Hemoglobin in urine

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Patricia
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Hemoglobin in urine

Post by Patricia »

I had an appointment with my PCP this week for a follow-up and also because I still have hip/groin pain, itching of my skin, and also sometimes a burning sensation with urination. They also tested again the calcium and the PTH since my last calcium test result was elevated (10.3) while being very vitamin D deficient, which suggests primary hyperparathyroidism. Well, this time the calcium was completely normal (9.1) and the PTH was normal, too (53.7). They will measure it again in a week as it can fluctuate in primary hyperparathyroidism.
The pain in my ribs and my right side have decreased since being on the elimination diet. I told my PCP about Enterolab, Tex's book, this wonderful forum, the elimination diet, and how the diet has helped me so much. She was very open to all of it and listened intently.
She is sending me to a doctor specialized in Physical Medicine for the hip pain and ordered urinalysis and urine culture because of the burning sensation that I sometimes have.
They called me today and said that there was no infection, but that they found hemoglobin in my urine. She ordered another urinalysis as well as urine cytology.
Has anybody else had hemoglobin in their urine???
I have to say, it freaked me out. I have lost a few friends to cancer, they died way too young. The last one was my best friend who died last year. Having been one of her caretakers and witnessing the physical and emotional pain (school-age child at home) was truly traumatizing. And I do believe the stress of helping out for 15 months, while my one daughter was home at the same time for a few months with a severe concussion and required all kinds of treatments, contributed to me developing microscopic colitis. The first symptoms popped up 2 months after my friend passed away.
Anyway, I now have a tendency to think of the worst and when I saw that my PCP ordered urine cytology and this is usually done to rule out cancer cells in urine it really, really scared me.
A friend of mine suggested the hemoglobin could also be due to interstitial cystitis, which apparently frequently occurs with autoimmune diseases. I read that it often occurs with IBS as well (which may just be undiagnosed microscopic colitis). Do any of you have interstitial cystitis? And if you do, do you have hemoglobin in your urine? And what are your symptoms?
I received the order for the urinalysis and the urine cytology late this afternoon. So I won't find out anything for the next few days...

Love, Patricia
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Post by UkuleleLady »

Hi Patricia,
I have IC but I haven't had a flare or problem with it since MC and revising my diet. I think IC and MC are the same for the most part, that is lymphocytic infiltration of the lining. The docs never mentioned hemoglobin in my urine, but I wouldn't be surprised if many of us have had IC. Mine used to be pretty painful and it was tough to get a diagnosis. It was similar to the way a UTI feels, pain upon urination, frequent urination, but there was never a pathogen involved...

I pray you don't have cancer but please, please try not to worry about that unless you have a reason to. Stress is bad for all our symptoms.

Take care,
Nancy
If you want others to be happy, practice compassion. If you want to be happy, practice compassion. ~The Dalai Lama
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Patricia wrote:Has anybody else had hemoglobin in their urine???


Yes, I have had hematuria. It showed up both in April and October of 2013. No test was done in April, 2014, but in October, 2014, the test result was negative. This also happened a couple of years prior to that, but a subsequent test result was negative. My doctors have never seemed to be concerned about it, so I haven't been concerned either.

I too have recently had a reason to suspect hyperparathyroidism, since my kidney stone episode last October/November. My calcium level was 10.0 then, and a test done last week shows a result of 10.1. But a PTH test a couple of months ago showed a level of 17 pg/mL, which should rule out hyperparathyroidism.

In my case, I'm pretty sure that a high vitamin D level has something to do with my elevated calcium level, but I have a hunch that dehydration, which causes hypovolemia (reduced blood volume) may be having an even greater effect on my elevated calcium level test results, because ever since late last summer, I've been having dehydration problems, especially at night. And of course I did the blood draw last week without drinking any water for roughly 10 hours before the draw. With an ileostomy, I can't recycle water normally. But the point is, our hydration level affects blood volume, and therefore it surely affects certain blood test results. I note that my blood pressure is almost always significantly higher at night, than it is first thing in the morning, and that would also be affected by blood volume (higher blood volume means higher blood pressure). Dehydration is typically associated with low (or at least lower than normal) blood pressure.

Because of my nighttime dehydration issues, I tend to overhydrate during the day and before bedtime. This morning my BP was 112/58. I tested it just now and it was 154/91. That pretty well supports my suspicions. Maybe you were just much better hydrated this time, than you were prior to the previous test.
Patricia wrote:Do any of you have interstitial cystitis? And if you do, do you have hemoglobin in your urine? And what are your symptoms?
As Nancy mentioned, MC can cause symptoms very similar to the symptoms of interstitial cystitis. Many members here (including me) have experienced that effect. I have no idea if it can cause blood in the urine, but it can certainly cause an irritated bladder, frequent urination, etc, similar to interstitial cystitis.

