Do any of these blood results reveal anything (my GP shrugs her shoulders)?

[Trippin]

Hi everyone,
I've had (undiagnosed) CFS for over 7 years. During that time I've had extensive blood work and some markers have been consistently out of range

As per the attached, they are:
- Very high strep ASO antibodies in blood (GI Map also showing them as high).
- Low IGM
- High IGA
- High IGE
- Low platelet count
-

My Dr has consistently maintained that everythign is fine as far as blood markers are concerned. However, the high ASO/strep antibodies in particular has me thinking they need further investigation, especially after reading @Hip & @Hipsman recent posts on Dr Markov's theories.

So my questiosn are:
- Are these blood markers worth investigatign further?
- I'm in the UK, are there are any recommended drs? Or what type of Dr would be best to see? I found Dr Weir in London who is a Consultant in Infectious Disease and specialises in ME. Would that be a good route?

Many thanks in advance.

 

[Crux]

Hi,

Your transferrin is low and transferrin saturation is high. These are markers for iron overload.
Some docs pay no mind until the numbers are much higher. But there can be organ damage even with these numbers.

You can get a full iron panel, including ferritin.

 

[Shanti1]

I'm sorry your doctor wasn't helpful, maybe you can find another one who is more willing to consider and persue the findings on your lab tests? These are my thoughts:
Elevated antistreptolysin O antibodies usually signify a complication of an acute strep infection wherein the bacteria has migrated to some other area of the body, such as the heart, kidney, or skin. If you haven't had a recent strep infection, you may have an active chronic infection. I would see if you can correlate any of your symptoms with symptoms of post-strep complications. There is another test you can take to confirm infection called anti-DNase-B. Depending on your symptoms, a course of antibiotics may be in order.

As Crux mentioned, the transferrin is low and transferrin saturation is high. This can be due to ingesting too much iron (for example, if it is in your multi and you don't need it), or a genetic condition called hemochromatosis in which people absorb too much iron. You may want to check your supplements and eliminate any iron you are taking, as well as not using cast-iron cookware and making sure you don't have iron-rich water (if on well water), then allow a clearing out period of 4 weeks and then retest but also include ferritin. Too much iron can cause health issues long-term since it is oxidizing.

Low platelets can occur due to bacterial infection, oxidative stress, and a host of other things, but if you have an active strep infection, that could be related.

 

[Learner1]

As per the attached, they are:
- Very high strep ASO antibodies in blood (GI Map also showing them as high).
- Low IGM
- High IGA
- High IGE
- Low platelet count

The low IgM, high IgA, and low platelets could be due to one or more infections. What does your complete blood count look like? The high IgE can be allergic.

Have you had IgG immunoglobulins with subclasses done, or any tests on types of T cells or B cells? Any testing for viruses like Epstein-Barr, HHV6, cytomegalovirus, Cocksackie viruses, etc? Or bacterial infections? Or any allergy testing or celiac disease testing?

My Dr has consistently maintained that everythign is fine as far as blood markers are concerned.

I strongly think you need a second opinion.

I'm in the UK, are there are any recommended drs? Or what type of Dr would be best to see

Here in the US, an infections disease doctor or allergy/immunogy doctor or functional medicine doctor might be helpful. But you may need to see more than one to get to the bottom of this.

Be persistent - there's something behind this, and identifying it and tackling it will help you feel better.

 

[Trippin]

Hi,

Your transferrin is low and transferrin saturation is high. These are markers for iron overload.
Some docs pay no mind until the numbers are much higher. But there can be organ damage even with these numbers.

You can get a full iron panel, including ferritin.

Thank you @Crux. Here's my last full iron panel. transferrin has always bordered on the low side, but other markers all seem okay other than the last test where it was high.

 

[Trippin]

I'm sorry your doctor wasn't helpful, maybe you can find another one who is more willing to consider and persue the findings on your lab tests?

Thank you @Shanti1 yes I'm saving up to see a functional Dr.

Elevated antistreptolysin O antibodies usually signify a complication of an acute strep infection wherein the bacteria has migrated to some other area of the body, such as the heart, kidney, or skin. If you haven't had a recent strep infection, you may have an active chronic infection. I would see if you can correlate any of your symptoms with symptoms of post-strep complications. There is another test you can take to confirm infection called anti-DNase-B. Depending on your symptoms, a course of antibiotics may be in order.

