Tex, do you know much about various blood tests?
I'm asking for numerous reasons. One, my sister's nuero told her her b12 was low and was surprised as she was taking b12 vitamins, etc. (He is considering malabsorption problems). I'm not sure if my b12 was tested, and I'm wondering if I should have it tested.
She, my mother, and I all have many similar symptoms, many of which are neurological and nueropathic. Raynaud's also runs in my family, my mom has a rash on her legs, and used to get rashes from the sun. We all, including another sister, deal with vertigo, especially during or after exercise. At one point, doctors were thinking I (and my mother, incidentally) had MS, but all three of us had clear MRIs. (I had with and without contrast of my head and spine.)
In Nov., I went to the ER with pancreatitis. You had mentioned it could be gluten, and although I was gluten free, I wasn't as diligent about cross contamination as I am now. Anyway, the ER doc said pancreatitis, but my GI indicated she thought it wasn't as my amylase/lipase were normal. The ultra sound showed a striated liver.
Anyway, chatting with my sister about all her tests and the neuro's discussion (who thought all of our issues were related), I wondered if there was any significance to the following:
From blood tests, slightly elevated:
lymphocytes
blood sodium
hemoglobin
mean corpuscular hemoglobin
bilirubin
As an aside, does "erthematous duodenopathy with grossly blunted appearance" have anything to do with celiac?
Thanks for any info you can give. My brain tends to shut down when I attempt to read technical information. lol.
Blood tests--questions for Tex
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While I know a little about various blood tests, I certainly wouldn't consider myself an expert.
Here are my thoughts on your questions. If your sister is the one who received a pathology report that included the wording "erythematous duodenopathy with grossly blunted appearance", that probably explains her B-12 deficiency. "Erythematous duodenopathy" describes reddened (IOW, inflammed) mucosal tissue in the first section of the small intestine (the duodenum). "Grossly blunted appearance" would presumably be a reference to villus atrophy of at least a Marsh 3b level of villus damage, or worse. This would clearly be a diagnostic marker of celiac disease. The term "gross" means that the damage is visible without the aid of a microscope, so that's a pretty serious level of damage. That level of inflammation would cause a major malabsorption problem.
Probably the reason why she is vitamin B-12 deficient is because she has been taking a vitamin B-12 supplement in the form of cyanocobalamin. Cyanocobalamin is a provitamin, meaning that it has to be converted into the active form of B-12 (methylcobalamin) by the body. But it is poorly absorbed when a malabsorption problem exists. The solution is to take the active form (methylcobalamin), in the form of sublingual lozenges. Sublingual lozenges are designed to be placed under the tongue, where they will be promptly absorbed directly into the blood stream. This method of supplementation (sublingual lozenges) is as effective as receiving B-12 by means of injections, and it's a lot simpler to deal with.
Yes, IMO you should definitely either have your vitamin B-12 level tested, or start taking a sublingual B-12 supplement. Unless you have kidney issues, the body will purge any excess amounts, so the risks of an overdose are minimal. On the other hand, the risks of living with a moderate to long-term B-12 deficiency are significant, and will almost invariably lead to neurological damage, some of which may be permanent. B-12 deficiency is a primary cause of peripheral neuropathy.
IMO, pancreatitis (inflammation of the pancreas) is common with MC, and it may or may not affect enzyme production. When enzyme production is not affected, then it probably typically goes unnoticed/undiagnosed. Did your doctor offer an explanation for the striated liver?
I agree with your neuro, it certainly seems that all of your issues are related. And many/most of them appear to be related to a chronic vitamin B-12 deficiency.
Concerning the slightly elevated blood test results:
Are all lymphocytes elevated, or only certain ones?
Elevated blood sodium can cause permanent damage to nerve cells.
Elevated hemoglobin can be caused by various things such as dehydration, breathing problems (or living at high altitude), smoking, kidney or liver cancer, or heart or lung disease.
Elevated mean corpuscular hemoglobin is typically a sign of a vitamin B-12 deficiency (this condition is known as microcytic anemia). An elevated mean corpuscular hemoglobin result can also be caused by a thyroid malfunction, of some other vitamin deficiency.
Bilirubin is a byproduct that results from the breakdown of hemoglobin (a natural process that results from red blood cells being replaced by new ones). There are many, many possible causes for an elevated bilirubin result, including many diseases, antibiotics and some other medications, and even some kinds of birth control pills. But I would guess that in this case, the elevated bilirubin result probably is associated with the other hemoglobin issues.
I hope that some of this is helpful.
