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Suggest Treatment For Persistent Sinus Drainage
Question: I am 58 y/o female who is in pretty good physical shape. My BMI is in normal range. I just received some blood work results and would like to know if the Differential numbers that are high and low are anything to be concerned about. I do not feel bad but have a continual sinus drainage and have been to an ENT who said my allergies are causing the drainage which is most likely causing an ongoing inflammation. I have had some enlarged lymph nodes on the back of my neck and behind my left ear on the bone. They have been there probably over a year. In Sept I had a virus that caused me to feel pretty bad and ever since that time I have had some sinus drainage. The ENT checked by throat, ears and nose and said no signs of infection and everything looked okay. This was just done about a week ago. I am attaching my blood work results.
Brief Answer:
labs, which are Not within normal limits, is explained below
Detailed Answer:
Hello Dear,
Thank you for using HCM to post your health query.
I read carefully your question and reviewed your blood tests results.
The Bun/creat ratio together with the CO2, are not significant values. As soon as the creatinine is withing normal limits, means that your kidneys are working fine.
The total cholesterol is high due to high LDL which are the bad lipids in the blood. Now, they are not that much high to be concerned in short term, but can cause problems in long term, with the increasing age, so I would recommend watching out the fat processed foods in your diet, eat plenty of green vegetables, drink plenty of water and if possible adding some exercising (running or jogging).
The TSH is high and that is a value to be taken seriously because it indicates that your thyroid is producing less hormones then it should, and so most probably you will need to take a treatment with the hormone of the thyroid (Levothyroxine). I would suggest you consult an endocrinologist so they prescribe this treatment, after you have checked other labs if needed.
Please continue the medications as per the ENT, as it seems to working okay for you.
Hope this is helpful.
Please let me know if you need more clarifications.
Regards,
Dr. Papaqako
labs, which are Not within normal limits, is explained below
Detailed Answer:
Hello Dear,
Thank you for using HCM to post your health query.
I read carefully your question and reviewed your blood tests results.
The Bun/creat ratio together with the CO2, are not significant values. As soon as the creatinine is withing normal limits, means that your kidneys are working fine.
The total cholesterol is high due to high LDL which are the bad lipids in the blood. Now, they are not that much high to be concerned in short term, but can cause problems in long term, with the increasing age, so I would recommend watching out the fat processed foods in your diet, eat plenty of green vegetables, drink plenty of water and if possible adding some exercising (running or jogging).
The TSH is high and that is a value to be taken seriously because it indicates that your thyroid is producing less hormones then it should, and so most probably you will need to take a treatment with the hormone of the thyroid (Levothyroxine). I would suggest you consult an endocrinologist so they prescribe this treatment, after you have checked other labs if needed.
Please continue the medications as per the ENT, as it seems to working okay for you.
Hope this is helpful.
Please let me know if you need more clarifications.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Hello. My main concern was with the high and low outcomes in the differential values and you did not answer that question unless you do not consider those to be of any concern (I am assuming that may be true). I was trying a different diet that had more good fats in it and I stopped that because I felt like it was too high in fat. How long does it take for your blood to reflect that type of diet change? It has only been about 4 weeks since I changed it. I keep forgetting to take my Levothyroxine and that has to change!! My workout regimen consists of running 2-6 miles or some type of cardio 3 x wk and strength training 2 x wk. My strength training includes some interval training with ropes. I had a high LDL last year too, but my ratio is good and my HDL is the highest it has ever been. I can't seem to get the LDL down, but I am trying a different diet right now. I drink lots of water but I also like Diet Coke and I have heard that dehydrates you. My water intake is around 70 oz a day. I weigh around 140 lbs and am 5'4". I have great muscle tone. Any additional suggestions and please address the differential. It concerned me. Thanks.. XXXX
Brief Answer:
The abnormal values does not go together
Detailed Answer:
Dear XXXX,
Thank you for the follow up question.
The values of the differential did not concern me. As you may notice, the Bun and Creatinine are normal, while their ratio is abnormal.
Both they accumulate in the blood when a person has kidney dysfunction. So, with renal disease, the BUN and creatinine usually both rise together. However, there are some conditions in which one rises more than the other, and some (as in yours) where one is normal while the other is low.
Some possible explanations:
-- it can be a Lab error: a creatinine of 0.72 is unusually low for a woman who is so active and has build muscle. So I would suggest that you repeat the blood test, if you still are concerned.
-- It can be dehydration: if you were dehydrated at the time the lab test was done (for example, were having a GI viral illness), the BUN may have increased just due to dehydration (resulting in a high ratio), and should have come back down as soon as you had enough water in your body.
