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What Do These Blood Test Reports Indicate?
Question: Hello Sir,
My Father is 78 Years old.
ESR=40
RBC=3.86
WBC=8.3
HGB=12.7
INR = 1.3
FERRITIN= 33.50
MCH= 33
MCV=93
PLT= 120
25-Hydroxy VitaminD=23.1
Glucose=102
Uric Acid=6.9
Total Cholestrol=139
HDL=25
LDL=97
Triglycerides=76
Urea=62
Creatinine=0.9
Sodium=141
Potasium=0.9
ALT=12
AST=19
ALP=72
Total Bilirubin=0.6
His doctor asked Him that INR should not be lower than 2.0 as he has a weak Heart Muscle (39%).
Since 10 days he is coughing all day, he took an antibitec course twice in 2 weeks, but still coughing, he made X-ray for his chest and it was almost clear as report,
What he can take to help his coughing in night?
and ESR is too high i think.?
can you please check the above records??
My father is coughing all day and cant sleep in night, what Medicine he can take to stop coughing ?
the Ferritin was 6.74 and HGB was 9.00 then after he took the Iron and B12 it reach 38.50 Now its 33.50 and HGB is 12.70
is it considered as low Ferriten and why it was dropped?
Can you check the MCH AND MCV , the values are getting high , right?
Can i send you his tests results as of Aug,2014 ?
My Father is 78 Years old.
ESR=40
RBC=3.86
WBC=8.3
HGB=12.7
INR = 1.3
FERRITIN= 33.50
MCH= 33
MCV=93
PLT= 120
25-Hydroxy VitaminD=23.1
Glucose=102
Uric Acid=6.9
Total Cholestrol=139
HDL=25
LDL=97
Triglycerides=76
Urea=62
Creatinine=0.9
Sodium=141
Potasium=0.9
ALT=12
AST=19
ALP=72
Total Bilirubin=0.6
His doctor asked Him that INR should not be lower than 2.0 as he has a weak Heart Muscle (39%).
Since 10 days he is coughing all day, he took an antibitec course twice in 2 weeks, but still coughing, he made X-ray for his chest and it was almost clear as report,
What he can take to help his coughing in night?
and ESR is too high i think.?
can you please check the above records??
My father is coughing all day and cant sleep in night, what Medicine he can take to stop coughing ?
the Ferritin was 6.74 and HGB was 9.00 then after he took the Iron and B12 it reach 38.50 Now its 33.50 and HGB is 12.70
is it considered as low Ferriten and why it was dropped?
Can you check the MCH AND MCV , the values are getting high , right?
Can i send you his tests results as of Aug,2014 ?
Brief Answer:
Diuretic to be added...
Detailed Answer:
Hi XXXXXXX,
I have through the medical history of your father and am sorry about the situation he is in.
I have also gone through the lab reports you sent in and I can say as following:
1. He is not having anemia as long as HGB and iron level are ok.
2. His coughing is due to congestive heart failure. I want to know what medications he is currently taking. If no diuretic, I'd advise to add diuretic (e.g. furosemide).
I also advise to make him sleep with 2 pillows (head raised more than legs from shoulders).
3. I need to know the results of echocardiogram. Can you please send the reports?
4. ESR is considered high indicative for inflammation. However, it is not considered too high.
Looking forward to have the echocardiogram result in!
Dr.Benard
Diuretic to be added...
Detailed Answer:
Hi XXXXXXX,
I have through the medical history of your father and am sorry about the situation he is in.
I have also gone through the lab reports you sent in and I can say as following:
1. He is not having anemia as long as HGB and iron level are ok.
2. His coughing is due to congestive heart failure. I want to know what medications he is currently taking. If no diuretic, I'd advise to add diuretic (e.g. furosemide).
I also advise to make him sleep with 2 pillows (head raised more than legs from shoulders).
3. I need to know the results of echocardiogram. Can you please send the reports?
4. ESR is considered high indicative for inflammation. However, it is not considered too high.
Looking forward to have the echocardiogram result in!