I hope that some of this is helpful.

Love,
Tex
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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.
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Post by Lilja »

tex wrote:
Patricia wrote:Has anybody else had hemoglobin in their urine???


Yes, I have had hematuria. It showed up both in April and October of 2013. No test was done in April, 2014, but in October, 2014, the test result was negative. This also happened a couple of years prior to that, but a subsequent test result was negative. My doctors have never seemed to be concerned about it, so I haven't been concerned either.

I too have recently had a reason to suspect hyperparathyroidism, since my kidney stone episode last October/November. My calcium level was 10.0 then, and a test done last week shows a result of 10.1. But a PTH test a couple of months ago showed a level of 17 pg/mL, which should rule out hyperparathyroidism.

In my case, I'm pretty sure that a high vitamin D level has something to do with my elevated calcium level, but I have a hunch that dehydration, which causes hypovolemia (reduced blood volume) may be having an even greater effect on my elevated calcium level test results, because ever since late last summer, I've been having dehydration problems, especially at night. And of course I did the blood draw last week without drinking any water for roughly 10 hours before the draw. With an ileostomy, I can't recycle water normally. But the point is, our hydration level affects blood volume, and therefore it surely affects certain blood test results. I note that my blood pressure is almost always significantly higher at night, than it is first thing in the morning, and that would also be affected by blood volume (higher blood volume means higher blood pressure). Dehydration is typically associated with low (or at least lower than normal) blood pressure.

Because of my nighttime dehydration issues, I tend to overhydrate during the day and before bedtime. This morning my BP was 112/58. I tested it just now and it was 154/91. That pretty well supports my suspicions. Maybe you were just much better hydrated this time, than you were prior to the previous test.
Patricia wrote:Do any of you have interstitial cystitis? And if you do, do you have hemoglobin in your urine? And what are your symptoms?
As Nancy mentioned, MC can cause symptoms very similar to the symptoms of interstitial cystitis. Many members here (including me) have experienced that effect. I have no idea if it can cause blood in the urine, but it can certainly cause an irritated bladder, frequent urination, etc, similar to interstitial cystitis.

I hope that some of this is helpful.

Love,
Tex
I have had "microscopic" blood (blood only seen under microscope) in my urine for the last 20 years. The doctors have never been able to trace the reason for this, and I have given up, and I had forgotten all about this, until I read your concern.

Since I'm getting so much better day by day now, maybe I should get my urine tested and see if there is still microscopic blood in my urine, i.e. of course wait till I have gone off Entocort completely plus a few weeks. I hope and think that the test will be "clean".

IOW, I suspect the microscopic blood in my urine is due to the intestine inflammation, and that this inflammation has been going on for decades, without me knowing the root cause. Until now. Perhaps.

Lilia
Collagenous Colitis diagnosis in 2010
Psoriasis in 1973, symptom free in 2014
GF, CF and SF free since April, 2013
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Patricia
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Post by Patricia »

Thank you for all your helpful and kind posts!!!

I went to the hospital today for the urine tests. They think my PCP should have the urinalysis results on Monday, they were not sure about the cytology results, it could be Tuesday or later.
Stress is bad for all our symptoms.
Yes, Nancy, I noticed that right away with bowel movements that were much less formed or not formed at all (while still on a lamb-sweet potato diet). Unbelievable how fast mind and body interact.

By the way, I like the name UkuleleLady. My oldest daughter just bought a ukulele last week :lol:
Yes, I have had hematuria. It showed up both in April and October of 2013. No test was done in April, 2014, but in October, 2014, the test result was negative. This also happened a couple of years prior to that, but a subsequent test result was negative. My doctors have never seemed to be concerned about it, so I haven't been concerned either.
That's reassuring! Thanks for letting me know.
I too have recently had a reason to suspect hyperparathyroidism, since my kidney stone episode last October/November. My calcium level was 10.0 then, and a test done last week shows a result of 10.1. But a PTH test a couple of months ago showed a level of 17 pg/mL, which should rule out hyperparathyroidism.
Having read about primary hyperparathyroidism I am under the impression that the parathyroid glands are active, turning on and off dozens of time a day, regulating the calcium levels. In people without primary hyperparathyroidism, the levels are very consistent and tightly regulated, while in patients with primary hyperparathyroidism the levels fluctuate. I am not sure, but I think that the PTH and the calcium have to be measured at the same time to be able to evaluate the parathyroid glands. If the calcium levels are elevated, the PTH levels should be very low. If the calcium level is elevated and the PTH level is normal, primary hyperparathyroidism is suspected.
I have had "microscopic" blood in my urine for the last 20 years. The doctors have never been able to trace the reason for this, and I have given up and I've forgotten all about it, until I read this.
Thank you, Lilia. That makes me feel a lot better!!!
Since I'm getting so much better day by day now, maybe I should get my urine tested and see if there is still microscopic blood in the urine
It would be interesting to see!!!
I read that interstitial cystitis is often connected to mast cell issues, and that patients are advised to do an elimination diet to find out what they can tolerate and what not.
Maybe it really is all connected with each other, and managing microscopic colitis with diet will also help manage the inflammation in the bladder....

