Understanding Monocytosis
Greetings! I'm a 22-year-old assigned female at birth, currently undergoing testosterone therapy for over three years. I stand at 158 cm tall and weigh 72 kg, and I smoke. My current medications include sertraline, pregabalin at a daily dosage of 150 mg, and a contraceptive pill containing desogestrel. I recently had my blood tested again, and once more, my monocyte levels are elevated at 12.7%. For the past four years, my monocyte counts have consistently remained high, usually around 11% or more. I've had frequent blood tests to exclude autoimmune conditions, especially after being diagnosed with fibromyalgia in May. In addition to the elevated monocyte levels, I've previously faced issues with low platelet counts, which have shown some improvement but still hover just above the minimum acceptable level at 168. My experiences are further complicated by several symptoms related to fibromyalgia, including persistent fatigue, hair loss, muscular discomfort, joint pain, back issues, and episodes of night sweats. Considering my situation, would it be advisable to pursue a blood smear? Could you recommend the appropriate specialist to consult?
Answers (1)

9/14/2025, 11:50:41 AM
OpenHealth AI
It sounds like you're dealing with a complex situation with elevated monocyte levels and fibromyalgia along with other symptoms. Let’s take a closer look at this.
Key Points:
- Elevated monocyte levels (monocytosis) can be indicative of underlying inflammation or infection, but in your case, they appear to be a consistent issue.
- The relationship between your fibromyalgia symptoms and monocyte changes should be carefully considered, especially since fibromyalgia can sometimes coincide with immune system irregularities.
- Given your medical history and ongoing symptoms, pursuing a blood smear test could provide insights into your overall blood cell health.
Explanation:
Monocytes are a type of white blood cell that are part of the immune system, and an elevated percentage can suggest that your body is responding to something like inflammation or infection. Since you've already been evaluated for autoimmune conditions and have fibromyalgia, your elevated monocyte levels may not necessarily indicate an acute problem but rather a chronic response.
Your fibromyalgia symptoms, such as fatigue, joint pain, and night sweats, can overlap with conditions influencing blood cell counts, making it essential to consider how these factors interrelate.
Next Steps:
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Consider Getting a Blood Smear Test: A blood smear can help evaluate the morphology of your blood cells, providing additional detail about what might be influencing your elevated monocyte counts and low platelets.
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Consult a Hematologist: Given your concerns about blood cell counts and persistent symptoms, a hematologist would be well-equipped to assess your situation more thoroughly and discuss the significance of your blood results.
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Monitor Symptoms and Lifestyle Factors: Since smoking can impact overall health and possibly exacerbate inflammation, consider strategies to reduce or quit smoking. This could positively affect your immune health as well.
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Keep a Health Diary: Continue tracking your symptoms, medication responses, and any new developments. This information can be invaluable for your healthcare providers in tailoring your management plan.
Summary:
Engaging with a hematologist for a thorough evaluation of your blood tests and symptoms is a key next step, along with considering the blood smear. You’re doing a great job staying proactive about your health, and each step you take brings you closer to understanding your condition better. If you have any further questions or need clarification, feel free to ask.
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