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Concerns Over Lab Results and New Doctor's Perspective

7/11/2025, 2:30:57 PMMale25-34

At 40 years old, I’m a non-smoker, standing at 5 feet 4 inches tall and weighing 160 pounds, maintaining an active lifestyle. My medical history includes polycystic ovary syndrome (PCOS), a past diagnosis of ovarian cancer, varicose veins which have caused blood clots in my legs, and the presence of two sizable fibroids attached to my remaining ovary. Recently, I transitioned to a concierge medical practice where I underwent comprehensive lab testing. My former physician suggested that I might be suffering from an iron deficiency; however, my new doctor asserts that this is unlikely due to my elevated red blood cell (RBC) count. Her primary focus appears to be my weight, which is 15 pounds over what she deems healthy – a separate topic entirely. Here are the results from my laboratory tests: - RBC: 5.38H (normal range 5.38-5.10 million/ul) - Hematocrit: 45.9 H (normal range 35-45%) - MCH: 25.7 L (normal range 27-33%) - MCHC: 30.1 L (normal range 32-36 g/DL) A new concern has arisen regarding a notable increase in my cholesterol, now at 223 (previously it was around 150), including high levels of LDL, non-HDL, elevated apolipoprotein B, and HS CRP indicating inflammation. Considering that I am investing $2000 annually for the benefits of concierge care, I am troubled that the sole response to my lab results was, "you are not anemic; try increasing carbohydrates and reducing protein." It feels as if there’s something significant going on, but I am uncertain about what it could be.

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Answers (1)

Cony

7/11/2025, 2:31:20 PM

OpenHealth AI

It’s understandable to feel concerned about your lab results, especially given your medical history and the changes in your health markers. Here’s a summary of your main points and actionable suggestions based on the information provided.

Key Points:

  1. Your RBC and hematocrit levels are elevated while your MCH and MCHC are low, suggesting some underlying issue possibly related to your iron status or blood health.
  2. Your cholesterol levels have significantly increased, particularly with high LDL and inflammation markers present.

Explanation:

  • Elevated Red Blood Cells (RBC): While high RBC counts can occur for various reasons, they may not always correlate with iron deficiency. The low MCH and MCHC suggest that while you are not anemic, your red blood cells may not be functioning optimally in transporting oxygen.
  • Cholesterol Rise: An increase in total cholesterol, especially elevated LDL, can indicate a higher risk for cardiovascular issues. The presence of inflammation (shown by HS CRP) further complicates matters as it may indicate an underlying process that needs to be addressed.

Next Steps:

  1. Monitor Symptoms: Keep a daily record of any symptoms you may have, such as fatigue, unusual pain, or changes in weight or mood. This can provide valuable information for you and your healthcare provider.

  2. Dietary Adjustments:

    • Consider adopting a heart-healthy diet, which emphasizes fruits, vegetables, whole grains, lean proteins, and healthy fats (like those from nuts and olive oil).
    • Specifically focus on reducing saturated fats found in red meats and full-fat dairy, while increasing fiber from plant sources.
    • It might be beneficial to speak with a nutritionist to create a tailored plan that addresses both cholesterol management and your unique conditions, including PCOS.
  3. Follow-Up on Lab Results:

    • Request clarification from your current doctor regarding the significance of your lab results, particularly concerning your RBC, hematocrit, and inflammatory markers.
    • Consider asking for further tests, like a lipid profile and specific inflammation markers, or a comprehensive metabolic panel to see if there are other underlying issues.
  4. Physical Activity: Continue regular physical activity, focusing on a balanced approach that includes both cardiovascular and strength-building exercises. This can help manage weight and improve your cholesterol levels.

  5. Evaluate Medical Approaches: If your concerns remain unaddressed, it’s worthwhile to seek a second opinion or consult with a specialist, such as a hematologist for blood-related issues or a cardiologist for heart health and cholesterol management.

Taking a proactive approach by monitoring your health and engaging in lifestyle adjustments can greatly empower you in managing the situation. Please continue to communicate openly with your healthcare providers to ensure your concerns are adequately addressed.

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