Thank you very much for this. Very helpful. I don't recall ever having strep, although the ASO antibodies have been very high since I started doing bloods 4 years ago. I had a lot of amalgam removals done with infection problems and root canals etc, so the strep may have come from there? Also, I have low stomach acid (was on PPIs for a year before my main health issues all started), so I'm thinking it could easily have spread downstream. Also, my GI Map showed high strep overgrowth (see below), so it seems definite that strep is an issue in the gut at least. Is it still worth doing the dnase test?

As Crux mentioned, the transferrin is low and transferrin saturation is high. This can be due to ingesting too much iron (for example, if it is in your multi and you don't need it), or a genetic condition called hemochromatosis in which people absorb too much iron. You may want to check your supplements and eliminate any iron you are taking, as well as not using cast-iron cookware and making sure you don't have iron-rich water (if on well water), then allow a clearing out period of 4 weeks and then retest but also include ferritin. Too much iron can cause health issues long-term since it is oxidizing.

Low platelets can occur due to bacterial infection, oxidative stress, and a host of other things, but if you have an active strep infection, that could be related.

Very helpful. Thank you for taking the time to write this.

 

[Trippin]

The low IgM, high IgA, and low platelets could be due to one or more infections. What does your complete blood count look like? The high IgE can be allergic.

Hi @Learner1 thank you for your thoughts. I attached my red and white cell info in the reply above. Is this what you mean?

Have you had IgG immunoglobulins with subclasses done, or any tests on types of T cells or B cells? Any testing for viruses like Epstein-Barr, HHV6, cytomegalovirus, Cocksackie viruses, etc? Or bacterial infections? Or any allergy testing or celiac disease testing?

I went to see an NHS consultant to check for allergies etc. They said the high IGE was due to dust mites and dog dander and that other markers were just over range (they didn't look at the ASO).

I have never specifically test for any viruses although I noticed my GIMAP looked at Cytomegalovirus and EBV (both okay on GIMAP, although I'm not sure how accurate that is).

I had celiac testing done and it was not signifcant.

I strongly think you need a second opinion.
Here in the US, an infections disease doctor or allergy/immunogy doctor or functional medicine doctor might be helpful. But you may need to see more than one to get to the bottom of this.

Be persistent - there's something behind this, and identifying it and tackling it will help you feel better.

Thank you very much for the encouragement. It means a lot.

 

[Learner1]

Hi @Learner1 thank you for your thoughts. I attached my red and white cell info in the reply above. Is this what you mean?

Did you have percents of your different types of cells on your CBC? Just the numbers, it's hard for me to tell. Your MCV is a little high, even though the interpretation says it's optimal, it's not. You might be short of B12, folate and/or B6.

I went to see an NHS consultant to check for allergies etc. They said the high IGE was due to dust mites and dog dander and that other markers were just over range (they didn't look at the ASO).

Yes, the IGE could be high due to allergies. But, they didn't test your other immunoglobulins, which might she'd some light on your ability to fight infections.

I have never specifically test for any viruses although I noticed my GIMAP looked at Cytomegalovirus and EBV (both okay on GIMAP, although I'm not sure how accurate that is).

GI Map is looking at what's in your gut, not your bloodstream. You'd need the correct testing to find out.

Keep looking!

 

[Martin aka paused||M.E.]

The low IgM, high IgA, and low platelets could be due to one or more infections.

+1 can't believe some physician’s ignorance/lack of knowledge

 

[Trippin]

Did you have percents of your different types of cells on your CBC? Just the numbers, it's hard for me to tell. Y

@Learner1 the last time I got the %s was 5 years ago and they looked like this:
neutrophils 61.7%
basophils 0.4%
lymphocytes 21.5%
monocytes 12.1%
eosonophils 4.3%

You might be short of B12, folate and/or B6.
Yes, the IGE could be high due to allergies. But, they didn't test your other immunoglobulins, which might she'd some light on your ability to fight infections.
GI Map is looking at what's in your gut, not your bloodstream. You'd need the correct testing to find out.

Keep looking!

Yes, I'm considering B12 as a next step especially given the low stomach acid. I've always assumed it was okay since the blood showed it to be okay. But maybe this isn't optimal?

