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Wanted to know significance of some lab values - Online Doctor Chats

Date : 13-Jan-2012
User rating for this question
Good Posted in: X-ray, Lab tests and Scans
Answered by

General & Family Physician
Practicing since : 2008
Answered : 3481 Questions
User :   I was wondering if anyone could discuss lab values with me. I am a pharmacy student but I've had a blood test done for medical reasons and was hoping for an interpretation.
Doctor :   Hi
User :   Hi there.
Doctor :  
Yes, sure
User :   I was wondering if you could tell me possible reasons for high albumin globuin ratio along with slightly low WBC
Doctor :  
May I ask you few questions to know about you, before we proceed further?
User :   sure
Doctor :  
Please give your Age, Gender, Location, Marital status, Height, Weight and Waist circumference.
User :   i'm a 21 year old male 5'8" 120lbs excellent waist hip ratio
Doctor :   Ok
Doctor :  
Albumin globulin ratio is ordered as part of
Doctor :  
liver function test
Doctor :  
In the presence of a normally
Doctor :  
functioning liver, this ratio is maintained
Doctor :  
within a ratio of 0.9 to 2.0
User :   mine was 2.2
User :   My albumin looked fine. Globulin was lower but still within the normal reference range they provided
Doctor :   Because disease states affect the relative changes in albumin and globulins in different ways, this may provide a clue to
Doctor :   the cause of the change in protein levels
Doctor :   2.2 is beyond the
Doctor :  
normal range, but need not necessarily indicate
Doctor :  
an underlying disease
Doctor :  
As you can see
Doctor :  
individually, these
Doctor :  
proteins are within their normal ranges
User :   So I guess the ratio doesn't mean much in this case?
User :   my globulin was 2.2
Doctor :   Albumin was 4.4?
Doctor :  
OK
User :   albumin 4.8
Doctor :  
What symptoms do you have & what was the indication
Doctor :  
for the tests to be ordered?
User :   well, there's a long story. I've had stomach aches for a almost a year now. My GI settled on functional dyspepsia
User :   my primary care doctor thinks it is depression/anxiety
User :   I've been feeling slightly dizzy in the last few weeks
User :   My primary care doctor ordered the tests for malaise
Doctor :  
K
Doctor :  
How about the other
Doctor :  
liver function test?
Doctor :  
are they whithin nornal range?
User :   do you mean like bilirubin?
Doctor :  
Liver enzymes, total proteins, Bilirubin?
User :   I suppose I'll just type up what's here
Doctor :  
Ok
User :   total protein 7.0
User :   albumin 4.8 globulin 2.2
User :   bilirubin rtotal 0.6
User :   alkaline phosphatase 54
User :   AST 16
User :   AL18
User :   ALT* sorry
Doctor :  
OK
Doctor :   Your liver is
Doctor :  
functioning well
User :   Yeah, besides the ratio they all seemed within the reference values.
User :   My WBC was 3400
Doctor :  
That is lower than normal
User :   But individually they all seemed within the reference values
User :   albeit on the low sides on neutrophils
Doctor :  
What about the differential count ?
Doctor :  
Could you elaborate?
User :   neutrophils 1690
User :   that seemed within normal although at the bottom of the range they gave
Doctor :  
Just use Alphabets- N for neutrophil
User :   lymphocytes 1253
User :   1353*
User :   monocytes 279
User :   eosinophils 54
User :   basophils 24
User :   They all fell within the normal ranges they gave, but I suppose since they were on the lower end of normal, they made the total lower than normal.
Doctor :  
Your neutrophils are is low
Doctor :  
Ok, sorry that
Doctor :  
too is within range
Doctor :  
OK
Doctor :  
There is nothing wrong with the hemogram
Doctor :  
except that the total count is
Doctor :  
below normal
User :   Yeah that's what I found odd.
Doctor :  
So that makes you a candidate either
Doctor :  
for a repeat test
Doctor :  
or for further investigations
User :   Can being underweight cause low WBC?
Doctor :   No
Doctor :  
not for how much you weigh
Doctor :  
Your BMI is 18
Doctor :  
which is 0.5 short of normal
Doctor :  
If you happened to be much lesser, then we could
Doctor :  
have suspected your weight
Doctor :  
Do you get frequent infections?
User :   I don't think so.
User :   Unless this slight dizziness means something
User :   Is it possible I have mono?
Doctor :  
May be your BP is low, any idea
Doctor :  
how much it is?
User :   usually its been fairly low. anywhere between 100/60 to 120/80
Doctor :  
What do you mean by mono?
User :   mononucleosis
Doctor :   Do you have any symptoms that could
Doctor :  
help me suspect it?
User :   fatigue maybe
User :   I probably don't have it though because I don't have much of the symptoms
User :   but if I had some chronic viral infection, could that make my WBC low?
Doctor :  
I guess your Iron levels are normal?
Doctor :  
The lymphocytes would have been more in case you had viral infection
User :   Hmm I don't see Iron on this hemoglobin is normal
Doctor :  
Thats good enough, that indicates Iron
Doctor :  
OK
Doctor :  
How is your
Doctor :  
lifestyle?
User :   I don't excercise much mostly because of feeling tired, and I don't want to lose any more weight.
Doctor :  
You are a student, are you involved in sports
User :   I suppose I really do need to get more active.
Doctor :  
That is a very wrong cocept
Doctor :  
concept
Doctor :  
the more you exercise
Doctor :  
more your appetite will
Doctor :  
increase
User :   I suppose that's true.
Doctor :  
Try to get as much exercise as possible
Doctor :  
but first consult your Doc
Doctor :  
regarding this
User :   Would it be better for strength exercise? or more like cardio exercise?
Doctor :  
a combination of both
User :   Do you think being sedentary could make WBC lower?
Doctor :  
Being sedentary
Doctor :  
will reduce your immunity
Doctor :  
WBC is the mainstay
Doctor :  
of this immunity
User :   So then that could explain the lower value I received.
User :   Or could it?
Doctor :  
Yes, unless there is no other cause
User :   And you don't think the slightly low globulin has anything to do with this?
User :   Or maybe depression/anxiety?
Doctor :  
No
Doctor :  
Just get them repeated after a month or so
Doctor :  
meanwhile
Doctor :  
exercise
User :   How much would be enough?
Doctor :  
How much of
Doctor :  
exercise?
User :   yes
Doctor :  
Get as much as
Doctor :  
you possibly can
User :   Haha alright.
Doctor :  
But for a start though
Doctor :  
you keep it low
Doctor :  
increase gradually
User :   maybe start with light lifting and walking?
Doctor :  
Do nt go for weights right away
User :   So just walking then?
Doctor :   Tune your body slowly, start with push ups
Doctor :  
& pull ups
Doctor :  
along with slow jog
User :   Ah I see.
Doctor :   have a healthy diet
Doctor :  
with a lot of proteins
Doctor :  
fresh fruits & vegetables with meat
User :   Vegetables I think I lack when I'm at school.
User :   I wouldn't mind eating them, but none of my roommates do, so we don't get any.
Doctor :  
Well its time to start eating it then
User :   Otherwise my diet has been mostly carbs and proteins.
User :   Haha I suppose so.
User :   My cholesterol levels are excellent.
User :   My father is jealous.
Doctor :  
Joining a gym will help
User :   We have a gym on campus. I think I should try to make more use of it.
Doctor :  
Yes do not waste anything on the campus
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