Dr.Benard
Above answer was peer-reviewed by :
Dr. Raju A.T
Hello Doctor,
Many thanks for your mail.
Attached you will find his Medication list.
As well, he take "Centrum" Multi vitamins and "Iron" tablets.
His tall is= 172 cm
His Weight is= 72 KG's.
Additionally, My father took in the last 3 weeks, two courses of Antibiotics as of:
1- Tavanic 500mg (7 PCs) (Course One) - FINISHED IT
2- Floxine 500mg (7 PCs) (Course two) - FINISHED IT.
In the beginning of 2014, the Ferritin was 6.74 and HGB was 9.00 then after he took the Iron and B12 it reach 38.50 Now its 33.50 and HGB is 12.70 but I think now stable.
I attached for you his 2011+2012 History when he took 'Cataflam' He has a very big problems due to Potassium increase.
My Intention now:
1- The INR is too low I think, how can we make it better?
2- The Ferritin is low I think, what is your advice?
3- The Values of MCV and MCH , is getting higher, plz advice,?
4- The coughing which he has since 4 weeks approx. what is your idea.
5- He is suffering from constipation from time to time (twice a month).
6- He is having his power down and hurting in his knees from time to time.
Many thanks for your mail.
Attached you will find his Medication list.
As well, he take "Centrum" Multi vitamins and "Iron" tablets.
His tall is= 172 cm
His Weight is= 72 KG's.
Additionally, My father took in the last 3 weeks, two courses of Antibiotics as of:
1- Tavanic 500mg (7 PCs) (Course One) - FINISHED IT
2- Floxine 500mg (7 PCs) (Course two) - FINISHED IT.
In the beginning of 2014, the Ferritin was 6.74 and HGB was 9.00 then after he took the Iron and B12 it reach 38.50 Now its 33.50 and HGB is 12.70 but I think now stable.
I attached for you his 2011+2012 History when he took 'Cataflam' He has a very big problems due to Potassium increase.
My Intention now:
1- The INR is too low I think, how can we make it better?
2- The Ferritin is low I think, what is your advice?
3- The Values of MCV and MCH , is getting higher, plz advice,?
4- The coughing which he has since 4 weeks approx. what is your idea.
5- He is suffering from constipation from time to time (twice a month).
6- He is having his power down and hurting in his knees from time to time.
Brief Answer:
I would like to make the following suggestions...
Detailed Answer:
Hi back XXXXXX,
I would like to make the following suggestions to your queries:
1. Your father INR is 1.3 which is to low and i suggest to increase the coumadin dose till the INR values will be between 2-3.
2. The Ferritin levels is 33.5 ng/ml which is within the normal range (25-380 ng/ml). You have nothing to worry about for now.
3. Yes it's true that MCV and MCH are slightly elevated but those are findings to be expected in people (as your father) who are taking treatment for anemia and suffer from congestive heart failure.
4. Unproductive Coughing (dry coughing) which prevent from sleeping may be a sign of congestive heart failure. This is why i recommended to increase the dose of diuretics. Your father is taking already burinex 1mg and zaroxolyn 5 mg which are diuretics. If your father was my patient I would recommended a larger dose of Bumex.
5. For constipation I would recommend to use lactulose and to drink plenty of water. This will soften his stool and prevent constipation in the future.
6. I would recommend recreational activities with friends and relatives in order to create a positive thinking atmosphere. For the hurting knees i recommend to use only NSAID gel (voltaren emulgel) and paracetamol tablets. Avoid the use of NSAID tablets (advil, voltaren ect.)
Hope this answer all your queries!
Wish you and your father health!
Dr. Benard
I would like to make the following suggestions...
Detailed Answer:
Hi back XXXXXX,
I would like to make the following suggestions to your queries:
1. Your father INR is 1.3 which is to low and i suggest to increase the coumadin dose till the INR values will be between 2-3.
2. The Ferritin levels is 33.5 ng/ml which is within the normal range (25-380 ng/ml). You have nothing to worry about for now.
