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What Causes Mild Anemia, Diarrhea And Headache?
Question: I just had my annual physical last week and I have some values that concerned me. I have an ast level of 53 and normal alt of 26 level. I have elevated bilirubin, it fluctuates between 2.1-2.5. For my past physicals it was 2.0, 2.1, 2.4, and now 2.5. This is over a four year period and all of my other results were normal till now. I also was just diagnosed with mild anemia. My Hgb is 12.1. I had high RDW around 19 and my MSV was normal. Of course hemocorit was low and my platlet count was below normal at 121 I am usually at 150.
I also had two or three viral infections this summer. One or two a month before my physical, they were within two weeks of each other and the other was the week of my physical. The first infections caused massive headaches, bodyaches, fever, chills, and sweating. The second one caused stomach cramping with frequent diarrhea. I am fairly healthy, I work out four days a week three days with weights and one for cardio and maintain a decent diet.
. I have two questions.
1. How concerned should I be with my results? I have spoken with some people who said its not a concern at all and others said I need to be checked for chronic liver disease despite the fact I rarely drink.
2. My bilirubin has been high for four years and as increased a little each year. My DR thinks I have XXXXXXX Syndrome. And at this last physical he said I have a fatty liver. Would a fatty liver cause these types of lab values to be abnormal?
My doctor told me not to drink for a month, which I rarely do probably about 4-8 beers a month and they would recheck my levels in a month. He is also having me perform fecal tests at home to check for blood in my stool. I did an at home kit to check for blood in my stool and so far 2 of the 3 tests have came back negative.
I also had two or three viral infections this summer. One or two a month before my physical, they were within two weeks of each other and the other was the week of my physical. The first infections caused massive headaches, bodyaches, fever, chills, and sweating. The second one caused stomach cramping with frequent diarrhea. I am fairly healthy, I work out four days a week three days with weights and one for cardio and maintain a decent diet.
. I have two questions.
1. How concerned should I be with my results? I have spoken with some people who said its not a concern at all and others said I need to be checked for chronic liver disease despite the fact I rarely drink.
2. My bilirubin has been high for four years and as increased a little each year. My DR thinks I have XXXXXXX Syndrome. And at this last physical he said I have a fatty liver. Would a fatty liver cause these types of lab values to be abnormal?
My doctor told me not to drink for a month, which I rarely do probably about 4-8 beers a month and they would recheck my levels in a month. He is also having me perform fecal tests at home to check for blood in my stool. I did an at home kit to check for blood in my stool and so far 2 of the 3 tests have came back negative.
Brief Answer:
Repeat the tests when you are without symptoms of a viral infection.
Detailed Answer:
Hello,
Thank you for using Healthcaremagic to post your health query.
I read carefully your question and I understand your concern.
I agree with your doctor that it is important for you to understand why the mild anemia. The most possible cause it losing blood from the bowel, so that is why he is suggesting the stool for occult blood test. The home kit test is very reliable, so you might needs other testing after to diagnose the cause of that anemia.
I think also that your results are not of concern. The only one that needs to be followed is the bilirubin. The others are not to worry about at all, even the hemoglobin value.
I think also that you must repeat the tests when you are completely free of symptoms of a viral infection, because they may alter and cause those results.
So the plan of the doctor to repeat them in one month sounds good to me.
Maybe the drinking is not the affecting cause, but also make sure to not take medications that are metabolized in the liver too.
If you are a bit overweight you may have fatty liver but that can be reversed with weight loss. Also, fatty liver can be confirmed with an ultrasound, so ask that to your doctor if you still have doubts either if you have that or not.
I hope I have helped you and have clarified some of your doubts.
Let me know if you need more clarifications.
Regards,
Dr. Papaqako
Repeat the tests when you are without symptoms of a viral infection.
Detailed Answer:
Hello,
Thank you for using Healthcaremagic to post your health query.
I read carefully your question and I understand your concern.
I agree with your doctor that it is important for you to understand why the mild anemia. The most possible cause it losing blood from the bowel, so that is why he is suggesting the stool for occult blood test. The home kit test is very reliable, so you might needs other testing after to diagnose the cause of that anemia.
I think also that your results are not of concern. The only one that needs to be followed is the bilirubin. The others are not to worry about at all, even the hemoglobin value.
I think also that you must repeat the tests when you are completely free of symptoms of a viral infection, because they may alter and cause those results.
So the plan of the doctor to repeat them in one month sounds good to me.
Maybe the drinking is not the affecting cause, but also make sure to not take medications that are metabolized in the liver too.
If you are a bit overweight you may have fatty liver but that can be reversed with weight loss. Also, fatty liver can be confirmed with an ultrasound, so ask that to your doctor if you still have doubts either if you have that or not.
I hope I have helped you and have clarified some of your doubts.
