I started seeing an MPN specialist on July 1. He tested for lactase dehydrogenase and in was 242. I just had it repeated and it is now 327. My platelets rose from 648 to 725, wbc went from 13 to 16. HCT went down a little bit from 48.3 to 47.5 which I think both are high for female. I am really bothered by the LDH level! Anyone else get tested for that? Thanks!
Kimberly
Some docs check for LDH, but not all do. It is an indicator for some sort of tissue damage. It is very non-specific and can only be interpreted in regards to what all is going on in your body. I expect references ranges can vary, but I think 280 is top of the reference range. I would certainly ask your doc sooner rather than later since you are concerned about how to interpret the results. It may well be no big deal, but better to ask than to worry.
It sounds like WBC and HCT are both a bit high. Be sure to compare the numbers you quoted to the reference range your lab is using to be sure. Interpretation of these numbers also depends on what else is going on in your body. This would be another thing to check with your doc about.
Since your PLT also increased, I would wonder about some kind of injury or inflammatory issue going on. That is just pure conjecture, it it might explain the results.
Hope you get answers soon.
Thanks, Hunter. I have been very fatigued, this week and also noticed a lot of pain in bones and joints. So, I would bet lots of inflammation!
Damn that JAK2 mutation!!!!!!
Indeed!! I hope you have a great weekend!
I had the same thing happen this week. LDH was always normal and it went from 170 to 297. Platelets went from 674 to 723. Everything else was pretty normal for me or in line with past results. She said it could be infection or a injury? We are repeating tests in 6 weeks. She told me not to worry. I have always been in range for LDH until this time. I guess we have a similar situation with the rise in Platelets and LDH. I have ET JAK2 positive and I have been on 2 baby aspirin a day since 2015. I wish you well.
This is exactly what happened to me also. When my hematologist repeated the test 2 weeks later, my LDH dropped down to 160 from 250. By any chance did you do any intense exercise before your LDH test? I told my hematologist that I had gone out for a long run a few days before the LDH test that came back at 250.
Hi Jmctrek,I have not done any strenuous activities. I have been suffering with shortness of breath for quite a while. I am an asthmatic but my new heme/onc Dr suggested I be tested for pulmonary hypertension possibly due to clots. So, he has scared the be geezus out of me! I bought a treadmill and I won’t use it until my pulmonary issues are fully addressed! I have a heart echo and a chest angio CT next week. Thanks for reaching out to me! So very appreciated!
Please keep us posted. I am curious to get a cardiology work up also, to rule out any heart ailments as a result of our condition. My blood pressure has been higher since my diagnosis even though my weight and healthy diet has remained the same. Hope your upcoming tests are uneventful and bring you peace of mind.
My Haem started monitoring my LDH last year. Mine does vary slightly, but is always slightly raised. The reference range for readings has just been changed I believe, with the new range 135-250 U/L. Mine hovers in the mid 250s. Here is a transcript from Patient Power:
Dr. Thompson: Patient Power March21
LDH is an enzyme that’s part of your body’s metabolic process. It helps the normal cells generate energy, and it also helps cancer cells generate energy.
Now, cancer cells, because they’re abnormal cells, they often have abnormal ways of handing normal metabolic processes. Cancer cells that are particularly metabolically active so those that are dividing quickly, those that are growing quickly, will often have high amounts of LDH. Although we don’t think of this happening, cancer cells often spontaneously die. And when they do, they release whatever’s inside the cell into the bloodstream. For example, they release LDH into the bloodstream, and we can measure it in the lab. Essentially, in CLL, the higher the level of LDH generally the more quickly the CLL is growing, and the more quickly it’s going to progress. It correlates with the aggressiveness of the disease. If the levels are very, very high, sometimes it can signal that the disease has changed into a more aggressive disease, which we call a Richter’s transformation, but there are many other causes of a high LDH other than Richter’s transformation.
Usually, Richter’s transformation is associated with the patient feeling very sick. They might have drenching sweats. They might have weight loss. They might even have fevers, and they will usually have a very rapidly growing lymph node or groups of lymph nodes. Essentially, LDH is a marker that we use to determine how aggressive the disease is.
