T Nation

Blood Test Results - Enlarged Liver


#1

Hey Everyone,

I recently had a blood test/urine test at the VA hospital. It came back with elevated bilirubin. My PC doc scheduled an ultra sound, and a second blood test. Ultrasound revealed an enlarged liver. PC doc now has schedule me for Gastroenterology. Unfortunately, earliest appointment was for September 25th. Any idea what might be going on?

I also tested positive for Hep A, however I have been deployed to Iraq from 07-09. And have been told that once you’ve had a vaccine it will always show positive. HEP B and C came back negative.

Since being told about the enlarged liver, I have become aware of a dull throbbing where my liver is located. Previously, I thought it was just indigestion. Also, nothing symptomatic caused me to go in, I just realized I better start taking care of myself, as far as scheduling doctor appointments.

Also, no AAS
Supplements: Whey, BCAA, creatine, dextrose

Blood test from 2009

Whole Blood:
BAND#(CAL) 0.05 k/cmm 0-0.8 Details
BANDS%(MAN) 1.00 % 0-10 Details
BASO#(CAL) 0.00 k/cmm 0.0-0.2 Details
BASO%(MAN) 0 % 0-2 Details
EOSINO#(CAL) 0.00 k/cmm 0.0-0.3 Details
EOSINO%(MAN) 0 % 0-3 Details
HCT 42.5 % 41-52 Details
HGB 15.1g/dL 13.9-18 Details
LYMPH#(CAL) 1.52 k/cmm 1.2-3.6 Details
LYMPHS%(MAN) 29.00 % 25-33 Details
MCH 32.3 pg 27-33.3 Details
MCHC 35.5 g/dL 31.8-37.1 Details
MCV 90.8 um3 80-98 Details
MONO#(CAL) 0.84 High k/cmm 0.14-0.76 Details
MONO%(MAN) 16.00 High % 3-7 Details
MPV 10.4um3 7.4-10.5 Details
PLATELET MORPHOLOGY Normal Details
PLT 156k/cmm 130-440 Details
PLT ESTIMATE Adequate Details
RBC 4.68M/cmm 4.44-6.1 Details
RBC MORPHOLOGY Normal Details
RDW 12.2% 11.5-14.5 Details
RDW-SD 40.4 fL 39.0-52.2 Details
SEG#(CAL) 2.84k/cmm 1.8-7.8 Details
SEGS%(MAN) 54.00 % 54-65 Details
WBC 5.25k/cmm 4.6-10.8 Details

Plasma 2009:
ALBUMIN 4.5g/dL 3.5-5.0 Details
ALKALINE PHOSPHATASE 62 U/L 0-125 Details
ALT 18 U/L 0-40 Details
AST 17 U/L 0-45 Details
BILIRUBIN,TOTAL 2.1 High mg/dL 0.0-1.3 Details
CALCIUM 9.8 mg/dL 8.4-10.5 Details
CHLORIDE 100 mmol/L 98-108 Details
CO2 34 High mmol/L 23-32 Details
CREATININE 1.2 mg/dL 0.5-1.2 Details
GLUCOSE 82 mg/dL 65-99 Details

Blood Test 2017:
BASO # 0.06 k/cmm 0.0-0.2 Details
BASO % 1.1% 0-2 Details
EOSINO # 0.18 k/cmm 0.0-0.3 Details
EOSINO % 3.2 High % 0-3 Details
GRAN % 45.4 Low % 54-65 Details
GRAN # 2.53 k/cmm 1.8-7.8 Details
HCT 41.8 % 41-52 Details
HGB 14.4 g/dL 13.9-18 Details
IMMATURE GRAN.# 0.01 k/cmm 0.00-0.2 Details
IMMATURE GRAN.% 0.2 % 0.00-2.00 Details
LYMPH % 40.9 High % 25-33 Details
LYMPH # 2.28 k/cmm 1.2-3.6 Details
MCH 32.7 pg 27-33.3 Details
MCHC 34.4 g/dL 31.8-37.1 Details
MCV 95.0 um3 80-98 Details
MONO % 9.2 High % 3-7 Details
MONO # 0.51 k/cmm 0.14-0.76 Details
MPV 10.7 High um3 7.4-10.5 Details
NRBC # 0.00 k/cmm 0-0.2 Details
NUCLEATED RBC/100WBC 0.0%/WBC 0-6 Details
PLT 197 k/cmm 130-440 Details
RBC 4.40 Low M/cmm 4.44-6.1 Details
RDW 12.4 % 11.5-14.5 Details
RDW-SD 43.3fL 39.0-52.2 Details
WBC 5.57 k/cmm 4.6-10.8 Details