Thanks for highlighting the MCV. Interstingly my MCH is above the threshold. Hopefully when I get a functional Dr he can do these tests. Thanks again

 

[Shanti1]

I don't recall ever having strep, although the ASO antibodies have been very high since I started doing bloods 4 years ago. I had a lot of amalgam removals done with infection problems and root canals etc, so the strep may have come from there? Also, I have low stomach acid (was on PPIs for a year before my main health issues all started), so I'm thinking it could easily have spread downstream. Also, my GI Map showed high strep overgrowth (see below), so it seems definite that strep is an issue in the gut at least. Is it still worth doing the dnase test?

The Antistreptolysin O is specific for Streptococcus A (the strep that causes strep throat) and your GI Map doesn't specify which strep species is in your gut, just that bacteria from the streptococcus genus are present, but usually, it is strep B in the gut, so I would venture that the Antistreptolysin O antibody is a separate issue from the gut. The anti-DNase is also specific for group A strep, so would be confirmatory. You may not need to have that test done depending on how certain whichever new doc you see is that your titers are related to your symptoms.

 

[Shanti1]

Here's my last full iron panel. transferrin has always bordered on the low side, but other markers all seem okay other than the last test where it was high.

Around 30 is optimal for iron saturation, which is where you were in Oct. Based on this I suspect you may have some iron hidden in something you are taking, I would not suspect genetic hemochromatosis.

 

[SWAlexander]

+1 can't believe some physician’s ignorance/lack of knowledge

I believe it is real carelessness on the physician’s part.
I experienced almost the same. In Jan. 2021 I had extensive bloodwork because I could not walk. I requested a copy but I didn't get it until May. There it was: D-Dimer 3003. She had not seen the tests at all. I demanded a sonogram and the result was several Thrombosis in the left leg. since I´m on blood thinners.

 

[Trippin]

The Antistreptolysin O is specific for Streptococcus A (the strep that causes strep throat) and your GI Map doesn't specify which strep species is in your gut, just that bacteria from the streptococcus genus are present, but usually, it is strep B in the gut, so I would venture that the Antistreptolysin O antibody is a separate issue from the gut. The anti-DNase is also specific for group A strep, so would be confirmatory. You may not need to have that test done depending on how certain whichever new doc you see is that your titers are related to your symptoms.

Thank you very much

 

[Learner1]

Who would like to be so kind and help me with explaining my blood test?

It would be helpful to post a PDF - not sure how you added these, but they do weird things when viewed on my Android phone.

Looks like you had a clothing problem in the first set. You might find this helpful:

https://www.ihtc.org/elevated-clotting-factor-levels

Homocysteine was very high - 7 is optimal.

Looks like there might be some autoimmunity if I'm making out what was being tested correctly - the test names are abbreviated and not in English, so identifying what they are would be useful.

On the second set, neutrophils are quite high in relation to lymphocytes.

"Recent studies suggest that patients’ baseline—and even postoperative—NLRs, (measured by dividing neutrophil counts by lymphocyte counts) might be a prognostic marker of outcomes across several cancer types.

The association of NLR with cancer patients’ outcomes is biologically plausible because NLR is a proxy of inflammation processes.
Unfortunately, that also leaves NLR nonspecific to tumor progression that is likely confounded by such comorbidities as metabolic syndrome, diabetes, hypertension, thyroid dysfunction, infection, and other conditions or disorders affecting inflammation—not to mention medications used to manage these conditions.6

“Some people say NLR is a measure of the systemic inflammatory state, and that this could impact cancer progression,” explained Eric Ojerholm, MD, physician in radiation oncology at the Hospital of the University of Pennsylvania in Philadelphia. “Other researchers observed that patients with high levels of neutrophils also had high levels of pro-growth signals [cytokines] for tumors. And low levels of lymphocytes might mean the body’s immune system can’t respond well to cancer. So a high level of neutrophils plus a low level of lymphocytes (high NLR) could reflect an environment that promotes cancer progression.”

https://www.cancertherapyadvisor.co...-lymphocyte-ratio-not-ready-for-clinical-use/

That's a very impressive set of labs you've had done. I would hope that you are working with a hematologist or immunologist to determine what's going on.

 

[Shanti1]

Who would like to be so kind and help me with explaining my blood test?

I also had a hard time viewing the images, even on a full screen computer. Might I suggest posting this as its own thread with PDFs, you will likely get more responses and we can better evaluate your labs.

