Interpreting Lab Result Looking for a lead for the cause of my devastating fatigue

[KERRINGTON]

My RBC is 3.99 LAB anything below 3.8 is low

MY Hemoglobin is 12.3 LAB anything below 11.7 is low

My Hemocrrit 35.4. LAB anything below 35.0

I say my scores look too low, my doc says they are low normal

[Juliegrace]

it looks borderline to me, but you could try an OTC iron supplement or just try to eat a lot of high iron foods. I thought that typically PWP lean towards high iron levels, but I could be misremembering that.

[kaypeeoh]

"Low-normal" for these 3 is not enough info. Low normal RBC might be ab early sign of anemia.

[KERRINGTON in reply to kaypeeoh]

I'll be adding moe tests as I get the energy, thank you.

[fnedorez70]

These are all normal. Do you have any history readings for comparison? I would check your thyroid function

[KERRINGTON in reply to fnedorez70]

I will check with older tests. I will add thyroid and others, little by little. Thanks

[park_bear]

Fatigue is commonplace in Parkinson's - 50% prevalence according to this review:

researchgate.net/profile/Ma...

Fatigue in Parkinson’s Disease: A Systematic Review and Meta-analysis

"The absence of an association between fatigue and motor symptoms in our analyses provides indirect support for the hypothesis that fatigue in PD results from disruption of nondopaminergic pathways...the evidence considered above supports the hypothesis that fatigue is an independent nondopaminergic symptom, which may characterize a “serotoninergic” phenotype of PD."

albertoalbanese.it/wp-conte...

Clinical management of pain and fatigue in Parkinson’s disease

"Table 2

Management of fatigue in Parkinson’s disease

1. Screening and early identification of fatigue

2. Search for contributing factors that are treatable (e.g., lack of sleep, excessive stress, depression, anxiety, orthostatic hypotension)

3. Non-pharmacological therapy: Physical exercise

4. Pharmacological therapy:

a. Methylphenidate (Level C)

b. Antiparkinsonian medications: dopaminergic agents

c. Antidepressant treatment

d. Modafinil"

"The only drug that has shown significant improvement of fatigue in patients with PD in controlled studies is the dopamine transporter blocker, methylphenidate, at a dose of 10 mg three times a day (Level C) [16]. Open label studies have indicated a beneficial effect of some dopaminergic agents such as levodopa and apomorphine infusion. A recent prospective open-label observational study evaluated the effect of intrajejunal levodopa infusion and confirmed a significant improvement of motor symptoms and dyskinesias, but also observed a benefit on non-motor features, including fatigue and pain [17]. One study has shown that bromocriptine, which mainly has a D2 activating function, does not ameliorate fatigue, while pergolide, which has both D1 and D2 activating functions, reduces fatigue. This may suggest a possible correlation between fatigue and the D1 receptor."

[KERRINGTON in reply to park_bear]

Thanks you. Taking a while to go through.

[LAJ12345]

Have you checked B12 and iron?Watch some Ari Whitten energy blueprint.com podcasts on mitochondrial dysfunction. Lots of helpful stuff on there.

[mhberman]

I’d say you can probably improve scores with photobiomodulation using 1070nm wavelength for fastest response. It has been shown in a trial with normal subjects using laser and LED light To boost ATP and oxygenated hemoglobin output 100% more than 810nm.

Marvin Berman PhD

[Ashti]

Though not related to blood work results, I am wondering how much fatigue in PD is related to mitochondria function. My husband is now using Symbyx Biome light therapy with both the hand held wand and the helmet. His energy which had taken a huge hit is not back up to the level of the good old days, but it is now high enough that he can participate in most activities again. He thinks the light therapy makes a significant difference in that regard. Wishing you success in your efforts to regain your energy.

[KERRINGTON in reply to Ashti]

Thank you. I've always been a low energy person, but it became worse as my PD got worse, and it's now to the point where I'm surprised when I wake up in the am.. I think if I loose anymore energy I'll be bedridden. I used the RED LIGHT hat for about a year and stopped because it was interfering with sleep, but I'm much worse now.. I may as well begin again.