Tex
Here are my thoughts on your questions. If your sister is the one who received a pathology report that included the wording "erythematous duodenopathy with grossly blunted appearance", that probably explains her B-12 deficiency. "Erythematous duodenopathy" describes reddened (IOW, inflammed) mucosal tissue in the first section of the small intestine (the duodenum). "Grossly blunted appearance" would presumably be a reference to villus atrophy of at least a Marsh 3b level of villus damage, or worse. This would clearly be a diagnostic marker of celiac disease. The term "gross" means that the damage is visible without the aid of a microscope, so that's a pretty serious level of damage. That level of inflammation would cause a major malabsorption problem.
Probably the reason why she is vitamin B-12 deficient is because she has been taking a vitamin B-12 supplement in the form of cyanocobalamin. Cyanocobalamin is a provitamin, meaning that it has to be converted into the active form of B-12 (methylcobalamin) by the body. But it is poorly absorbed when a malabsorption problem exists. The solution is to take the active form (methylcobalamin), in the form of sublingual lozenges. Sublingual lozenges are designed to be placed under the tongue, where they will be promptly absorbed directly into the blood stream. This method of supplementation (sublingual lozenges) is as effective as receiving B-12 by means of injections, and it's a lot simpler to deal with.
Yes, IMO you should definitely either have your vitamin B-12 level tested, or start taking a sublingual B-12 supplement. Unless you have kidney issues, the body will purge any excess amounts, so the risks of an overdose are minimal. On the other hand, the risks of living with a moderate to long-term B-12 deficiency are significant, and will almost invariably lead to neurological damage, some of which may be permanent. B-12 deficiency is a primary cause of peripheral neuropathy.
IMO, pancreatitis (inflammation of the pancreas) is common with MC, and it may or may not affect enzyme production. When enzyme production is not affected, then it probably typically goes unnoticed/undiagnosed. Did your doctor offer an explanation for the striated liver?
I agree with your neuro, it certainly seems that all of your issues are related. And many/most of them appear to be related to a chronic vitamin B-12 deficiency.
Concerning the slightly elevated blood test results:
Are all lymphocytes elevated, or only certain ones?
Elevated blood sodium can cause permanent damage to nerve cells.
Elevated hemoglobin can be caused by various things such as dehydration, breathing problems (or living at high altitude), smoking, kidney or liver cancer, or heart or lung disease.
Elevated mean corpuscular hemoglobin is typically a sign of a vitamin B-12 deficiency (this condition is known as microcytic anemia). An elevated mean corpuscular hemoglobin result can also be caused by a thyroid malfunction, of some other vitamin deficiency.
Bilirubin is a byproduct that results from the breakdown of hemoglobin (a natural process that results from red blood cells being replaced by new ones). There are many, many possible causes for an elevated bilirubin result, including many diseases, antibiotics and some other medications, and even some kinds of birth control pills. But I would guess that in this case, the elevated bilirubin result probably is associated with the other hemoglobin issues.
I hope that some of this is helpful.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.
Thanks, Tex,
Actually, the gross blunted appearance was from my endoscopy, as were the blood results. After hearing her share the info from her doctor, I went back to check my labs. I can't help but wonder if maybe there's something else delaying my recovery or explaining my other symptoms, and we're sort of in cahoots. I share my results so she can have some suggestions to take with her to her docs. Which helped in her last apt., as when the neuro learned I had mc, he began to pay attention to signs for malabsorption. She hasn't had a colonoscopy, but they did discuss her staying away from gluten.
In regard to the lymphocytes, the lab results didn't say.
I'm going to share your response with her, if that's ok.
Actually, the gross blunted appearance was from my endoscopy, as were the blood results. After hearing her share the info from her doctor, I went back to check my labs. I can't help but wonder if maybe there's something else delaying my recovery or explaining my other symptoms, and we're sort of in cahoots. I share my results so she can have some suggestions to take with her to her docs. Which helped in her last apt., as when the neuro learned I had mc, he began to pay attention to signs for malabsorption. She hasn't had a colonoscopy, but they did discuss her staying away from gluten.
In regard to the lymphocytes, the lab results didn't say.
I'm going to share your response with her, if that's ok.
Sorry, failed to answer your question about the liver. I haven't seen my GI since the ER visit, so I haven't asked her about it, but my PCP indicated that could be normal or could indicate liver disease. Since the bloodwork (amylase/lipase) came back normal, I assumed the striations weren't an issue. Perhaps I should bring it up at my next apt.
In general, a high lymphocyte count can be caused by a viral infection, or by the inflammation associated with many/most autoimmune issues. IOW, in this case it may be associated with MC.
Sure, I don't mind if you share my response, as long as you both keep in mind that I'm not a doctor, so those are strictly unprofessional impressions/observations.
Tex
Sure, I don't mind if you share my response, as long as you both keep in mind that I'm not a doctor, so those are strictly unprofessional impressions/observations.
Tex
It is suspected that some of the hardest material known to science can be found in the skulls of GI specialists who insist that diet has nothing to do with the treatment of microscopic colitis.