OpenHealth Q&A

Should I Request Further Testing Based on My Symptoms and Lab Results?

At 30 years old, I am a female enthusiastically seeking answers to my ongoing health issues, which seem to be escalating. I have already received several diagnoses, including a low level of Vitamin D identified during a routine CBC, for which I am taking a prescribed supplement. Additionally, I am managing anxiety and depression with sertraline and have recently been diagnosed with severe sleep apnea—demonstrated by an apnea-hypopnea index (AHI) of 93. Complicating matters, there is a family history of various conditions, including MTHFR mutations (both of my siblings have them), Hashimoto’s thyroiditis, dementia, and attention-deficit hyperactivity disorder (ADHD), for which I am currently pursuing a diagnosis. My symptoms are quite extensive, encompassing migraines that typically occur around the time of my menstrual cycle (for which I take naproxen and sumatriptan), persistent fatigue, and heartburn (managed with Pepcid). I also deal with hypertension, which generally sits around 130/80, though it occasionally dips lower, joint discomfort, episodes of sharp chest pain that affect my breathing, tingling sensations in my hands and feet, increased heart rates (tachycardia), memory lapses, and visual disturbances like blurry vision and dry eyes, requiring me to wear prescription glasses. Additionally, I find myself feeling unsteady and clumsy, particularly when I stand up. I periodically experience phantom smells of smoke that can last for several days, which I am currently trying to understand. Previously, I was diagnosed with exercise-induced asthma and a dairy intolerance, so I avoid dairy products. A lipoma was also surgically removed in the past, although I’m unsure how relevant that information is to my current situation. I’ve recently received blood test results indicating several values that are outside the normal range as established by the clinic. I will include the typical results afterward for clarity. Given the symptoms I've detailed and the flagged lab outcomes, I am curious whether there are additional tests I should consider requesting. Would it be prudent for me to advocate for further testing relating to autoimmune disorders, specifically regarding MTHFR or other potential conditions? Here are the blood results that were highlighted as high or low: - RDW CV: 15.2% (High) - MCH: 24.6 pg (Low) - MCV: 77.90 fL (Low) - Platelets: 453.0 x 10^3/uL (High) - MPV: 8.4 fL (Low) - RBC: 5.660 x 10^6/uL (High) - CRP: 0.8 (High) Other test outcomes include: - Immature Granulocyte Absolute: 0.03 x 10^3/uL - Immature Granulocyte Percentage: 0.1% - nRBC Absolute: 0.01 x 10^3/uL - Hematocrit: 44.1% - Neutrophil Percentage: 63.9% - Monocyte Percentage: 3.9% - MCHC: 31.5 g/dL - Hemoglobin: 13.9 g/dL - Neutrophil Absolute: 4.48 x 10^3/uL - Eosinophil Percentage: 1.3% - WBC: 7.01 x 10^3/uL - Lymphocyte Percentage: 30.5% - Mono Absolute: 0.27 x 10^3/uL - Baso Absolute: 0.03 x 10^3/uL - Basophil Percentage: 0.3% - Sed Rate: 9 mm/hr - Eosinophil Absolute: 0.09 x 10^3/uL - Lymph Absolute: 2.14 x 10^3/uL With all this information, I would appreciate any guidance on possible next steps or additional tests to consider. Thank you!

Answers (1)

6/20/2025, 1:20:54 AM

OpenHealth AI

It’s understandable to feel overwhelmed by your numerous symptoms and complex health history. You’re proactive in seeking clarity, especially considering your family history and recent lab results. Here’s how to approach your situation:

Main Points:

1. Addressing abnormal lab results: Your blood tests indicate several values outside the normal range, which may warrant further investigation.
2. Considering autoimmune and deficiency tests: Given your symptoms and family history, exploring further tests for autoimmune disorders and nutritional deficiencies could be beneficial.
3. Prioritizing symptoms management: Managing your current symptoms is essential as you navigate this process.

Explanation:

Your ongoing symptoms—including fatigue, heartburn, and cognitive issues—combined with your lab results suggest potential underlying conditions. The high RDW, low MCH and MCV, and elevated CRP can indicate anemia or inflammation. These could be linked to various causes, including dietary deficiencies, autoimmune issues, or chronic conditions.

Specific, Prioritized Next Steps:

1. Discuss Lab Results with Your Healthcare Provider:

   • Schedule an appointment to review your specific lab results, focusing on those that are abnormal. Highlight any new symptoms or changes since your last visit.
   • Request Further Testing: Ask about tests that evaluate for autoimmune disorders (like ANA or thyroid function tests) and specific nutritional deficiencies (such as B12 and folate levels).

2. Track Your Symptoms:

   • Keep a detailed diary of your symptoms, noting their frequency, duration, and any potential triggers. This can provide valuable insights to your provider.
   • Include information about when you experience episodes of tachycardia, chest pain, and sensory disturbances.

3. Prioritize Self-Care:

   • Nutrition: Ensure you’re eating a balanced diet rich in vitamins and minerals. If you’re avoiding dairy, consider alternative sources of calcium and vitamin D.
   • Hydration and Rest: Maintain proper hydration and establish a regular sleep schedule to support your overall health.
   • Stress Reduction Techniques: Engage in activities such as mindfulness, gentle exercise (with your healthcare provider’s advice), or therapy to help manage anxiety and depression.

4. Assess Your Medications:

   • Discuss the effectiveness of your current medications, including sertraline for anxiety and any treatments for sleep apnea. Ensuring these are optimally managed can help alleviate some symptoms.

5. Second Opinion (if needed):

   • If you feel your concerns are not being adequately addressed, don’t hesitate to seek a second opinion or a referral to a specialist, such as a rheumatologist or a hematologist, to further investigate your symptoms and lab results.

Remember, you’re not alone in this process, and advocating for your health is incredibly important. Tailor your discussions with healthcare providers to ensure they are aware of your concerns, family history, and wishes for further testing. Let me know if you have more questions or need guidance on specific tests!