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Blood test showed WBC 4.4 L and MPV 10.9. Cholesterol-LDL:92 and HDL:91.2. TSH is 2.05. What does all this indicate?

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General & Family Physician
Practicing since : 2009
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I just got my blood test results and I would love to know what they mean as I see some Highs and lows and other things. My WBC is 4.4 L and I see it is low. This is very alarming to me as I know it could mean leukemia or other things bad. I haven't been feeling good lately and very tired so I would like to know what I need to do from here. My MPV is 10.9 H and I see it is high. I have heart issues so anything you can tell me would be of great help. The doctors where I live will never go over the blood results so I picked them up myself from the hospital. I have the letter A beside my BUN and it is 15. My CREAT has a (B) beside it and says it is 0.77. My CO2 has an (H) beside it and I know that means high and this is very concerning to know my carbon dioxide level is high and I stay short of breath all the time. My TP has a (C) beside of it and it is 7.4. I see on the paper that the (C) stands for ambulatory reference range, but I haven't a clue what that means. My ALB has a (D) beside of it and don't know what that is either or if that is or bad. My ALK PHOS is 86 and has an (E) beside it. Now on to my cholesterol. My total is 189 which is lower than last year. My LDL is 92 and has a (G) after it. I am hoping that is good as last year it was bad. My HDL however has a (H) beside it and it is 91.2. I thought the higher the better for the HDL, but I take it from the (H) beside it that is too high. I am confused. Then finally my TSH is 2.05 and has an (H) beside it which I take it to be high. This is concerning as my hair has been falling out and my eyebrows and I am tired a lot and also fast heart rate. I always get told my thyroid is good and this makes me wonder. I just want to know what these things mean and would like to be for sure and no guessing. Also I picked up my echo on my heart as I have to have one yearly. I have Mitral Valve Prolapse and an aneurysm in the atrial septum. It didn't show up on this echo obviously because it doesn't say anything about it on the report, which I find weird because I know it doesn't go away and when I pay for this test would be nice if they would do it until it shows up so I would know what is going on with it. It says on the conclusion (1) Mitral valve prolapse (2) Normal LV systolic function (3) Decreased compliance of the LV. (4) Moderate mitral regurgitation (5) Mild tricuspid regurgitation. My heart dr. which spends all of 5 minutes with me says everything looks good. I asked for a copy of the echo and this is what I read. I am concerned with the Decreased compliance of the LV. I don't really know what that mean other than what I have read, and that is what is concerning to me. I stay short of breath and with the blood results of the carbon dioxide and knowing I have been diagnosed with COPD in the past from lung x-rays from the hospital and never being told I had it, makes me worry. I never have smoked, yet it has said at times I have COPD but my breathing tests that were ordered came back good. Please give me some info and your opinion as to what I need to do and if I need to seek a professional.
Posted Thu, 10 Oct 2013 in Medicines and Side Effects
Answered by Dr. Yogesh D 4 hours later
Brief Answer:
Need to schedule an appointment soon

Detailed Answer:

Thank you for writing in. I have carefully gone through your description and the lab values.

I agree with you on carbon dioxide being high. It could be because the COPD which might have gotten worse, this associated with shortness in breath warrants an urgent visit to the ER.

WBC counts are fine, don't worry about that, as well as your BUN and creatinine is normal, nothing to worry.

Your TSH level is also fine.

The findings which are worrisome are high CO2 levels and moderate mitral regurgitation. This is particularly because you have had history of COPD which when coupled with a leaky heart valve can become a serious issue.

My honest suggestion keeping in mind all the findings, consult your doctor as early as possible or go to the ER if your shortness of breath is not improving with your medication.

TP stands for Total protein which is normal.

Your liver tests, particularly alkaline phosphatase which you have mentioned is also normal, And your cholesterol and lipids are fine. Don't worry about these. But please do visit your doctor and see what can be done to decrease your CO2 levels, you may need supplemental oxygen or a Bipap and some medicines to improve your heart functioning.

Decreased compliance of the Left Ventricle means, the left side of your heart is not relaxing all the way before it starts to contract again, this could be explained by your mitral prolapse associated with mitral regurgitation but since the systolic function is mentioned as normal which means even though you have a mitral regurgitation it is not causing any major problem right now.

With all these together, I feel it is your COPD which is causing the rise in CO2 levels.

