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Low Anion gap result in my latest blood tests?? and iron question.

Discussion in 'Diagnostic Guidelines and Laboratory Testing' started by taniaaust1, Jun 3, 2010.

  1. taniaaust1

    taniaaust1 Senior Member

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    My blood biochem. test results from last week have come back showing my "anion gap" result is abnormal and two numbers below the normal range. On researching this I've found out low anion gap is uncommon. Im wondering if others with CFS have had an abnormal result in this area??? Could it be related to the CFIDS????

    What further is confusing about this is I have very low D3 and in my research on anion gap I saw that D3 deficiency affects anion gap the other way to my results and would make my anion gap result higher (not lower) than it would be without a D3 deficiency.. so i guess my anion gap would be showing as even more abnormal then it is now if i didnt have a possibly severe again, D3 deficiency affect it the other way. (doctor gave up trying to correct my D3 deficiency as it went even lower after supplementation so ive no idea what it is now as its been a long while since we gave up with trying to supplement).

    from http://www.haps.nsw.gov.au/Research/Communique_List/Anion_Gap.aspx

    What is the clinical significance of a low anion gap?
    There are three possible causes of a decreased anion gap, decreased unmeasured anions circulating in the blood (usually low protein, especially hypoalbuminaemia), increased unmeasured cations (e.g. hypercalcaemia or an atypical IgG myeloma cation), and laboratory error.

    1.Decreased unmeasured anions
    Severe Hypoalbuminaemia
    Nephrotic syndrome
    Protein-losing enteropathy
    Exfoliative dermatitis
    Malnutrition
    2.Increased unmeasured cations
    Hypercalcaemia - hyperparathyroidism, malignancy, excess Vitamin D
    Hypermagnesaemia (rare)
    Increased unusual cations
    Atypical IgG myeloma proteins
    3.Laboratory error

    .........

    I are not malnorished (im eatting a lot and well, have gained weight), I havent got Hypoalbuminaemia, dermatitis, dont fit the Nephrontic Syndrome (thou i do have hyperlipidemia), my calicum and magnesium levels are normal.

    Maybe my result is a lab error??? Thou if my bicarb. level went up one level more then that would be in the abnormal range so i guess my bicarb level would of pushed the anion gap level down some?

    On that link i gave it says "increased unusual cations" can cause a low anion gap result. Does anyone know of anything to do with CFIDS which is a cation which could be floating about in my body and affected this test????

    My other question is on multiple myelona (cancer of the white blood/plasma cells) which i read also can cause a low test result of anion gap .. if i had something like that developing after 13 years of CFIDS.. would abnormalities show up on the normal general haematology blood tests the doctors do???? (my calicum levels are fine, im not currently suffering from any bone pain thou have done in past, i dont have anemia, blood iron levels fine thou for some reason on more in depth iron testing my test came out as abnormal and said i had no iron stores.. i just eat meat 2-3 times per day so that result surprised me and seemed strange).

    Im still a little concerned about the low anion gap result as I think I remember reading of one with CFIDS dying from multiple myelona on a CFIDS death list (wrong diagnoses??? or caused by CFIDS??). And every year I get something else going wrong with me.

    Anyone else here finding they have good iron blood levels but no iron stores in body??? could this be a CFIDS thing???
     
  2. JT1024

    JT1024 Senior Member

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    Massachusetts
    Tania,

    Before you get too worked up about a low anion gap, I recommend getting retested.

    The anion gap is a calculation and while you may be on to something, the anion gap varies frequently. It is also used as an indication that the instrument may not be holding its calibration. I work in a clinical lab in a hospital and the usual anion gaps are between 5 and 15. Even these ranges vary between labs.

    If I see too many low values, I run control samples to ensure the instrument is running properly. If it is not, I have to recalibrate, rerun controls, and then retest the samples. Techs running laboratory instruments have a wide range of education and motivation levels. If a tech is not paying attention or is too lazy to run controls to validate the instrument, erroneous anion gaps can be resulted.

    Just something to consider! ~ JT
     
  3. lucy

    lucy Senior Member

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    Considering iron - I have the same, depleted storage (13, and it was 22 few months ago), but good RBC - my dr. says it is insignificant, as well as slightly low values of WBC, MCHV.
     
  4. taniaaust1

    taniaaust1 Senior Member

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    Interesting, we could be sharing the same blood :p .
    My iron storage was at 13, my WBC is sits on the fence, any lower at times and it would then be out of normal range.. i dont know if its the same thing but my MCHC has been just out of normal range and low.

    I wish more was known about CFS blood and what things we can all be sitting more so in the lower ranges in. I never had my blood retested as all the doctors just told me not to worry about it.
     
  5. rebeccainsc

    rebeccainsc

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    Dear Tania,
    I googled and came across your post today. Just got my bloodwork back with the low Anion Gap. Most all other bloodwork normal except ferritin is on the very low range of normal. Yes, I too have been suffering from Chronic Fatigue for about 10 years. I also have low D3. As I understand the anion gap being low, it means that I am acidic. However I will also tell you that my blood under live blood cell analysis has no "energy" in the cells. Normal healthy blood cells will have a "sun" in the middle. Mine do not. The doctor says that this means they don't have energy. That was no surprise!