It’s not perfect. And in terms of what’s a normal level, what’s an abnormal level, it actually depends on which laboratory is doing the test, so different laboratories use slightly different methods to do an LDH test. When you look at a lab report they will give you a normal range, they will give you a normal range for that lab, and that will give you a good idea of whether the LDH is normal or it’s elevated.
Hope this is useful.
Thank you for that explanation. It was very interesting and the only article I’ve read that gave me an understanding of LDH.
My first hematologist from 2008 never tested me for LDH levels, but when I switched to an Mpn specialist in 2019, that was the first time I’d heard of it. The first time I got tested, my levels were about 660. Since then my levels have fluctuated from the high 200’s to almost 900. I was diagnosed with Et jak 2 positive in 2008 and post Et Mf in 2019. My doctor never talks about it. Her main concerns are my hemoglobin and platelets.
My husband was recently diagnosed with ET but his bone marrow suggests he may have pre-fibrotic MF. As you can imagine we have gone down rabbit hole trying to understand everything because MF is much scarier place to be. I found a research paper that talks about high LDH being an indicator for MF over ET when you are on the blurry line like he is. Apparently LDH of 500 plus is good indicator you might have MF. The standard deviation in that study was pretty high though so even LDH of high 200s ended up being patients with MF. His LDH is 269 right now. His Dr. is honestly frustratingly hands off. Just handed us a lifeline basically predicting how long he has to live and put him on aspirin. I am currently getting him in touch with an actual MPN expert. Good luck! I hope you get the care you need and that your LDH stops increasing.
Oh my goodness! I hate to hear that news about your husband. I glad you are looking for a specialist! I appreciate your response and I am calling my Dr tomorrow to get his feedback. Good luck to you and your husband!
Mine fluctuates a lot! I’d say try not to worry and see if it hasn’t gone down next time. I think it’s also very sensitive to being handled correctly (like, it can’t be shaken too much) so might just be a lab thing…
Hi KimberlyWith MPN LDH is usually a bit high , mine can be 250 then 500 etc, yours is not a level to be concerned about, your MPN doc should confirm that. My haem doesnt pay much attention to it, if it were 1000-2000 your haem would likely pay more attention to it. What is very important and needs fixing quickly is your HCT, it should be under 45 for men and the US experts say it should be under 43 for women, not sure if the UK guidelines are also 43 for women.
High HCT greatly increases thrombotic risk and above the guideline levels the risks rise exponentially. Again your haem should be making that very clear as it’s the basics.
I hope that helps more than it concerns.
I have PV
Hi Wewo01. Similarly, my LDH level was always around 180 but was flagged as elevated when it reached 250 last week. My platelets also reached 700s when they usually hover around 600s. I remember feeling more fatigued and achy a few days leading up to my blood draw, but wasn’t sure if it was because I had gone out for a long run. My hematologist repeated the LDH test 2 weeks later and it came back down to 160. She said higher LDH readings can also result from mishandling of lab samples. Hope you are feeling better.
I did see that hemolysis of the blood sample can alter the results. Thanks for your reply!
Hi! How are you? Did you ask questions to your heam? I follow this discussion. My LDH has been slightly high science january. I have CALR mutation.
Hello! I am doing okay. Thanks for asking. I did not follow up, yet. I decided to wait for my next lab appointment which I missed because of Hurricane Ida. And that reminds me that I need to make a new appointment! I will keep you posted on my discussion with my hem/onc doc! I hope you are doing well!
Hi! Did you get any answers from the heam? I am curious because i have the same issue 
I decided to move on from that Dr as he refused to listen to me. He does not want any input from his patients. I had messaged him that I was concerned about my hematocrit of 50.4 and that I just had a stent placement in my LAD for a 98% blockage. He said my cardiac blockage was entirely unrelated to my MPN! I saw an MPN specialist a month ago. He is wonderful and disagrees with my other doctor about the cardiac issue being unrelated. My LDH was at 280. The new doctor said nothing about it. I go back this coming Monday for labs and a follow up with him. I’ll ask him about my LDH and at what level there should be concern.
Take care! ☺️
Came across this post. My Docs have been tracking it. This is my numbers for the last ~1 year. The HU I started at the beginning may be helping but time since Covid infection early 2020 might also be relevant.
High ferritin post transplant
High potassium anyone
High platelets for 5 years now 
High alkaline phosphatase
High red and white blood cells
