Abnormal Labs Advice

I recently had some routine lab work done as part of my annual physical with my primary care doctor. My results indicate some values outside of the normal range, the ones in question by my doctor I’ve highlighted in yellow on the attached spreadsheet. I’ve included my most recent test results (July 2022) and my previous test results (April 2021). My doc has requested that I repeat the metabolic panel again in 2 weeks, and also has referred me to a hematologist to investigate the CBC with differential further. I have an appointment next week.

I’ve read the Abnormal Labs article on your website, listened to the Abnormal Labs podcasts, as well as the Screening podcast. I’m feeling a lot of anxiety about these results, as my online research suggests the possibility of a very serious condition or disease like cancer.

I’m 32 y.o./male in what I believe to be good health (healthy blood pressure and lipid levels). I have no symptoms that would suggest my immune system is compromised - I’ve gotten sick only twice throughout the entire pandemic and both were just colds. I’m the only person in my family and group of friends to not have gotten Covid. I meet the guidelines for physical activity, strength train 4-5 days / week, eat 85%+ natural whole foods, and limit my consumption of alcohol. Regarding the Kidney/Liver function tests - over the past 4 years i’ve had an ultrasound on my kidneys and bladder, and a prostate exam; both of which came back with normal/“unremarkable” results.

I’m just looking for advice on how to proceed. After listening to the screening podcast, i’m wondering if these tests are just causing more worry than anything. I feel like i’ve been on a rollercoaster of emotions between feeling healthy and feeling like there is some unknown condition going on with my body. In the event that my repeated test results are still unfavorable, I think a second opinion will be worthwhile. Does Barbell Medicine offer medical related consultations? I’ve come to really trust the content you provide regarding training and overall health. Thanks for your time.

Hi,

Sorry to hear about this situation. As you may have learned from the content, a healthy 32 year old with no symptoms does not require an “annual physical” or CBC. But now that we have these findings, it’s obviously too late to “un-do” that knowledge.

I think repeating the metabolic panel is a reasonable first step, in particular to see whether that Creatinine measurement normalizes. The white blood cell count is a bit lower than we’d typically expect, but this does not put cancer as the most likely cause, so I would recommend not reading about this on the internet as it is certainly causing more anxiety than it is helping.

I would be happy to consult with you once you have gone through your follow-up and repeat measurements.

I really appreciate your reply and guidance Austin. That sounds like a good plan, I will follow up after completing the follow up and measurements.

Hi Austin,

I wanted to check back in with you and update you on my follow ups.

I was referred by my primary doc to a hematologist to look further into my blood results. The hematologist ruled out serious disease at this time such as cancers or autoimmune disorders. He ordered repeat tests (CBC, metabolic panel) as well as an ultrasound of my liver and spleen. Blood cell counts were normal, Creatinine and AST/ALT still mildly elevated, and ultrasounds confirmed no abormalities. Hematologist referred me back to my primary doctor to follow up.

Primary doctor ordered more blood tests - CBC, metabolic panel; plus GGT, iron/tibc, and hepatitis panel. Only abnormalities still are mild elevation of the AST/ALT creatinine. From my interpretation they look steady with the other tests over the past few months, and have not significantly increased. Primary doc is now ordering another ultrasound of my liver to investigate further.

I’ve not yet asked why he wants to look at the liver again, when I just had an ultrasound within the past 60 days.

Attached are the latest blood test results. At this time I think I would like to setup a consult with you to discuss, ask questions, and get a second opinion on a path forward. Could you provide me some instructions on how to set something up with you?

Many thanks for your time,
John