    So if my ferritin is not oxidating my iron, I would be acidic....thus the low anion gap.....

    I am wondering if anyone else has looked at the mitochondria function of their blood? My ferritin levels are also very low and just above the acceptable range.
    "Mitochondrial ferritin has many roles pertaining to molecular function. It participates in ferroxidase activity, binding, iron ion binding, oxidoreductase activity, ferric iron binding, metal ion binding as well as transition metal binding. Within the realm of biological processes it participates in oxidation-reduction, iron ion transport across membranes and cellular iron ion homeostasis." The ferritin being low may be contributing to the lack of energy seen in my blood under a microscope.

    I was wondering how your ferritin levels are?
     
  6. rlc

    rlc Senior Member

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    hi don't know to much about low anion gaps, but i know alot about vitamin D you say that your vitamin D levels didn't responed to treatment this is interesting because there are alot of conditions that stop the body from being able to absorb vitamin D, alot are kidney and liver problems, hyperlipidemia can also be caused by kidney problems. this is a differential list copiled from a couple of source for all the things that can cause vitamin D defficency other then lack of sunlight, differential diagnosis for vitamin D deficency, malabsorbtion syndromes, hypocalacemia, hypoparathyroidism, franconi syndrome, proximal renal tubular acidosis, kidney conditions, primary sclerosing cholangitis, parenchymal liver disease. associared diseases and rule outs. calcium deficiency, hypercalcuria. associated diseasese and complications, bone marrow fibrosis, franconi acquired renal syndrome, tetany,hypocalcemia, hypoparathyroidism secondary, myleofibrosis, osteomalacia, proximal myopathy. my point is that if your vitamin D levels are not responing to treatment your doctor should be finding out why!!!! you might also want to read this article about how the body can't absorb vit d with out magnesium http://www.vitamindcouncil.org/newsletter/more-vitamin-d-questions-and-answers.shtml lack of vitamin d cause fatigue because of its involvement in ATP it also causes muscle and joint pain amongst many other symptoms. On this site you will also find how the referance ranges and treatment is out of date. hope this helps. it's just my opinion but i would say that whatever is stoping vit D supplementation from working is probably the cause of all your problems. to rebeccainsc try and get that low vit d treated it may greatly help your problems
     
  7. taniaaust1

    taniaaust1 Senior Member

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    bumping this post in the hope that the guest who was asking about low anion gap results in chat but isnt there now will see it.
     
  8. rlc

    rlc Senior Member

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  9. taniaaust1

    taniaaust1 Senior Member

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    That's the actual iron stores.. mine are low

    I wonder if we are looking at a CFS/ME subgroup here??? low anion gap, low ferritin level, low D
    .............

    Low anion gap isnt acidity ... its the other way around.. high anion gap is acidity or can indicate metabolic acidosis http://www.medterms.com/script/main/art.asp?articlekey=20154

    .................

    ric.. i agree with your post, I think my doctors should of looked at the reasons of why I keep having vitamin D issues... but my doctors really are missing a lot of stuff with me (they dont even believe in POTS which I have).
     
  10. rlc

    rlc Senior Member

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    Hi Taniaaust1 have you ever been checked out for Nephroatic syndrome? because low anion gap and low ferritin indicates it's a possibility link here http://en.diagnosispro.com/differen...eased-ferritin-serum/11734_11876-153_153.html it can also cause low vitamin D because it damages the kidneys and vitamin D is processed in the Kidneys, Nephrotic syndrome can also be caused by things like lupus that often get misdiagnosed as CFS link here http://www.nlm.nih.gov/medlineplus/ency/article/000490.htm might be worth getting a doctor to do the tests for it if they haven't already been done.

    All the best
     
  11. taniaaust1

    taniaaust1 Senior Member

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    great site :) , Ive never been there before. I added in hyponatremia (low sodium) as Ive had a couple of blood tests come back showing out of normal range sodium levels in the past (now im eatting a ton of salt) came back with http://en.diagnosispro.com/differen...-hyponatremia-causes/11734_10610-153_154.html. Now Im wondering if multiple myeloma is one of the cancers more common in CFS/ME? (I'll do some research on that).

    I havent had that blood test redone to know if it was a lab error or not as Im too busy getting throu my other appointments and medical stuff but when Im more caught up with my specialists appointments and tests they want done again ... I will ask for a repeat test of anion gap to see if the result comes back again abnormal or not.
     
  12. taniaaust1

    taniaaust1 Senior Member

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    No i didnt look at that one, .. oh boy.. its all complex so many different possibilities due to so many different abnormal test results. I have been tested for lupus once or twice and that's negative. (doctors are now saying its possible that my hyperinsulinemia (high insulin levels) and the fact i was eatting a lot of carbs with this condition, may of affected some of my past test results. Ive no idea which ones they think may of been affected).

    Anyway..im on a low carb diet now to keep the insulin in better range so it will be interesting to see if any of my test results change.
     
  13. rlc

    rlc Senior Member

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