Let me know if you need more clarifications.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Prasad
Thank you. Since I have elevated bilirubin for at least four years and probably more than that how likely would the cause be an obstruction like gallstones cysts tumors etc.
I have no jaundice urine is not discolored stools are normal color. Could I have an obstruction for a year or more with no visible symptoms.?
Also no pain or discomfort in the stomach or chest area. Also my rbc was down below normal and my wbc was normal but lower than past lab results normal is 3.4-10.5 I was at 4.4 but usually around 7
I have no jaundice urine is not discolored stools are normal color. Could I have an obstruction for a year or more with no visible symptoms.?
Also no pain or discomfort in the stomach or chest area. Also my rbc was down below normal and my wbc was normal but lower than past lab results normal is 3.4-10.5 I was at 4.4 but usually around 7
Brief Answer:
It is not likely an obstruction for such a long time without symptoms.
Detailed Answer:
Hello,
Thank you for the follow up question.
Elevated bilirubin indicates obstruction but also fatty liver infiltration, damage if the liver by drugs or alcohol, and many other causes which are more rare.
Since you have 4 years with it, I think it is less likely to be a tumor.
Also gallbladder stones would be visible by ultrasound just like the fatty liver too.
If you are overweight than most probably fatty liver is the cause. Avoid alcohol and medications during this time and repeat the tests. The diagnoses and the cause of your problem is decided by elimination of the most common causes, until it goes to other causes which are less possible and which need further testing.
I don't think you would have an abstruction for such a long time without having symptoms like jaundice, pain and other symptoms.
The values of wbc are not significant of a problem. Most probably they are low because they are consumed by your last viral infection.
Also, the low RBC go together with the hemoglobin and hematocrit, since they are decreased at the same time in an anemia.
What I want you to discuss with your doctor at the next blood testing result though, is if the RBC, WBC and the Platelets are all lower then the limit at the same time. In this case, that would be a problem. But as I said, we can justify it now, since you did the testing after 2 viral infections. We don't want that to be persistent though or lower then it is.
Hope that makes sense.
Let me know if you have other questions or concerns.
Regards,
Dr. Papaqako
It is not likely an obstruction for such a long time without symptoms.
Detailed Answer:
Hello,
Thank you for the follow up question.
Elevated bilirubin indicates obstruction but also fatty liver infiltration, damage if the liver by drugs or alcohol, and many other causes which are more rare.
Since you have 4 years with it, I think it is less likely to be a tumor.
Also gallbladder stones would be visible by ultrasound just like the fatty liver too.
If you are overweight than most probably fatty liver is the cause. Avoid alcohol and medications during this time and repeat the tests. The diagnoses and the cause of your problem is decided by elimination of the most common causes, until it goes to other causes which are less possible and which need further testing.
I don't think you would have an abstruction for such a long time without having symptoms like jaundice, pain and other symptoms.
The values of wbc are not significant of a problem. Most probably they are low because they are consumed by your last viral infection.
Also, the low RBC go together with the hemoglobin and hematocrit, since they are decreased at the same time in an anemia.
What I want you to discuss with your doctor at the next blood testing result though, is if the RBC, WBC and the Platelets are all lower then the limit at the same time. In this case, that would be a problem. But as I said, we can justify it now, since you did the testing after 2 viral infections. We don't want that to be persistent though or lower then it is.
Hope that makes sense.
Let me know if you have other questions or concerns.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
I'm not overweight my bmi is 25 though. I'm 5'8 and 165.
If all those values are low at the same time what would that indicate?
Could I have fatty liver with no visible symptoms and risk factors? Just be genetic or my liver can't breakdown fat.
And is elevated bilirubin common with fatty liver?
If all those values are low at the same time what would that indicate?
Could I have fatty liver with no visible symptoms and risk factors? Just be genetic or my liver can't breakdown fat.
And is elevated bilirubin common with fatty liver?
Brief Answer:
Elevated bilirubin is quite common with fatty liver.
Detailed Answer:
Hello again,
Yes, fatty liver can be possible sometimes in people who have been overweight during their life, even if they are not now. It can be genetic too, but in the case the bilirubin would be elevated since earlier in life, and I don't know if you have measured the bilirubin before when it resulted normal. Bilirubin is common with fatty liver, because fatty liver means that the liver is infiltrated with fat, so in a way it can cause many little obstruction of the liver tubes.
If there is no visible cause of the lost of blood which might have caused the anemia (your doctors need to find that out), and also no visible cause of the consumption of the WBC and the platelets (in your case that might be the fact tha you just went though a viral infection), then I would think that your bone marrow is not producing enough WBC, RBC and Platelets. That is called Aplastic anemia.
But again, that is a diagnoses which is complicated to decide by not knowing a full history and all the tests that involve ruling out possible causes of the problems.
