emergency Physician
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I had bloodwork that my internist is saying is fine. it indicated

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I had bloodwork that my internist is saying is fine. it indicated a total bilirubin high at 1.4mg/dL, Uibc low at 135ug/dL, and tibc low at 238ug/dL. Also Mcv was at high end 96. I am concerned that these are interrelated and could indicate a problem. Thoughts?

911Doctor :

I agree with your internist

911Doctor :

the values, while technically abnormal

911Doctor :

are so close to normal, and do not tie together to lead to a suspicion of a diagnosis

911Doctor :

that I think you can safely put this worry away

911Doctor :

these values, with the exception of the bilirubin level

911Doctor :

are only significant given an underlying blood disorder such as anemia

911Doctor :

and if you are not anemic then they are not of any importance at present

911Doctor :

standing by

Customer:

could the mcv value indicate a deficiency in folic acid or b12? or is the level too low for this concern?

911Doctor :

only IF you were anemic, and since you did not list that value (hematocrit or hemoglobin) then you are reading too much into this

Customer:

hematocrit is 41.3%, Hemoglobin is 13.8g/dL

911Doctor :

normal

911Doctor :

you are not anemic

Customer:

Thank you for your prompt response. I keep hoping to find a reason why I am always fatigued and feel "old" for an athletic 34 year old. And my acne issues.

911Doctor :

I understand

911Doctor :

Your internist is, no doubt, working on this, but the answer does not lie in these results.

Customer:

One more question. Would 258.0ug/dL Dhea Sulfate cause adult acne?

911Doctor :

stand by, that's not an easy one to answer off the cuff

911Doctor :

As you can see

911Doctor :

your results fall in the normal range

Customer:

I also have hair dark course hair growth on chin/cheek/neck/abdomen/nipple

Customer:

it is not thick heavy growth but there nonetheless and began in my late 20's

911Doctor :

and i suspect your internist is looking at the possibility of Polycystic ovarian syndrome

Customer:

My GYN says I don't have enough risk factors for it.

911Doctor :

Hmmmm

911Doctor :

Might be worth running it down anyway, especially since it would explain many of your symptoms.

911Doctor :

An ultrasound would be helpful.

911Doctor :

And i think your internist needs to drive this workup...

Customer:

And my periods are VERY regular (like clockwork) and I had no trouble with fertility (have two healthy young sons)

911Doctor :

so that does argue against PCO

911Doctor :

and again, the answer to your issue is not in these labs

911Doctor :

I assume you have had your thyroid checked

911Doctor :

?

Customer:

And I don't think I'm overweight. 5'6'', 129lbs. Runner/triathlete

911Doctor :

again, agree that it's not likley to be PCOS.

911Doctor :

but i can not diagnose you online

Customer:

Just had thyroid checked. Everything mid-range as far as blood values

911Doctor :

you may want to read this

911Doctor :

so that's good the thyroid was checked

911Doctor :

as you can see, there are a few medical causes that your internist, no doubt, is looking at, but sometimes no identifiable cause is found

911Doctor :

in which case, a dermatologist may be able to to permanent hair removal for you

911Doctor :

but I do not believe the medical workup is complete at present

911Doctor :

but as to your original question, these labs do not give us an indication of a possible cause.

Customer:

don't know if it relates but my heart rate tends to be a little high also. resting around 90 and 190-200 with comfortable running (talking pace)

911Doctor :

standing by

911Doctor :

can't see how that would relate if your thyroid is normal

911Doctor :

but I'm glad you are seeing an internist

Customer:

Ok. I'll just treat these as isolated cosmetic issues then. I was concerned they were part of a bigger picture/health problem. I've googled everything from digestion to candida.

911Doctor :

dr google is notoriously bad. it sounds like, from what you have told me, that you are in good hands medically. these days folks tend not to have much trust in their doctors and much if it is our fault, but from what you have told me i agree with the testing ordered and the information your doctors have provided.

911Doctor :

do take a look at that mayo clinic link as it is very good and reliable and maybe something will strike you

911Doctor :

do you have any final questions for me?

Customer:

Thank you. I do not have any further questions. You were very helpful.

911Doctor :

Thank you so much for your question. It was a pleasure talking with you. Should you need my assistance in the future simply start your question with ‘for 911doc only’.


Positive feedback is always appreciated.


Be Well


911Doc

Customer:

Will this conversation be saved? I would like to keep it

Customer:

I see where to save. Thank you and have a great day!

911Doctor :

you too.

911Doctor :

best

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