[LeharLover62 in reply to KERRINGTON]

Yes maybe try red light again and then work on your sleep. (Melotonin, magnesium, etc)

Also could the worsening fatigue be a sign that you need to adjust your dopamine medications or timing?

[KERRINGTON in reply to LeharLover62]

I went through many sleepless night on and off thru the years, but it resolved itself as my PD got worse. I've been taking 3 Magnesium theonates a day about 4-5 times a week. I have successfully used Melatonin over the years, but had to stop because it made me more fatigued.

[kaypeeoh]

Those three tests were all red blood cell tests. What about white blood cells? What about platelets. A CBC--complete blood count-- is red cells and white cells and platelets.

[KERRINGTON in reply to kaypeeoh]

will reply later, thanks

[chartist]

Have your B12 level checked as PwP tend to have lower B12 levels than healthy controls and B12 tends to decline with age due to poor conversion in the gut. Low B12 can lead to anemia, fatigue and higher homocysteine levels. Higher homocysteine levels cause fatigue, weakness, brain fog, neuropathy and pale skin.

Art

[KERRINGTON in reply to chartist]

Hi, will check...believe all are good..need to get more 'on time' to further reply

Thanks

[KERRINGTON in reply to chartist]

Result of Vitamin B12/Folate Serum Panel Range 200 - 1100 MINE 1595

[chartist in reply to KERRINGTON]

That rules out B12 deficiency, but that high of a level indicates other serious problems as discussed here :

medicalnewstoday.com/articl...

Art

[KERRINGTON in reply to chartist]

I forgot to mention that I take liquid B B12 undeIIr the tongue. I guess I should stop, or cut back ? Then retest and get my new value.

[MarionP]

These are fascinating contributions and I certainly would want them, no doubt about it... The deficiency ideas make a lot of sense to me...but I wonder about a couple of things:

1. Kind of a narrow lens here, which makes me wonder how is it that the patient is doing the ramrodding on the case rather than a doctor doing the investigative work and using a potential wide lens not just a narrow lens.

For instance, how is it that you were the one thinking about or being the one to decide on choose the tests, and really doing the diagnostic work yourself when you have a doctor in the picture? Who is using their clinical experience to think of alternatives that might appear to be something to do with PD but might be its own set of unrelated conditions, like chronic fatigue syndrome, exotic insect disease or parasite, tick bite disease or west nile virus etc etc etc, some other chronic infection or disease that is a matter of internal medicine, some other special disability, malaria, some sort of toxicity or poisoning with chronic effects, some other bacteria or virus, endocrine problems, etc etc etc.? How can anybody really contribute without knowing your whole medical history and including your experiences engagements and results with doctors through the years, or lack thereof?

Seems like there must be a dozen or a couple dozen alternative scenarios that could be contributing or responsible, how is anybody to know whether the suggestions make sense, or fail to make sense because they've already been tried or because something else might be going on and they lack the clinical skills and the medical skills to do a proper medical history and investigation in order to come up with something for you that is actually timely beneficial as well as correct? What has been the history of looking for differential diagnoses, multiple or co-occurring conditions to rule in and rule out? Without taking another 5 years of this hunt-and-peck stuff, which seems very highly informed as far as our friends' contributing ideas here, but seems a little bit blind to me for all the well-informed Ideas? Who here is backing up with their choosing to look into (or not), or what occurs to them (or not), based on having a medical license? Do you have the freedom and luxury of time on your side and survivability on your side and reduced suffering on your side, or do you have a serious problem and is this the way to go about putting your best time and resources into it compared to how serious your situation is? Implied picture seems to suggest that your doctor is not doing anything or is not doing very much or isn't allowed to do very much or doesn't know what to do or you can't get to him or pay him or her or you have some problem accessing it or that you don't want to access it. Seems like there are some obstacles, hopefully not but if there are, then what are they, in case they make a difference. ???

2. Your bio says this has been going on for a very long time. Are there things you know or have experienced that we don't know about? Is this a situation where maybe you need more diagnostic help than is able to be found here (because of a time and severity and those kind of healthcare costs and life costs involved in taking this what seems to be slow and a little bit random approach? Do you have a special situation you can't get access to or afford a real doctor in sufficient time, quantity, and organization needed to track down what's really going on that matches the severity and really severe trouble that you're going through?