I hope I have answered your questions.
Kind regards,
Dr. Papaqako
Brief Answer:
Glad to have been of help
Detailed Answer:
Hello,
I am glad to have been of help. Yes, aplastic anemia it is indeed very very rare.
Feel free to follow up with me if you have other questions or concerns.
If you don't have other questions about this issue, please kindly close and rate the answer.
Regards,
Dr. Papaqako
Elevated bilirubin is quite common with fatty liver.
Detailed Answer:
Hello again,
Yes, fatty liver can be possible sometimes in people who have been overweight during their life, even if they are not now. It can be genetic too, but in the case the bilirubin would be elevated since earlier in life, and I don't know if you have measured the bilirubin before when it resulted normal. Bilirubin is common with fatty liver, because fatty liver means that the liver is infiltrated with fat, so in a way it can cause many little obstruction of the liver tubes.
If there is no visible cause of the lost of blood which might have caused the anemia (your doctors need to find that out), and also no visible cause of the consumption of the WBC and the platelets (in your case that might be the fact tha you just went though a viral infection), then I would think that your bone marrow is not producing enough WBC, RBC and Platelets. That is called Aplastic anemia.
But again, that is a diagnoses which is complicated to decide by not knowing a full history and all the tests that involve ruling out possible causes of the problems.
I hope I have answered your questions.
Kind regards,
Dr. Papaqako
Brief Answer:
Glad to have been of help
Detailed Answer:
Hello,
I am glad to have been of help. Yes, aplastic anemia it is indeed very very rare.
Feel free to follow up with me if you have other questions or concerns.
If you don't have other questions about this issue, please kindly close and rate the answer.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thank you for your advice. My Dr thinks it is fatty liver at least that is what his nurse told me. A plastic anemia seems it's pretty rare. One last thing I tested for all hepatitis four years ago and have not had any new exposure. My Dr ordered hepatitis testing for me next month. One of the lab techs said that it is possible that hepatitis would not show up till years later. Is it possible that I tested negative four years ago but I am really positive? I am more concerned with hepatitis b.
Brief Answer:
It needs some time for the antigen to show in the blood after exposure.
Detailed Answer:
Hello,
If you have done the test in less then 6 weeks after the exposure, then it is possible that the test has not detected the antigen in the blood. In general the tests are done after 6 weeks and also after 6 months to confirm it.
Hepatitis B and other types of hepatitis are one of the main causes of high bilirubin, so it is an important cause to rule out.
Regards,
Dr. Papaqako
It needs some time for the antigen to show in the blood after exposure.
Detailed Answer:
Hello,
If you have done the test in less then 6 weeks after the exposure, then it is possible that the test has not detected the antigen in the blood. In general the tests are done after 6 weeks and also after 6 months to confirm it.
Hepatitis B and other types of hepatitis are one of the main causes of high bilirubin, so it is an important cause to rule out.
Regards,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Raju A.T
It was well beyond 6 weeks and beyond 6 months But I just did one test but there was two different hep b tests done
Brief Answer:
For sure it will show if you had HepB after 6 months.
Detailed Answer:
Hello,
The tests which are done are HBsAg (the antigen) and the HepBAb (the antibody).
Both would be visible 6 months after the exposure, that is for sure.
Regards,
Dr. Papaqako
Brief Answer:
Yes, you would have passed it.
Detailed Answer:
Hello,
Yes, it can be transmitted through sexual relationships and from mother to child.
Anyway, the best indicator if you had it or not is doing the test. It doesn't hurt to double check.
All the best,
Dr. Papaqako
For sure it will show if you had HepB after 6 months.
Detailed Answer:
Hello,
The tests which are done are HBsAg (the antigen) and the HepBAb (the antibody).
Both would be visible 6 months after the exposure, that is for sure.
Regards,
Dr. Papaqako
Brief Answer:
Yes, you would have passed it.
Detailed Answer:
Hello,
Yes, it can be transmitted through sexual relationships and from mother to child.
Anyway, the best indicator if you had it or not is doing the test. It doesn't hurt to double check.
All the best,
Dr. Papaqako
Above answer was peer-reviewed by :
Dr. Raju A.T
Plus if I had shouldn't I have passed it on to my wife and child? My wife would of been tested while pregnant so if she got we would of known correct?
Brief Answer:
Every pregnant woman gets tested for HepB
Detailed Answer:
Hello,
Yes, every pregnant woman gets tested for HepB at the beginning of pregnancy. So yes, she would know.
Regards,
Dr.Papaqako
Every pregnant woman gets tested for HepB
Detailed Answer:
Hello,
Yes, every pregnant woman gets tested for HepB at the beginning of pregnancy. So yes, she would know.
Regards,
Dr.Papaqako
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Above answer was peer-reviewed by :
Dr. Prasad
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