MPN Voice
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Hi all I hope the sun is shining in your part of the country. I have been looking at my results and comparing them over the last few months. I was diagnosed last October with early stage MF.

They have all decreased but are still ok but when I looked at LDH it has risen from 675 last November to 737 in February. I haven't a clue what it means so I looked up what the normal range is and it should be a lot lower than that. My haematologist has never mentioned that result but has just said they are all ok.

What exactly should LDH be please.

Janet x

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Hey Janet... :)

I was not entirely sure when I started seeing LDH levels rising in my bloods either...

So a quick bit of research revealed the following:

* What is LDH in blood test results?

Lactic acid dehydrogenase (LDH) is an enzyme that helps produce energy. It is present in almost all of the tissues in the body and its levels rise in response to cell damage. LDH levels are measured from a sample of blood taken from a vein.

* What is the normal range for LDH?

The enzyme LDH or Lactic Acid Dehydrogenase is responsible for creating energy for the cells in the body. It is found in almost all body tissues and can be measured by a simple blood test. Normal LDH levels are generally low and range between 140 IU/liter to 333 IU/ liter (Oct 11, 2013)

When I reread my literature on Ruxolitinib, I noted that one of the adverse effects of taking yet another cytotoxic drug was that this one might also raise my Cholesterol & LDH levels.

I keep a regular track of all my Bloods, and map them to watch for trends etc...

The first thing I noticed was that my LDH & Cholesterol levels immediately started to climb, when I commenced the Jakafi.

My response, was to endeavour to maintain a healthy balanced diet (bearing in mind that I am also a Pescetarian), however, my energy levels improved overall on Jakafi, and I am currently managing to maintain a fairly good workout 2-3 times pw.

Of course, all of this helps correct my rising cholesterol & LDH levels... Which might also prevent a future heart complaint, one lives in eternal optimism of course... :)



PS. I have also lost 12.5kg in 12 weeks... :)


Hi Steve

Thank you for the detailed info. I am not on ruxolitinib so maybe I ought to question these results if I am advised to take it.

I do try and stick to an healthy diet although I do like the odd chocolate muffin lol. I knew I needed to loose some weight. Unfortunately I have arthritis in my spine that limits what I can do.



Hey Janet... :)

No problem, we are all a tad different from one another I guess, as are our complaints.

However, I noted when my MPN journey first commenced, I began by gaining weight, first with HU, and then with Interferon.

I also have a back complaint with bulging discs, but the better my weight, the less of a problem. Hence, it seems like a bit of a catch 22...

The weight that I have now shed is really only a tad more than that excess I gained from when I first became diagnosed... (May 2016) But I am going to try to stick to both my diet & exercise regime for as long as I may...

And I have just realised, it's almost my first MPN anniversary... :)

Janet, please only think of my information as a guide. Your expert medical team are really the best people for you to discuss these issues with.

Best wishes



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Thank you Steve I realise we are all different. I am finding new things out almost every day. I wondered if the higher the level would cause fatigue as I suffer from that on most days and if ruxolinitib raises LDH levels maybe I wouldn't benefit from taking it.



Hey again Janet,

There could be a plethora of reasons why your fatigue grows worse on occasion... however, I believe that it is also perhaps the most chronic of all of my symptoms too...

Some times, I can just feel a tad less fatigued as I do today, however, that is not generally the case though either... much is the pity.

I usually collapse in a heap after my exercise, but not today, although I still feel quite spent all the same...

How are you iron levels Janet? Low iron levels can be a cause of increased fatigue, as can anemia...

Anemia, also spelled anaemia, is usually defined as a decrease in the total amount of red blood cells (RBCs) or hemoglobin in the blood.[1][2] It can also be defined as a lowered ability of the blood to carry oxygen.[3] When anemia comes on slowly, the symptoms are often vague and may include feeling tired, weakness, shortness of breath or a poor ability to exercise. Anemia that comes on quickly often has greater symptoms, which may include confusion, feeling like one is going to pass out, loss of consciousness, or increased thirst. Anemia must be significant before a person becomes noticeably pale. Additional symptoms may occur depending on the underlying cause.[4]

There are three main types of anemia: that due to blood loss, that due to decreased red blood cell production and that due to increased red blood cell breakdown. Causes of blood loss include trauma and gastrointestinal bleeding, among others. Causes of decreased production include iron deficiency, a lack of vitamin B12, thalassemia, and a number of neoplasms of the bone marrow. Causes of increased breakdown include a number of genetic conditions such as sickle cell anemia, infections like malaria, and certain autoimmune diseases. It can also be classified based on the size of red blood cells and amount of hemoglobin in each cell. If the cells are small, it is microcytic anemia. If they are large, it is macrocytic anemia while if they are normal sized, it is normocytic anemia.[4] Diagnosis in men is based on a hemoglobin of less than 130 to 140 g/L (13 to 14 g/dL), while in women, it must be less than 120 to 130 g/L (12 to 13 g/dL),[4][5] Further testing is then required to determine the cause.[4]

Certain groups of individuals, such as pregnant women, benefit from the use of iron pills for prevention.[4][6] Dietary supplementation, without determining the specific cause, is not recommended. The use of blood transfusions is typically based on a person's signs and symptoms.[4] In those without symptoms, they are not recommended unless hemoglobin levels are less than 60 to 80 g/L (6 to 8 g/dL).[4][7] These recommendations may also apply to some people with acute bleeding.[4] Erythropoiesis-stimulating medications are only recommended in those with severe anemia.[7]

Anemia is the most common disorder of the blood, affecting about a quarter of the people globally.[4] Iron-deficiency anemia affects nearly 1 billion.[8] In 2013, anemia due to iron deficiency resulted in about 183,000 deaths – down from 213,000 deaths in 1990.[9] It is more common in females than males,[8] among children, during pregnancy, and in the elderly.[4] Anemia increases costs of medical care and lowers a person's productivity through a decreased ability to work.[5] The name is derived from Ancient Greek: ἀναιμία anaimia, meaning "lack of blood", from ἀν- an-, "not" + αἷμα haima, "blood".[10]

Anyways... just a td more reading for you to have a look through, and don't forget to quiz your medical team about these possibilities when next you meet...

Best wishes Janet


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