Just been the local lab - in Thailand you can just rock up to the lab and tick some boxes and off and then an email - so important thing to note there is no pre or post consultatation not even in regard to suitable tests and certainly not with regards to results. And just like “speak to your lawyer”, I don’t have a doctor, nor do I have much faith in Thai doctors - its almost mandatory to leave the clinic with a goodie bag of antibotics no matter what.
Male/37/82kg/active. Been on Keto nearly 3 months, lost about 9 to 11kg, of note maybe, one of my first posts on here was about not drinking the same water amount as cabarge days (desk full of empty water bottles) - anyway attached, I’m not too impressed with the results, any thoughts?
2 from for today. and a CBC for ~3 years ago for possible partial comparsion .
Could all this be dehrydration, trying to get habital about drinking more water, I should note that I have a dull pain in left, pain probably an exageration in terms of scale, my phd in googling leads me to mild diverticulitis, or perhaps just dehydration again.
Or something else? any diet tips? Eating plenty of red meat, eggs, actually hammering it so much that watching GameChangers / WhatTheHealth gave me a little pause for thought, but damn RBC low.
Aside from lab ranges meaning near nothing, the things you’re out a range on are by almost nothing. What exactly are you worried about? Seems like you’re looking for a problem where there isn’t one.
Find a wall, smash your head off it a couple times. If you think those garbage propaganda pieces have any merit you should have a mental health consultation. You’re fine.
Nup, no, it’s not dehydration as the Total Protein is at the low end.
Your most recent blood test shows you are anaemic. In the presence of eosinophils might mean you have a gut parasite. A parasite more likely than an infection because there is no white cell response and globulins are low normal.
The lipid profile seems about right. Maybe not fully fat adapted. Total cholesterol is no help. The low HDL is the number to recheck. I’m not used to the units but they are the same as used in the USA, so we’ll get some interpreters soon. Did you drink a coffee within 24 hours of the blood draw?
Are you bleeding from anywhere? Blood in urine or in stools? Black poo. At gums when you brush your teeth? You seem to have adequate platelets and the liver function tests seem all good.
Inflammatory blood markers, glucose, HbA1C, electrolytes, fasting insulin, iron tests?
You might need a worm tablet. You had a low red blood cell count 3 years ago as well. That is worth getting investigated. A physical exam by a good doc and a proper interpretation of the results are probably in order.
Well done on the weight loss.
I’m not a doctor and I am Australian. So, these comments are in no way advisory and may be waaaaay wrong.
It seems to me that your lipids are in fine shape, since your ratio of triglycerides to HDL is quite low. As for the possibility of anaemia, my sister’s take is that the numbers are pretty stable, so unless your next blood test shows a drastic downward trend, you are probably fine. She suggests trying to increase your iron intake by eating iron-rich foods, and avoid accompanying those foods with black tea, since they inhibit the uptake of dietary iron. (Apparently that’s a problem in your part of the world.)
Since you are still relatively new to a ketogenic diet, I would recommend waiting and getting re-tested at the six-month mark. At that point, it would make sense to take stock and see what, if anything, needs to be dealt with. I’d also strongly advise including HbA1C and C-peptide, as well as ferritin and haeme iron tests.
Also, if you feel fine, you may well be fine, but if at any point you stop feeling fine, you should probably do what it takes to find a doctor you can trust and have a consultation.
The anaemic makes sense, I feel I should much fitter at this stage and not tied walking up the 3rd floor condo when the lift is busy, however other times I can go for a 2km jog without a struggle.
So what causing the anaemia - or slight anaemia, digesting the above notes, parasites or low levels of iron - possibly due to amount from source (apparently soil for grazing is poor in thailand) or possibly ingestion (bad guts, tea/coffee blocking etc…)
The parasite sounds interesting, I’ve had food poison several times in SE Asia, and sometimes months of distended stomach issues (always written off to boozzing too much) and regularly eat street food (although not as much nowadays since cooking myself 95%) - sticks of pork, chicken etc… I’m not sure on iron issue, as my freezer looks like an abattoir at the moment, although I have been drinking a lot of black tea recently in subsitutue for coffee…
Plan of attack today - Iron profile (2-3 tests) and stool examination, and redo CBC. I’ll go
today once I think i can poo lol. That should keep me under $40. Await the results this evening. If iron low add supplement and make a more consicious effort to prioritize iron rich food, if parasites i’ll pick up albamazolone from pharmacy along with ACV, coconut oil, garlic, papayya.
