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What do the following blood test results suggest?

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Posted on Tue, 19 May 2015
Question: hello doctor

i am asking query for my daughter aged 8 years and 2 months , today i have done battery of blood investigation , i need your opinion about the abnormal test values.,
she is clinically ok except her height she is tall when compared to her peers .,
she is in 90th centile of height and 90th centile of weight .,

fathers height 188cms mothers height 164
her height is 135cms and weight is 31 kgs

doctor
Answered by Dr. Ajish TP (41 minutes later)
Brief Answer:
These investigations are ok

Detailed Answer:
Hi,

Welcome to HCM. I have gone through the question and understand your concerns.

Since the parents are tall, the target height for your daughter is 170 cm (+/- 8cm) which I fact is in the 95th centile. So she is just in par with her genetic potential.

I have gone through the reports.
My comments:

1. Normal routine blood investigation - no anaemia, mild increase in lymphocytes is non specific. Automated machines will give a high value for lymphocytes.

2. Normal kidney and liver functions

3. Normal electrolytes and calcium. Phosphorus can be high in children especially after a meal.

4. Vitamin D insufficiency ( common in children) - needs vitamin D replacements
B12 is high - is she on vitamin replacement?

5. Hormonal evaluation

Normal thyroid function tests
Normal adrenal sex hormone function - testosterone and DHEAs
Sex hormones - LH is low as expected as she is not yet in puberty
FSH is normal - as this hormone is first to rise before puberty. Is she having any changes of puberty like sexual hair or breast development?

These hormonal tests are normal for her age and her height and weight are expected for her genetic potential. So no need to worry.

Hope I have answered your questions. If you have any further queries I will be happy to help you.

Regards,

Dr Ajish TP [MD,DM]
Consultant Paediatric Endocrinologist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajish TP (38 hours later)
Thanks doctor for your instant reply and sorry I forgetten her hair issue..
Last year she has undergone trichoscan for her hair fall and grey hair ..
And also this year also 2 month back
When comparing both reports there is rapid hair loss in hairdensity which I have attached the reports..
Let me know your opinion from endocrine side and advice. .
Trichologist advice us to get hair mineral analysis. .and few were eleveted and few were below which I attached reports. .
The following supplements are given and she is having for the past 2 months
Mvt (b12 content 200mcg) Ca mg cu k se msm Vit e vit c and omega 3
Thanks expecting your opinion and advice
doctor
Answered by Dr. Ajish TP (10 hours later)
Brief Answer:
These tests are not validated for deficiencies

Detailed Answer:
Hi,

Welcome back.

Hair mineral analysis can be used in toxin exposures like heavy metals, arsenic etc. But it's usefulness in deficiency disorders are not validated.

In her case the hair mineral analysis says she is deficient in potassium and excess in calcium and magnesium. In fact the blood tests are showing normal electrolytes.

Whether these reports can be used as a tool for supplementation is also controversial. If you are confident in your Trichologist, get these supplementations right and retest the hair analysis after 3 months. These are minerals which can be replaced immediately, so the results should be there in single hair cycle ( 3 months)

Decreasing stress by yoga/meditation and good food will always help in hair growth.

Regards
Dr Ajish TP
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ajish TP (35 hours later)
thanks again dr for your reply.,

finally any thing to be done for high phosporous and high b12 if so please advice .,

for low d3 i have started vit d 1000iu once a day .,

she is complying head ache regularly is that related to phosporous and b12

pls advice

doctor
Answered by Dr. Ajish TP (3 hours later)
Brief Answer:
Not related

Detailed Answer:
Hi Mr XXXX,

The answers to your concerns:

1. High B12 is probably due to vitamin supplementation she is on. It is a water soluble vitamin, so excess will be washed out body through urine. So no need to worry about that.

2. Phosphorus is usually seen in higher levels in children. This level doesn't warrant any treatment or further investigations. She can avoid processed foods which is high in phosphorus.

3. Vitamin D Replacement should be higher dose. 2000 iu per day for 2 months followed by 1000 iu per day for 6 months should be enough

4. Head ache is unlikely to be related to this

Regards
Dr Ajish TP
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ajish TP

Endocrinologist

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What do the following blood test results suggest?

Brief Answer: These investigations are ok Detailed Answer: Hi, Welcome to HCM. I have gone through the question and understand your concerns. Since the parents are tall, the target height for your daughter is 170 cm (+/- 8cm) which I fact is in the 95th centile. So she is just in par with her genetic potential. I have gone through the reports. My comments: 1. Normal routine blood investigation - no anaemia, mild increase in lymphocytes is non specific. Automated machines will give a high value for lymphocytes. 2. Normal kidney and liver functions 3. Normal electrolytes and calcium. Phosphorus can be high in children especially after a meal. 4. Vitamin D insufficiency ( common in children) - needs vitamin D replacements B12 is high - is she on vitamin replacement? 5. Hormonal evaluation Normal thyroid function tests Normal adrenal sex hormone function - testosterone and DHEAs Sex hormones - LH is low as expected as she is not yet in puberty FSH is normal - as this hormone is first to rise before puberty. Is she having any changes of puberty like sexual hair or breast development? These hormonal tests are normal for her age and her height and weight are expected for her genetic potential. So no need to worry. Hope I have answered your questions. If you have any further queries I will be happy to help you. Regards, Dr Ajish TP [MD,DM] Consultant Paediatric Endocrinologist