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What does this IgM level of 29 indicate?

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Posted on Fri, 13 May 2016
Question: I have an IgM reading of 29. I've been told that's low but I don't know how this is viewed - moderately low, very low? or whether this qualifies me as low enough for IVIG with Medicare rules. What's your opinion on how low it is? Do I qualify under Medicare. Do my blood tests seem to warrant IVIG?

Also my testosterone is 697, which I thought is low, but my hematologist says not low enough for Medicare. I can get a shot through the "men's clinic". What about that?
doctor
Answered by Dr. Anil Parth Desai (4 hours later)
Brief Answer:
Hi I would recommend the following

Detailed Answer:
Dear Mr XXXX, Welcome to HCM ,

Thank you for your query. I did review your question.

The lower value of IgM is 50mg/dl in adults and lower than that is low IgM. However, for IVIG replacement it is IgG and IgG subclass levels that are important. Unfortunately the low immunoglobulins in your case seem to be from chronic oral steroid intake which prohibits Medicare coverage for IVIG to the best of my knowledge.

Testosterone of 697 is between the normal value of 350-890mg/dl which is not low enough to be covered by Medicare and hence it is not clinically indicated also.

I hope this helps sir.

Let me know if you have any questions or concerns.

Wish you all the best.
Sincerely,
Dr Parth Desai
Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Follow up: Dr. Anil Parth Desai (13 hours later)
I feel tired all the time. Is this coming from the steroids which I take for pain? I cannot take opiods, and alleve and similar meds bother my stomach.
doctor
Answered by Dr. Anil Parth Desai (54 minutes later)
Brief Answer:
Hi I would recommend the following

Detailed Answer:
Dear Mr XXXX,

Thank you for your reply query sir.

Yes, most probably low gammaglobulins are due to long term oral steroids. Infact it is a very common cause of low gammaglobulins in adults. I believe your pain was diagnosed as chronic neuropathic pain of the leg as per the history reports. This condition is difficult to manage.I can see you are taking gabapentin for that too along with steroids and other medications including opioids. Opioids does cause constipation and it is a big problem for long term use. Chronic pain, steroids and illness all can contribute to your feeling tired.

However, I would recommend to discuss with your treating doctor regarding Pregabilin (Lyrica) which can be a very good option in this condition. Many patients have found relief with long term use of this medication. If it works steroids can be slowly reduced and its effects will be quickly reversed. Please do not stop taking the steroids suddenly as it can be harmful. It can be gradually tapered if needed.

I hope this helps sir.
Let me know if you have any questions or concerns and I will try to help to best of my ability sir.
Wish you all the best.
Sincerely,
Dr Parth Desai

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Anil Parth Desai

Pathologist and Microbiologist

Practicing since :2009

Answered : 593 Questions

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What does this IgM level of 29 indicate?

Brief Answer: Hi I would recommend the following Detailed Answer: Dear Mr XXXX, Welcome to HCM , Thank you for your query. I did review your question. The lower value of IgM is 50mg/dl in adults and lower than that is low IgM. However, for IVIG replacement it is IgG and IgG subclass levels that are important. Unfortunately the low immunoglobulins in your case seem to be from chronic oral steroid intake which prohibits Medicare coverage for IVIG to the best of my knowledge. Testosterone of 697 is between the normal value of 350-890mg/dl which is not low enough to be covered by Medicare and hence it is not clinically indicated also. I hope this helps sir. Let me know if you have any questions or concerns. Wish you all the best. Sincerely, Dr Parth Desai