Things for you to think about regardless of whether you can or have the ability to go into it here, because if you have only so much energy to expend in doing that, would it make better sense to do it with a professional since you only have the energy to do it once or maybe not even at all?

[KERRINGTON in reply to MarionP]

My doctor is an MD who specializes in Functional Medicine and Metabolic issues. He wrote and ordered prescription for the blood test. I am happy with him as he is very interested in trying to. get to to the root cause of the fatigue.

I must say, there was nothing in my post that should have caused such anger towards me..

[MarionP in reply to KERRINGTON]

If you perceive anger then you are drastically imagining it. Whoever you are, you are completely anonymous and unknown when you present something and we have people equally anonymous, with a wide range from completely unsophisticated to people with a great deal of experience and knowledge, since every one of us were close to it has Parkinson's but also human backgrounds too, and a lot of different backgrounds all the way from zero to considerable... and you know nothing of these when you come into the group, as also is the same that nobody in this group knows anything about you or who you are when you present. So really do you think it wise reading into things because there's nothing to read into.. You have no basis to assume anything and that's how I approach it, no basis to assume anything. Until you have had some experience with somebody. When you say you "never have seen such anger" etc etc maybe it means that you are in error here because if you never have seen such anger, then maybe its true here too... likely that's not what you're looking at now either. So please check your hypersensitivity and testiness at the door, because coming in here with a chip on your shoulder, its kind of lame dont you think? I was just asking a lot of questions because I used to be a career clinician health service provider myself, we always start at the ground, at zero, because we know to, and that includes assuming nothing and knowing nothing in a room where there is considerable background to have to go through in order not to create error and new problems instead of solving the problems presented...that is NOT simple, takes a lot of questions and words, but that is important. Some people have never seen a doctor before or are living in somewhere in the mountains or in a country where healthcare is severely rationed by Canada or Britain, and can't get out... Ever live inside Britain's NHS or Canada's NHS where they can't see somebody for months emergency or not. And when you present with a little bitty comment without a lot of detail, anybody who offers you advice without thinking about all the different realms it could be maybe helping you into a lot of hurt rather than help. And it's not their fault that you're approaching it by showing very limited information, but it takes a professional to not just rush in with some equally blinkered answer that may be very wrong, and there are a lot of people unsophisticated here who may actually take the information and then it becomes a source of further hurt or problem or trouble. I don't do that because it was trained out of me because I got paid as a professional, so starting you down the wrong course just because you don't open with a lot of context, or you present with something very narrow, it's not a good enough reason to respond with premature or bad advice... that's the difference between a professional and an amateur. It's not anger, it's doing it right. Doesn't mean you need flip out when encountering it.

Sometimes also people approach a new situation looking for hand holding instead of actual help. Well if that is the case with you, don't you think it would be most kind to really announce it, that what you want is a shoulder to cry on rather than an actual helping wanted? I think that's polite and reasonable and fair to announce your intentions and what you want. It's perfectly alright, fine if all you want to do is chat rather than actually attack of a problem. But so many people here are in such great pain that the last thing they want to do is have a coffee clatch. How are we supposed to know which one you are unless you say so. OK dear?

So please try and detach emotions from your interpretations because they are entirely wrong, all you know is the words you see, not inflections, not intentions, not tones, we're not in the same room or on a camera together so they can't exist, so the only place that can be coming from is inside your own mind. nothing like that, it's all on your side,...but just like you, I do not like people attacking me and now you have done so explicitly, no need for imagination filling in the blanks in your typed words. I'll assume it was a mistake because that's all it could be. so please consider withdrawing your accusations because they are unfounded an entirely imaginary... So please don't be so hypersensitive, nothing hostile was intended, and I sincerely doubt that any was conveyed. Just pretend the same words were given to you by Mr. Spock from Star Trek. and you will see what I mean. If indeed you are a little cranky well I wouldn't blame you. It doesn't stop me from trying to help you because I took your questions as given without any special hidden messages. There's nothing simple about neurological problems, there's only people who don't realize how complex and risky it is to try to think about a problem and solve it. Sometimes approaching something as very simple is a way to create many more many bigger problems very quickly. In fact it's a bit of a china shoppe. If your wood chipper starts making a lot of noise, wouldn't you wait and start to try figuring things out before sticking your arm in to feel around to see what the problem is?