-- Heart failure or liver cirrhosis: both of these conditions can cause a high BUN/creat ratio but I don't think you would have any of then, as otherwise there could've been many other symptoms .
-- Very high protein diet
-- GI bleeding: if there is a bleeding ulcer or bleeding of any type anywhere in the stomach or intestines, the BUN will rise disproportionately from the creatinine (again it's just a possibility, doesn't mean that it's at all present).
-- Steroids: in people taking high doses of steroid medications such as prednisone, the BUN can be elevated, causing a high calculated BUN/creatinine ratio.
I don't think that with the healthy lifestyle you have, and how you feel, you have any of the kidney, heart or liver failure.
Also, I notice that the electrolytes (potassium, sodium and cloride levels) are within normal limits while the CO2 and osmolarity are abnormal. It just does not fit the whole situation as they would have changed all together.
So, my main advice is to repeat that test again, and do that when you have stopped Singular and when you are better from the sinus infection.
Hope this helps to reassure you a bit.
Regards,
Dr. Papaqako
The abnormal values does not go together
Detailed Answer:
Dear XXXX,
Thank you for the follow up question.
The values of the differential did not concern me. As you may notice, the Bun and Creatinine are normal, while their ratio is abnormal.
Both they accumulate in the blood when a person has kidney dysfunction. So, with renal disease, the BUN and creatinine usually both rise together. However, there are some conditions in which one rises more than the other, and some (as in yours) where one is normal while the other is low.
Some possible explanations:
-- it can be a Lab error: a creatinine of 0.72 is unusually low for a woman who is so active and has build muscle. So I would suggest that you repeat the blood test, if you still are concerned.
-- It can be dehydration: if you were dehydrated at the time the lab test was done (for example, were having a GI viral illness), the BUN may have increased just due to dehydration (resulting in a high ratio), and should have come back down as soon as you had enough water in your body.
-- Heart failure or liver cirrhosis: both of these conditions can cause a high BUN/creat ratio but I don't think you would have any of then, as otherwise there could've been many other symptoms .
-- Very high protein diet
-- GI bleeding: if there is a bleeding ulcer or bleeding of any type anywhere in the stomach or intestines, the BUN will rise disproportionately from the creatinine (again it's just a possibility, doesn't mean that it's at all present).
-- Steroids: in people taking high doses of steroid medications such as prednisone, the BUN can be elevated, causing a high calculated BUN/creatinine ratio.
I don't think that with the healthy lifestyle you have, and how you feel, you have any of the kidney, heart or liver failure.
Also, I notice that the electrolytes (potassium, sodium and cloride levels) are within normal limits while the CO2 and osmolarity are abnormal. It just does not fit the whole situation as they would have changed all together.
So, my main advice is to repeat that test again, and do that when you have stopped Singular and when you are better from the sinus infection.
Hope this helps to reassure you a bit.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you very much. I have taken Singular for a long time. My sinus drainage has been going on for a long time. In early Oct when I had a really bad sinus flare up, I thought I might have infection but the doctor would not give me an antibiotic. Do you think I could have a chronic infection and because of my lifestyle it just never gets bad enough to make me sick? I have my yearly check up coming up with doctor and I will go over my results and sinus issues with him. It just seems like since I had that I have more sinus drainage. It is usually clear. By BUN/Ratio have been the same for the last 3 years with not much change so I am not concerned. I appreciate your responses to help me understand. I am just trying to age gracefully and do all I can to be healthy. I am not overly concerned just curious and I like to understand.
Brief Answer:
Glad to have been of help
Detailed Answer:
Hello,
You might have a chronic infection, not because you didn't take an antibiotic back then, but because it is a risk for the upper respiratory tract infection to be chronic in people who have allergies. But also, the sinus drainage can be from the allergy alone, without an infection. Allergies in some people can go on for all year long. So depends on what you are allergic from.
Congratulations on your lifestyle.
And it is always good to understand what is going on with your health, because so you can take better care of yourself.
If your Bun values have been going on for such a long time, then I would not be worried either.
Feel free to ask if you have other questions or concerns.
Regards,
Dr. Papaqako
Glad to have been of help
Detailed Answer:
Hello,
You might have a chronic infection, not because you didn't take an antibiotic back then, but because it is a risk for the upper respiratory tract infection to be chronic in people who have allergies. But also, the sinus drainage can be from the allergy alone, without an infection. Allergies in some people can go on for all year long. So depends on what you are allergic from.
Congratulations on your lifestyle.
And it is always good to understand what is going on with your health, because so you can take better care of yourself.
If your Bun values have been going on for such a long time, then I would not be worried either.
Feel free to ask if you have other questions or concerns.
Regards,
Dr. Papaqako
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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