Plasma 2017:
AFP 1.13 ng/mL 0-6.2 Details
ALBUMIN 4.8 g/dL 3.5-5.0 Details
ALKALINE PHOSPHATASE 55 U/L 0-125 Details
ALPHA-1-ANTITRYPSIN 104 mg/dL 90-200 Details
ALT 18 U/L 0-40 Details
ANION GAP 10 mmol/L 5-15 Details
AST 16 U/L 0-45 Details
BILIRUBIN,DIRECT 0.3 mg/dL 0.0-0.4 Details
BILIRUBIN,TOTAL 1.9 High mg/dL 0.0-1.3 Details
CALCIUM 9.9 mg/dL 8.4-10.5 Details
CHLORIDE 103 mmol/L 98-108 Details
CO2 29 mmol/L 23-32 Details
CREATININE 1.1 mg/dL 0.5-1.2 Details
FERRITIN 216 ng/mL 30-285 Details
GLUCOSE 89 mg/dL 65-99 Details
IRON 153 ug/dL 45-170 Details
IRON SATURATION 49 % 20-55 Details
POTASSIUM 4.6 mmol/L 3.5-5.0 Details
PROTEIN,TOTAL 7.4 g/dL 6.0-8.2 Details
SODIUM 142 mmol/L 135-145 Details
TIBC 312 ug/dL 235-430 Details
TRANSFERRIN 246 mg/dL 175-340 Details
UREA NITROGEN 19 mg/dL 9-20 Details
eGFR 83 mL/min Details

Also Doctor notes from 2017 Ultrasound:

  Findings: 
  The visualized pancreas is unremarkable, with the tail being 
  obscured by overlying bowel gas. 
  The liver is enlarged, with the right lobe measuring 20.3 cm in 
  length. The echotexture is normal. No hepatic mass identified. 

  Patency and normal hepatopedal direction of flow were documented 
  in the main portal vein with Doppler. 
  The gallbladder is normal with no signs of stones, wall 
  thickening, pericholecystic fluid, or sonographic Murphy sign. 
  The spleen is unremarkable, measuring 11.7 cm in length. 
  The kidneys were not evaluated on this limited exam but seen 
  sufficiently well to exclude hydronephrosis. 
  No free fluid in the upper abdomen. 
Impression:
   1. Hepatomegaly. No hepatic mass identified. 
   2.  Normal gallbladder and bile ducts.

#2

AST/ALT are not showing distress.

We sometimes see liver problems increasing SHBG that creates more non-bioavailable SHBG+T that reduces FT and inflates TT that then overstates your T-status. Get SHBG tested or FT and TT then extremes of SHBG can then be inferred.

HTC, RBC are low which can be from a GI bleed or very low-T, or a combination. You can have an occult blood test to rule the GI bleed in/out. Your HTC and RBC are actually lower than typically seen with low T guys.

Total proteins however do not imply low-T.

High MCV: https://en.wikipedia.org/wiki/Mean_corpuscular_volume#High
Could be B-12 - folic acid deficiency. If using heart burn meds, B-12 deficiency and multiple mineral deficiencies are possible. Foot/leg cramps or ability to tense a muscle and lock it up is a sign of magnesium deficiency and most people are magnesium deficiency. You could consider a high potency B-complex multi-vit that also has trace elements including 150mcg iodine and 150-200 mcg selenium.

You took 15 months to post!

Are you 32 years old? We do see a good number of guys here in that age group with hormone problems. Labs: TT, FT, E2. If TT/FT low, follow up with LH/FSH and prolactin. Blows to the head can lower LH/FSH from pituitary damage and then T levels are low.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys - need more info about you
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.

KSman is simply a regular member on this site. Nothing more other than highly active.

I can be a bit abrupt in my replies and recommendations. I have a lot of ground to cover as this forum has become much more active in the last two years. I can’t follow threads that go deep over time. You need to respond to all of my points and requests as soon as possible before you fall off of my radar. The worse problems are guys who ignore issues re thyroid, body temperatures, history of iodized salt. Please do not piss people off saying that lab results are normal, we need lab number and ranges.