3. Yes it's true that MCV and MCH are slightly elevated but those are findings to be expected in people (as your father) who are taking treatment for anemia and suffer from congestive heart failure.
4. Unproductive Coughing (dry coughing) which prevent from sleeping may be a sign of congestive heart failure. This is why i recommended to increase the dose of diuretics. Your father is taking already burinex 1mg and zaroxolyn 5 mg which are diuretics. If your father was my patient I would recommended a larger dose of Bumex.
5. For constipation I would recommend to use lactulose and to drink plenty of water. This will soften his stool and prevent constipation in the future.
6. I would recommend recreational activities with friends and relatives in order to create a positive thinking atmosphere. For the hurting knees i recommend to use only NSAID gel (voltaren emulgel) and paracetamol tablets. Avoid the use of NSAID tablets (advil, voltaren ect.)
Hope this answer all your queries!
Wish you and your father health!
Dr. Benard
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Hello Dr.
Thank you.
1- If He increases the Coumadin dose, he will get some other interuptions with PLT and so on right? why don't we think In a way of the Food he is eating may made the blood clotting ... can we make the INR more from the Food type?
As I think he will have side effects from increase the 5mg coumadine.. ? plz let me know.
2- The xray didn't show any water in lungs .and the ALT and AST values was not upnormal or increasing in a way that there is water ? am I right?
do u mean he increase the Burinex dose??to 2mg a day??
3- You said for constipation, to drink a lot of water? wont be problem that he will have more water??? and diuretics will be effective???
Thank you.
Thank you.
1- If He increases the Coumadin dose, he will get some other interuptions with PLT and so on right? why don't we think In a way of the Food he is eating may made the blood clotting ... can we make the INR more from the Food type?
As I think he will have side effects from increase the 5mg coumadine.. ? plz let me know.
2- The xray didn't show any water in lungs .and the ALT and AST values was not upnormal or increasing in a way that there is water ? am I right?
do u mean he increase the Burinex dose??to 2mg a day??
3- You said for constipation, to drink a lot of water? wont be problem that he will have more water??? and diuretics will be effective???
Thank you.
Brief Answer:
Increase the dose now and avoid this foods...
Detailed Answer:
Hi back again,
1. Yes it's true that some foods may interfere with coumadine (requiring a larger dose of it to reach the wanted effect). However in your father case you should temporally increase the coumadine dose till the INR levels is up to 2. As a second step i would recommend to avoid eating or drinking large amounts of:
- XXXXXXX
- Spinach
- Brussels sprouts
- Alcohol
- Cranberry juice
- Green tea
This will help to lower again the dose of coumadin in the future.
2. Yes x ray didn't show any sign of water in the lungs. However this findings are typical for an advanced phase of heart failure. Yes to increase the dose of Burinex is exactly what i suggested. However you should talk with your father doctor before increasing the dose.
3. Don't worry drinking more water (i recommend to drink 1.5-2 liters a day together with liquid foods) doesn't interfere with diuretics action.
Wish you and your father health!
Dr. Benard
Increase the dose now and avoid this foods...
Detailed Answer:
Hi back again,
1. Yes it's true that some foods may interfere with coumadine (requiring a larger dose of it to reach the wanted effect). However in your father case you should temporally increase the coumadine dose till the INR levels is up to 2. As a second step i would recommend to avoid eating or drinking large amounts of:
- XXXXXXX
- Spinach
- Brussels sprouts
- Alcohol
- Cranberry juice
- Green tea
This will help to lower again the dose of coumadin in the future.
2. Yes x ray didn't show any sign of water in the lungs. However this findings are typical for an advanced phase of heart failure. Yes to increase the dose of Burinex is exactly what i suggested. However you should talk with your father doctor before increasing the dose.
3. Don't worry drinking more water (i recommend to drink 1.5-2 liters a day together with liquid foods) doesn't interfere with diuretics action.
Wish you and your father health!
Dr. Benard
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Ashwin Bhandari
Answered by
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