Thanks again for making me feel better, I will keep you posted!

Love, Patricia
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Post by JFR »

Patricia wrote: I read that interstitial cystitis is often connected to mast cell issues, and that patients are advised to do an elimination diet to find out what they can tolerate and what not.
Maybe it really is all connected with each other, and managing microscopic colitis with diet will also help manage the inflammation in the bladder....
Makes one think that they are not really separate diseases but simply manifestations of the same problem that shows up in different ways in different people. I too had symptoms that seemed a lot like interstitial cystitis. They have now gone away.

Jean
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tex
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Post by tex »

Patricia,

Yes, if your calcium level is erratic on tests, then what you say is certainly a possibility. My calcium level is always consistent (it's always at the top of the range, and it never drops significantly), so my PTH would have to be high in order to indicate a hyperparathyroid problem.

Good luck with the test results.

Love,
Tex
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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.
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Post by Patricia »

I thought I'd give you an update.....

I finally received the urine cytology results when I saw my PCP today (16 days after the urine test!). They found rare atypical cells. She wants to repeat the urine cytology and also referred me for an ultrasound of bladder and kidneys and a urology consult. I have the appointment with the urologist in April. I asked my PCP what the atypical cells meant. She said it really didn't mean anything, the scare is obviously cancer, but inflammation can cause that and she said that sometimes perfectly healthy people have atypical cells.

The second urinalysis did not show any blood anymore and was normal.

The physical medicine doctor that she sent me to because of the groin pain ordered x-rays of the hips because he thought it might be osteoarthritis. I wonder, though, whether colitis and possibly interstitial cystitis could not result in groin pain as well? The pain is right in the crease between the abdomen and the right thigh.

The latest PTH and calcium tests were normal. She did order the thyroid tests. So we'll see what comes out of that.

Love, Patricia
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Post by tex »

Patricia wrote:The pain is right in the crease between the abdomen and the right thigh.
Thinking back, I used to have those pains, but I never knew what caused them. They were probably just an extension of all the abdominal inflammation.

With a clean second urinalysis, and normal PTH and calcium test results, you're looking good. :thumbsup:

Thanks for the update.

Love,
Tex
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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.
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Post by Patricia »

Tex wrote:With a clean second urinalysis, and normal PTH and calcium test results, you're looking good.
Thanks Tex!!! :grin:

Love, Patricia
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Post by LindyLou »

Hi Patricia,
I just had surgery this past April for primary hyperparathyroidism. It was extremely difficult to diagnose and I ended up firing more than one Endo in my quest for a diagnosis. The surgery was successful and they pulled an adenoma out of my thymus and in addition did a thymectomy. Below is a sample of my lab work leading up to and post surgery. I had my surgery on June 4th. PTH and calcium run on a feedback loop. When one is high, the other is low, and vice-versa. Some of these labs are obvious but others not so obvious but I had the symptoms. Body and bone pains that would travel from one part of the body for a few weeks only to move elsewhere. When the pains were in the bones it was dreadful. And I would take what I would call my 'coma' naps. They would last for 4 hours but I would still sleep 8 hours at night. I always blamed the later one on my thyroid problems, but post surgery my need for napping has greatly diminished. If you would like to explore a little deeper what your calcium/PTH/vitamin d levels mean relating to parathyroid disease, there is the CalciumPro App. It was developed through Dr. Jim Norman from Tampa Bay General Hospital. You input your numbers and it kicks back the likelihood of having this awful condition. I did buy this and once my results showed it was very likely I had pHPT I sought out a surgeon. This is one condition that should be diagnosed by lab values, however as it shows with me, I was considered normocalcemic and still had a tumor. If you have any questions, I would be delighted to answer them.

Linda

Ps. When I did a preview of this post, my columns aren't lining up correctly. I do hope you will still be able to understand them.


Name
PTH, Intact
15 - 65 pg/mL
Standard Range
6/26/13 10/14/13 2/7/14 5/7/14 7/16/14 10/13/14 12/1/14
121 60 53 50 28 33 33


Calcium
8.5 - 10.5 mg/dL
Standard Range
6/26/13 10/14/13 2/7/14 5/7/14 6/5/14 6/18/14 7/3/14 7/16/14 10/13/14 12/1/14
9.4 9.2 9.7 9.7 8.8 9.4 9.2 9.7 9.7 9.4
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Post by Patricia »

Hi Linda,

Thank you so much for your post!