I hope I have answered all your questions effectively. Please do write back if you need further clarifications.

Wishing you good health.

Above answer was peer-reviewed by
Follow-up: Blood test showed WBC 4.4 L and MPV 10.9. Cholesterol-LDL:92 and HDL:91.2. TSH is 2.05. What does all this indicate? 2 hours later
I just visited my heart dr today and he said my echo was fine and didn't want to see me again for 6 months. Also, my family dr's. office called and said my blood work came back fine. I find this worrisome, and that is one reason I went ahead and picked up the blood work on my own. I wanted to see what each thing said. If I didn't have COPD, what would cause my CO2 levels to be high? It wouldn't do any good to go to the ER because I stay short of breath all the time. I am just aggravated that it is high, and they tell me everything is good. I don't want to have something wrong with me, but when I pick up the blood work and it has that it's high, I want to know why. Can you tell me what kind of Dr. I need to schedule an appt. with so they can evaluate me good and see what is going on? I would greatly appreciate it. Thanks! What else could cause the CO2 to be high, and is my level that high?

I am not a smoker and never have been. I only found out that I had COPD when I was denied health insurance about 4 yrs ago for not being honest about my health history. I contacted the insurance co. after receiving a letter of denial saying I had COPD. That was the first I had heard of that. I asked where they got that info and they said it was from the XXXXXXX Regional Hospital. That is the hospital where I live. I had been there and had a chest x-ray done when I was there for a colonoscopy and was never informed that COPD showed up. I contacted the lung dr and he set up an appt. He told me that my x-rays showed up that my lungs were black, but he didn't think I had COPD. He said he thought maybe I had a touch of asthma and maybe the day I was there and had the x-ray there was some inflammation and that my breathing test was fine that he had me do in the past. He said he didn't know why it showed my lungs were black being I had never smoked or been around it a lot. I am just so confused as what to do now.
Answered by Dr. Yogesh D 14 hours later
Brief Answer:
You can consult a pulmonologist.

Detailed Answer:
Hello and welcome back.

Thank you for writing back with these details.

Your CO2 level is high, but that depends on whether it was taken from your vein or an Artery. We generally take samples from arteries to check the blood gases, so I presumed it to be venous blood gas analysis then you don't need to worry as the venous blood will be de-saturated hence will have high CO2 levels.

Apart from this, if you have seen your heart doctor today and if he has said that you are doing good, then you should stop worrying about your heart, as I have explained in my earlier response your echo report is essentially normal as it shows normal LV systolic function.

Now coming to your COPD, you don't have to be a smoker to develop COPD. We are an imperfectly evolved species so we will have such problems as we grow older.

And I do still feel that your breathlessness is more to do with an acute exacerbation of COPD than your heart. My suggestion would be to consult a pulmonologist or an XXXXXXX medicine MD.

I hope this clears all your doubts. Please feel free to write back if you have further questions.

Wishing you good health.

Warm regards,
Above answer was peer-reviewed by
Follow-up: Blood test showed WBC 4.4 L and MPV 10.9. Cholesterol-LDL:92 and HDL:91.2. TSH is 2.05. What does all this indicate? 1 hour later
My CO2 level of 34 that had an (H) beside it stating it was high was from blood drawn for my CBC blood work to check cholesterol and liver and all the things I had asked you about that showed up high like the TSH level and WBC also being low. Do I still need to have it checked with a aterial blood work to see if it is ok? Also, on the WBC, if it is ok, why did it have an L beside it saying it was low?
Answered by Dr. Yogesh D 38 minutes later
Brief Answer:
CO2 of 34 is not high.

Detailed Answer:
Hello Ma'am

Thank you for writing back.

CO2 level of 34 is not at all high, I must have misread your earlier question owing to continuous writing of values next to one another. I am sorry for that. Now I see that you have not mentioned any number for CO2 levels. A value of 34 is slightly below the normal value and it correlates with COPD.

WBC is just under normal reference range, that does not mean much, because each lab has different reference ranges. In my practice I do not consider a value such as yours significant at all. (Majority diagnostic labs take the lower cut off for WBCs as 4.5), yours is 4.4, so nothing to worry.

Your TSH is perfectly fine, the upper limit for TSH is 2.5 as per latest guidelines. So please stop worrying.

You don't need to do any arterial blood gas analysis.

I hope this will further clear up your doubts.