If not change by next week - in self - and possibly in a retest, i’ll go find a doctor and do the whole suite of tests.
@anon81060937 thanks, will do next if needed, on a budget so one step at a time. Just done a stool thing and had an iron profile. Get results in next few hours, really hoping for parasites as can get some pills and done, if thats makes sense, and then its boxed off.
TIBC - Total Iron Binding Capacity is my guess. Not sure. But it is low, so worth an Internet search… “blood’s capacity to bind iron with transferrin.”
Transferrin: iron binding and transportation glycoproteins that mediate the transportation of iron in the blood plasma.
But transferrin saturation seems within the reference range. So that is getting confusing for this layperson. My guess would be that it becomes a red blood cell anaemia rather than a plasma transferrin (iron) deficiency anaemia.
TMI Warning: That is good that there are no parasites on that one stool sample. Bummer it’s not the diagnosis and just needs a worming pill. Usually it takes multiple stool samples to find some of the protozoal parasites as they have quiet cyst life cycle stages. But there are no worm eggs. That’s good. Hookworm would be the main contender. One approach is to collect a few samples over a week. Choose the worst ones with mucus or blood, as they can indicate parasite activity in the gut, and combine them as one test. Maybe, Too Much Info? Here is a bit more, if the samples are collected over a week or so, freeze the early ones. By the sounds your Bristol Stool Score is healthy. I reckon move parasites further down the list. They are not ruled out because the eosinophil presence in the white blood cells might indicate they are there. The cells/mm^3 count is about 188. That’s less than 500, which is a more significant result number. Eosinophils can also be present with some allergies or viral infections. Again looking at higher results. The anaemia context points more at parasites. That makes us turn to the red blood cells and the circulation.
It’s good that the red blood cell morphology is normal.
So, we don’t have a clear answer based on this amateur assessment (not a doc, not a doc - quite likely wrong).
There is something interesting in there. It may be academic, if you are feeling well. Especially as it showed on you test 3 years ago as well. How heavy was the boozing… but your liver values look OK.
Maybe consider an online consult with a functional medicine practitioner. Possibly one with tropical environment context or South East Asia experience. Chris Kresser comes to mind but he may be quite spendy (expensive?).
Ha, I’m that tenacious personality type that keeps investigating. Do what you think is best Matt.
Thanks FrankoBear, good to know liver looks OK that was a point of worry before trying to troubleshoot the 3 low markers on CBC.
I’ve just been back the lab, and done by a B12 test, they can use the same blood from this morning FTW, but the results for that wont come to Thursday - they need to send to another lab, grrr, and I’ve started taking 500mg B12 supplements mecobalamin - if it turns out its not B12, 4 days dosage doesn’t look like something too toxic for me to handle - yeah maybe not too advisable to self medicate but im comfortable with the risk on this so far.
I will plot next move fully on Wednesday, but I’m thinking if B12 is low, ill continue doing B12 for another 4 days and get CBC again a week today to see if the RBC is rising with 7 days of B12 supplments, might as well get another stool test then too. I’ll have to ask about freezing, all staff are quiet crazy about CoVid-19 at the moment, so might impact handling. I have purchased a few Zentels also (albendazole - 400mg single dose) so I’m weighing up weather to have - they cost a $1 each so if my reading turns out negative no real loss.
5 weeks completely off the alcohol now - Allen Carr Easy Way. But I did drink too much prior to Keto, which was maybe 7 weeks prior to that 5 weeks…
Your HDL should rise over time. Mine started below 40 (37), and is nearing 60 (57 last time). Interesting that they suggest >60 for men, which is a pretty high HDL for a man. Unless, that is, you’re one of these lean mass hyper-responders (LMHRs), and those people have incredibly high HDLs.
Your trigs are really low, though, lower than mine, and I’ve been LC/keto for years.
Your RBC isn’t that bad. Mine was 4.75, and my test lists 4.2-5.8 being normal. So, by my testing company, yours is normal.
Who are the population that the pathology lab gets the data from? Is it mainly Thai people? The lab will be creating their reference ranges, in part, from the lab tests they do. The general Thai population are likely slightly different to you metabolically? Are you Thai? That difference may be seen in what is regarded as outside of the reference ranges.