The value that you get out of this process and forum depends on your effort and performance. The bulk of your learning is reading/studying the suggested stickies.


#3

KSman,

I appreciate you taking time to reply to my post.

Tomorrow, I will schedule to get the following tested:

SHBG, FT, and TT, E2
Occult Blood test

If TT/FT low, I’ll schedule LH/FSH, and prolactin tests.

I do not take heartburn meds, but do have heart burn quite a bit. I also do get foot/leg cramps every so often. I will purchase some high potency B complex with the traces of iodine and selenium. Also I will find out more about magnesium deficiency, and if present get a supplement.

Yea, it’s a long story for another post maybe…hahah. Anyway, I am 32 in August. Blows to the head, I haven’t had anything that I felt was concerning. I was infantry so a few bar fights, 2 IEDs and 1 EFP, thrown around, etc, but I didn’t have any head trauma that I know of. I feel like an idiot typing this out now without getting it check out.

I’ll read the links you provided.

I’ll post tomorrow with temperatures.

Iodized salt, I am un aware, so I am going to say no. I’ll see what I have and add it to the update.

Thanks again,
Chad


#4

Blasts can cause head trauma. These issues are common in guys with your history. So might be a factor. Do read the first two stickies.


#5

OIF 06-07, Hey man you taking any medications? I started using benzos after deployment, and recently my Bilirubin was a little high. 1.06 up from .90 (its always been in the normal range). So im just over the limit, but I had been drinking a little. Im not super concerned yet, because my other values look good, but it has been creeping up. I did use to drink and mix benzos frequently. SHBG is important, mine is fairly high, more than likely from the prolonged benzo use.


#6

Alphagunner,

Thanks for the reply. I took some anxiety meds for a couple of months, but it seemed to intensify everything, so I stopped. I’ve had a few good friends end up with a grocery bag full of scripts from the VA, one committed suicide, and I didn’t want to go down that road. It’s not that I don’t trust my judgement, but I don’t even want to think about going down that road. I’ll live with the anxiety, and everything that comes with it.

Thanks again for your input.
Chad


#7

MMJ Bro. Sleep was a huge issue for me and its not anymore, I also don’t have issues with waking up screaming/attacking spouse, and don’t “remember” the dreams, so I have way less sleep disturbances. Helps with anxiety too.

Anyhow, I think maybe my bili was high from some partying that I had been doing, drinking and so on. Im going to retest myself also, but this is an interesting thread to me because it seems im in the same boat. Although, not as high obviously. My liver values look good except for my bili.

Any other meds?


#8

Funny, you say that. It makes my anxiety worse. I used to smoke quite a bit before the Army, but it gives me panic attacks now.

No other meds.


#9

I had that issue when I first started TRT. The new “stimulation” made my anxiety worse. Had to switch to a high CBD strain. They make super high CBD strains for kids with seizures and stuff, to prevent them from getting the “negative effects”… Check it out. Best of luck my Sand Hill brother. and keep us updated.


#10

Temp has been @98.6-99.7F for the past couple of days. Ive had a sore throat, which might explain that. I’ll get another reading in a few days.


#11

I don’t know if you’re familiar with the VA, but I’ve requested the tests on Friday. I think it would be quicker to get a new primary care doctor with my current insurance. Thanks for your patience.

Chad


#12

I have my appointment for blood draw tomorrow for:

SHBG
FT, TT
E2

I’ll post results when they are received.

Chad


#13

ESTRADIOL FZN 22 pg/mL ><=29

SEX HORMONE BIND GL RT 39 nmol/L 10-50

PTH-INTACT 22.90 pg/mL 10-65

They haven’t posted TT or FT, and said FT was high. They want me to come in for a second draw.

Also, I haven’t gotten the occult test back yet.


#14

TESTOSTERONE,FREE 176.1 Highpg/mL35.0-155.0Details
TESTOSTERONE,TOT.-Q 708 ng/dL250-1100


#15

SHBG not too bad. For your Total test being 700 its odd that your free test is off the chart.


#16

I am assuming that is why they are retesting me. I thought it was strange as well.


#17

They retesting your liver values too? And Bilirubin?


#18

Hey did those twice as well.


#19

post them up when you get them. Bili especially, I want to see where you went with that since that was what was a little high with me. Ive been taking Sam-e and milk thistle to see if it improves, will post my numbers on my next check.


#20

The original post was the 2nd one. They were almost identical.