To add to the lymphocyte and neutrophil comment above, your actual counts of these WBC types are within normal, but the ratio is off in terms of what percentage of the total WBC count each represents. As a general statement, neutrophils are responsible for fighting bacterial/yeast and lymphocytes for viruses. I would suggest looking at past lab work and seeing if this is a trend for you, or if you had something going on at the time of the draw that could have altered the ratio. It is feasible that the lower % of lymphocytes represents depleted T cells from chronic viral infections. I would be curious what the ratio is in other pwME, I couldn't find any info on that.

 

[SWAlexander]

It would be helpful to post a PDF - not sure how you added these, but they do weird things when viewed on my Android phone.

Looks like you had a clothing problem in the first set. You might find this helpful:

https://www.ihtc.org/elevated-clotting-factor-levels

Homocysteine was very high - 7 is optimal.

Looks like there might be some autoimmunity if I'm making out what was being tested correctly - the test names are abbreviated and not in English, so identifying what they are would be useful.

On the second set, neutrophils are quite high in relation to lymphocytes.

"Recent studies suggest that patients’ baseline—and even postoperative—NLRs, (measured by dividing neutrophil counts by lymphocyte counts) might be a prognostic marker of outcomes across several cancer types.

The association of NLR with cancer patients’ outcomes is biologically plausible because NLR is a proxy of inflammation processes.
Unfortunately, that also leaves NLR nonspecific to tumor progression that is likely confounded by such comorbidities as metabolic syndrome, diabetes, hypertension, thyroid dysfunction, infection, and other conditions or disorders affecting inflammation—not to mention medications used to manage these conditions.6

“Some people say NLR is a measure of the systemic inflammatory state, and that this could impact cancer progression,” explained Eric Ojerholm, MD, physician in radiation oncology at the Hospital of the University of Pennsylvania in Philadelphia. “Other researchers observed that patients with high levels of neutrophils also had high levels of pro-growth signals [cytokines] for tumors. And low levels of lymphocytes might mean the body’s immune system can’t respond well to cancer. So a high level of neutrophils plus a low level of lymphocytes (high NLR) could reflect an environment that promotes cancer progression.”

https://www.cancertherapyadvisor.co...-lymphocyte-ratio-not-ready-for-clinical-use/

That's a very impressive set of labs you've had done. I would hope that you are working with a hematologist or immunologist to determine what's going on.

Thank you [SIZE=4]Learner1[/SIZE]. you are very kind. Unfortunately, there is no PDF, because I receive the lab slip via email as a pict. I also have problems with the German codes I cannot translatable them into English and neither one of the doctors are willing to explain the results. Yes, I have thrombosis and yes there is autoimmunity because I have Lupus and Psoriasis. My medical history is very extensive. I´m waiting for a hematologist appointment since May.

 

[Learner1]

You might at least repeat the Complete Blood Count to see if the % of neutrophils and lymphocytes normalizes in relation to each other. If they don't, it would be wise to be persistent about cancer surveillance.

Hopefully you are on a blood thinner? Are you on an immunosuppressant, which could be causing some of these results?

I saw you were tested for cytomegalovirus, the IgG looked high. Have you also been tested for other herpes viruses, like Epstein Barr and HHV6?

 

[SWAlexander]

I also had a hard time viewing the images, even on a full screen computer. Might I suggest posting this as its own thread with PDFs, you will likely get more responses and we can better evaluate your labs.

To add to the lymphocyte and neutrophil comment above, your actual counts of these WBC types are within normal, but the ratio is off in terms of what percentage of the total WBC count each represents. As a general statement, neutrophils are responsible for fighting bacterial/yeast and lymphocytes for viruses. I would suggest looking at past lab work and seeing if this is a trend for you, or if you had something going on at the time of the draw that could have altered the ratio. It is feasible that the lower % of lymphocytes represents depleted T cells from chronic viral infections. I would be curious what the ratio is in other pwME, I couldn't find any info on that.

Thank you Shanti1 for your help.
Like I said to Learner1 , unfortunately, there is no PDF, because I receive the lab slip via email as a pict. What is not in these lab results is, my cortisol level is very low fluctuating between 1.1 and 5.4.
Yes, I had Herpes.

 

[Shanti1]

You might at least repeat the Complete Blood Count to see if the % of neutrophils and lymphocytes normalizes in relation to each other. If they don't, it would be wise to be persistent about cancer surveillance.

Hi Learner, my understanding about the neutrophil / lymphocyte ratio is that is prognostic of cancer outcome inside of a cancer diagnosis, not that it is indicative of a possible cancer on its own. I just don't want to scare anyone unnecessarily.