Wishing you a healthy life.

Above answer was peer-reviewed by
Follow-up: Blood test showed WBC 4.4 L and MPV 10.9. Cholesterol-LDL:92 and HDL:91.2. TSH is 2.05. What does all this indicate? 1 hour later
So you think that my number of 34 is because of me having COPD? If I didn't have COPD would that be considered high? I am asking this because no one has this diagnosed but the hospital where I had a chest x-ray several years ago. What test would definitely tell if I had COPD or not? I would like to know once and for all. I appreciate your answers and input.

Wanted to ask one more thing. I feel so short of breath most all the time like I am struggling to get air and it wears me out. It feels awful. I have told this to the dr's. but nothing ever really said. Could the mitral valve prolapse make me short of breath, and if yes, should I have it repaired so I could breathe and not feel like this. I stay so tired all the time also, like I could just lie down and die. I have no energy at all. Would the level of CO2 (34) be high enough to make me short of breath and I may have asked this already, but if I don't have COPD, would this reading of 34 be too high on my CO2?
Answered by Dr. Yogesh D 1 hour later
Brief Answer:
CO2 of 34 is not high whichever way you look at it

Detailed Answer:
Hello and welcome back,

As I have mentioned earlier a CO2 reading of 34 is not high at all. It maybe a misprint, for venous blood it is slightly low as the normal lower cutoff is 35 for venous blood.

If you didn't have COPD it would be considered as normal, and even with that I would still consider that very much normal.

The definitive test for COPD would be an HRCT( High resolution CT scan) of the chest along with a pulomonary function test (Spirometry), I do understand that you had a normal one last time.

Feeling short of breath can be because of both COPD and heart disease. But I would like to stress this again that your heart is functioning well, as it is revealed by the echocardiogram, but yes the mitral regurgitation can cause shortness of breath as the blood pushes back and there will be fluid collection in the lungs leading to shortness of breath.

And please forget about the CO2 levels for now as they are normal.

Your CO2 levels even if you did not have COPD would be considered normal.

I would like to ask you a few questions though to try and understand your condition better..

1. What is your current weight and height?
2. When did this shortness of breath begin?
3. Do you exercise regularly?
4. Do you have shortness of breath when you climb stairs? If yes after how many stairs?

You have mentioned the TSH levels, could you also provide other thyroid tests like, T3 and T4 levels?

It would help me greatly to understand and interpret your results if you can upload a scanned or photographed copy of your reports. You can use the "upload reports" button on the right hand side of this page to do that.

Relax, stress can be a major contributing factor for your breathlessness.

Hope this helps you.

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Follow-up: Blood test showed WBC 4.4 L and MPV 10.9. Cholesterol-LDL:92 and HDL:91.2. TSH is 2.05. What does all this indicate? 1 hour later
I do understand stress can be a contributing factor in shortness of breath, but I just want to feel better and not let something get pushed to the side if it could be the reason I feel so tired and short of breath. As for my height, I am 5ft 6. Weight, 123lbs. Not sure exactly when my shortness of breath started. It comes and goes, but have had it for years. It is worse at times. There are days that it feels like I need oxygen and feels like I am breathing thru a straw. It wears me out and feels like I need to take a deep breath but cant and won't go all the way. It is just miserable feeling. This summer I have been trying to walk about 3 to four times a night at a walking track and walk about 2 miles. When I climb stairs, I do get out of breath and heart rate gets up a bit. My basement stairs consist of about 10 or 11 stairs. The dr said she would check my thyroid because I told her I had been feeling very tired and that my eyebrows were coming out and hair is thinning. The only thing it says is TSH 2.05 (H). It doesn't show anywhere on the blood work report of T3 or T4. I don't have a scanner or printer to send you the report of blood work results. I know you said my CO2 level is on the low side, but the reason I asked about it was because on my report it says CO2 34 (H) and the reference numbers to go by beside it are 22-32, so that would make mine two points above the highest they have listed. Also, my MPV is 10.9 (H) with the levels being 7.4- 10.4. I know that has something to do with the heart, so not sure if that means anything or not. Can you tell me if that is high and what it means? I also have the aneurysm in the atrial septum of my heart. Have had it for years and had it evaluated once with a scope several years ago.
Answered by Dr. Yogesh D 46 minutes later
Brief Answer:
MPV is is fine, Don't worry about aneurysm

Detailed Answer:
Hello again Mam,

Thanks for the information.