By the way, an answer to you is not just an answer to you only, since someone else may read these posts and start applying something without realizing that maybe it doesn't apply to them so well, and can get them into big trouble too. I just thought you asked a question for a serious problem you haven't been able to solve in 5 years and actually meant to have it answered. I made the mistake of assuming that you needed some help over looking for some help because so far you haven't been able to find it. So very sorry to have misread you. 🙂

[MarionP]

By the way, here's a PS for you and I really do hope you take it seriously as do all the others trying to help you:

Since you do have a doctor and you say you are happy with him, does he know you were going afield here, expanding now to a lot of extremely serious and consequential questions, asking for what sounds like professional interpretation of a very limited set of actual lab reports, coming out piecemeal, from a bunch of people who are anonymous to you and you know nothing about and have paid nothing for and have no idea what's in their minds or what they're going to give you and whether it's valuable or dangerous.

Does your doctor know you were doing this, and what does he think about you holding him accountable in case something goes wrong with your case if you're fooling around here? Maybe it'll be fair to him you ought to tell him what you're doing so that he doesn't feel you're going to undermine what he does, without telling him, suffer a bad consequence, and blame him. This is just a casual anonymous website you know. Maybe your doctor that you are so happy with should know that you're dancing with more than one (most especially, a "non-medical") partner.

[KERRINGTON in reply to MarionP]

This has nothing to do with my doctor.. I just wanted opinions, ideas, thoughts anyone may have had on 1 little piece of my blood test....I as others do realize this site is not intended as a substitute for medical advice. Also, I have time and energy constraints that thwart me from including more info. Every 3 hrs between meds doses I get approx 2 hrs mediocre on time, and 1 hr of crappy off time in addition to the awful fatigue.

Thank you for all your efforts in my situation.

[MarionP in reply to KERRINGTON]

Well that is good to hear and needed to be said so thank you. Personally, seeing the results you posted for your blood test, and having read your comments and those of other people, also what's not there and what's missing, and knowing how much context it actually takes to be able to interpret that correctly, since it is in a borderline-normal area and without understanding scales or whether tiny differences matter a whole lot in some cases but not a lot in other cases, greatly depending on the medical condition and context overall, and then considering that there might be differences in what a doctor knows about you and differences in the way different doctors practice within their judgment and experience variation, if I were a lay person, I would not even dare to take the bait. And I sure as heck wouldn't do it as a professional because there's not enough information to give a responsible answer, considering that you might actual take action or that somebody else might look at it and take action. And you again are assuming, which professionals will not do, that there were plenty of excuses such as people who read this understand the terms or the circumstances. Your assurance that everybody who enters here understands and is competent to keep themselves safe... From experience to the contrary here I can assure you that's not the case. (That is also why this website has disclaimers, but not such obvious disclaimers that they would run away business, because they are not so much interested in your benefit as their own, because they have to.)

As for presuming to speak for others as you just now did, I think maybe you might have more energy than you think, and that would be a good thing so I hope it is true. I also hope anybody who gives you advice prefixes it with "I could be totally wrong here, but..." If someone else who knows they can hide behind the anonymity and if you harm yourself or somebody else or if somebody else reads this and harms himself, and they wouldn't care, well that's up to you and that's up to them. It HAS happened here before. "Garbage in garbage out," or "free advice is worth the price" (hopefully, sometimes free advice is very expensive). Maybe you are not at risk, but I can't assume that other people who read this and read what you say and what other people are saying can't be harmed. This is not a private conversation after all, people do not come here because they are in perfect shape and that includes ability to interpret and their mental state, so you never know who's going to read it and what state of mind or impairment they might be. The difference between us is I have a protective instinct naturally to "do no harm," nor make convenient excuses that favor or are biased toward the one making the assumption. At your own risk as they say... and need to say and say and say.