So, if I understand it correctly, only your first PTH listed was elevated, all the other ones were within the normal range and all the calcium results were within the normal range. Right? Did the app show that pHPT was likely despite of the PTH and the calcium being within the normal range?

On Dr. Norman's website it said the following:
IMPORTANT: If your blood calcium is high and your blood vitamin D is LOW, then 100% you have a parathyroid tumor. Read that sentence again folks, as this is one of the most confusing things for doctors to understand. Some uninformed doctors will see that your calcium is high and your vitamin D is low and they will prescribe a high dosage of vitamin D "to help make the calcium go down". We have an entire page of this website dedicated to this one topic, but allow us to summarize it here in one absolute, very clear sentence: If you have a high blood calcium and your vitamin D level is low, then near 100% you have a parathyroid tumor in your neck that is the cause of the high blood calcium and this tumor must be removed. Giving Vitamin D to a patient with high blood calcium can be dangerous and shows that the doctor doesn't understand parathyroid disease very well. See our page on "Low Vitamin D with High Blood Calcium".

So, when I first read that in January, after realizing that my vitamin D was very low and my calcium was elevated, I was pretty convinced that this was the problem. But now the last two results were normal for PTH and calcium. Which apparently is not that unusual for pHPT as it fluctuates. The question is, how do you catch it when it is high?

I did buy the app in January, but so far it did not show that pHPT was likely. It shows me within the light blue blob of pHPT in the advanced comparison of calcium/vitamin D. But the general analysis shows "very unlikely". It states that the more information I enter, the more accurate it will become. So the question here is, is it "very unlikely" or do I not have enough measurements yet? Last week's results were 9.7 mg/dl for the calcium and 40.4 pg/ml for the PTH.

Also, I am taking vitamin D. Should I not be taking vitamin D? I don't know what is worse, not taking it when it is that low or taking it while possibly having pHPT?

Thanks again, Linda. This is so helpful!!!

Love, Patricia
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Post by LindyLou »

Hi Patricia,
Hopefully this image will show up. These are the labs that were used for diagnosis. As you can see (hopefully) some of my labs were over some were not. What you do see is there is not a tight control of my calcium. It bounced all over the place. I was placed on Vitamin D and had a horrible reaction to it. I caused a lot of pain throughout my body. There is some controversy over vitamin D levels with pHPT. almost like which came first, the chicken or the egg. I belong to a support group on facebook for this condition. Like this group, they are more researched based with probably over 2000 members. The general consensus of the group is when you have primary hyperparathyroidism, you body suppresses your vitamin D to try to keep your calcium lower. Although I must say I started recently supplementing with vitamin D and the body pains came back. When they did my surgery the surgeon was not able to locate one of my parathyroid glands. He did biopsy the other two and also did intraoperative PTH testing during the surgery. My PTH the day of the surgery was 83. Post surgery it came down to 28.Still have other issues going on and will probably be back to have my thyroid removed as a PET scan showed activity in the thyroid but they're thinking that is due to a very active case of Hashimotos. It is so aggressive that it lit up the PET, but that a story for another day. A good endocrine surgeon is what you need to evaluate you. The endocrinologist CANNOT diagnose you. Only a surgeon can. I highly recommend the facebook group 'Parathyroid Disease Support and Awareness' There is also a member there who does active research in Vitamin D as her career. Come join the group and ask questions. They have a master list of recommended surgeons. There are quite a few members who went to Tampa for their surgery but there are many others who are just as qualified.


Image



Image

Once again, I hope these images show up. Once again, if you have any questions, I be more than happy to help.

Love
Linda
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Post by LindyLou »

I just realized I wrote the wrong date of my surgery. It was in June of last year

Love Linda
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Patricia
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Post by Patricia »

Hi Linda,

Thank you so much for posting all your values. That's so helpful!!!

So far, I have not been on Facebook....I'll think about it.

It just feels like my body has been completely out of balance for the past year. What I don't know is if this is only due to LC, generalized inflammation in the body, or whether there is anything else going on, such as primary hyperparathyroidism, nutritional deficiencies, or anything else. I find it very confusing and difficult to sort out. And not knowing, it is hard to get a grip on things!

My calcium levels have gone from 10.3 to 9.1 to 9.7 within the last three months. Unfortunately, the PTH was only measured the last two times (53.7 and 40.4) and not when the calcium was at 10.3. That would have been very interesting! But at that time, calcium was just part of other blood tests that were done and it was a surprise that it came back elevated. I am glad that my PCP wants to keep an eye on the calcium and the PTH. She did warn me that primary hyperparathyroidism is very difficult to diagnose and that it usually takes a long time because so often it is not obvious. I am glad she did not completely dismiss it.

Good luck with your thyroid!!!

Thanks again for all your help! :grin:

Love, Patricia
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