You have ideal weight for your height, a relapsing breathing difficulty could most likely be COPD or asthma, since you say it is the drawing in of breath that you have difficulty with it rules out asthma for the most part.

Your exercise tolerance is quite good if you are able to walk 2 miles. So again I will say you are fine. You just need to relax and stop worrying about your health so much.

I do understand we have to rule out all probable causes for breathlessness before we consider stress, after this prolonged discussion I do feel stress maybe playing a role in your case.

As for uploading the reports, you can use your phone camera, take a picture from your phone camera in full size and transfer those photos to your computer via bluetooth or a cable and then you should be able to upload the reports.

The reference ranges for Carbon Dioxide are generally given as mmHg(millimeters of mercury) and for your reference I mention them below,

PaCO2     35-45 mm Hg in arterial blood     38-52 mm Hg in venous blood.

Considering that the sample was taken from a vein, a PaCO2 of 34 is slightly less.

What this means is, you are hyperventilating, causing a condition called respiratory alkalosis. Since it is not very significant and can be affected by the method of blood sample collection (If the blood gets exposed to air then some CO2 will be released and oxygen will be taken up which shows a false positive respiratory alkalosis.

All that says is you have less carbon dioxide in that particular blood sample.

Is this significant in your case? Maybe, since once you have been found to have COPD.... Generally in COPD we see a regular pattern of carbon dioxide retention which increases the carbon dioxide levels in the blood owing to poor gas exchange in the lungs.

That is the reason I wanted you to go to the ER when I thought you had high carbon dioxide levels of above 70 in my first response.

A mild alkalosis or acidosis will be taken care by our inbuilt systems of acid/base buffers.

You say that in your report it says the cut-off for CO2 is 22 to 32, I do not know what unit they are using, because that is no reference range for CO2 which is between 22 and 32. Hence uploading the results will clear these doubts of mine.

Now consider your CO2 values, it is less than what it should be according to the international reference ranges, this means you are either getting too stressed about your health and as a result are hyperventilating or during the sample collection the technician exposed the blood to air briefly.

Coming to your MPV. Up to 12 is considered as normal, the reference range varies again, and as per latest research anything above 12 is considered a risk factor for developing heart attacks, at your level it does not increase the risk. You have the same risk as any other person.

Aneurysms on the atrial septum will not cause any major issue and since you are following up with your heart doctor, he will be able to pick up if there are any changes, so please stop worrying.

It is okay if you don't find T3, T4 levels in your blood work, you can request for them during your next GP visit. Consider a course of antibiotics after discussing with your doctor, if there are any signs of infection in the lungs as that can also cause breathlessness.

Divert your attention to something interesting. Do some activities which you like the most.

I hope I have been able to address all your questions. Please do let me know if I have not addressed any.

Wishing you good health. Keep walking, you will be fine.

Warm regards.
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Follow-up: Blood test showed WBC 4.4 L and MPV 10.9. Cholesterol-LDL:92 and HDL:91.2. TSH is 2.05. What does all this indicate? 59 minutes later
I don't have a very expensive phone, so the pics it takes are very blurred and not good. I did look at the report and where the CO2 of 34 (H) it has [ 22-32] MEQ/L where the units are. Thank you for your opinion and suggestions. I don't feel that my symptoms are from me worrying, I do feel however my worrying is due to the fact I feel bad and can't seem to find out why. Thanks for everything.
Answered by Dr. Yogesh D 20 minutes later
Brief Answer:
MEq/L is not the way of reporting CO2 levels

Detailed Answer:

Thanks for writing back.

CO2 levels are generally not reported as MEQ/L, we measure the partial pressure of Carbon Dioxide and the units for pressure are either Pascals or mmHG.

In pascals the reference ranges are
kPa     5.5[88]-6.8[88] arterial          4.7[88]-6.0[88] venous

And in MEQ/L it is in the range of 23 to 30 mEq/L, and this we do not interpret independently as it is not a very good indicator for giving any valuable information.

And it becomes only significant if it is reduced highly.

So you can relax.

I understand that you are having difficulties breathing and that is causing the worry, but what i meant was by worrying unnecessarily you will be worsening your problem so stop worrying because all your tests are essentially normal.

Good luck.

Above answer was peer-reviewed by
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