What Does My Lab Test Results Indicate?

Posted on Tue, 2 Feb 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Tue, 2 Feb 2016 Answered on

Mon, 28 Mar 2016 Last reviewed on

Question : 7 months ago I was at the hospital because I had a slightly strange EKG and elevated creatine kinase levels (I was working out a lot). They have now found out I have a bicuspid heart valve with a discrete insufficiency. Nothing I noticed before.

I was in the hospital for 3 days and got some blood thinners. Then I was told to take some baby aspirin. After 3 weeks on that I suddenly became very out of breath. I got pain in my chest and couldn't train anymore. I continued with the aspirin for another week and started getting pain in my lower back and dizziness. After stopping the aspirin, the lower back pain went away, but I started feeling extremely thirsty, waking up every hour to drink. The blood samples at the emergency didn't show anything. The thirst persisted. It got better when drinking full fat milk. If I stopped the milk it would start again stronger.

At the same time many of my veins have gotten more swollen and visible. The smaller ones are also more visible. Especially around the feet. I also got toe nail fungus on all nails and it all happened in a very short time while this was going on... maybe 2-3 months.

I had an endoscopy 2 months ago because I had some stomach and solar plexus discomfort on and off for the past year or so. The endoscopy showed

- esophagitis, class A Los Angeles
- small hiatal hernia
- gastric mucosal erythema

I also took a bunch of blood tests (see attached PDF). It showed slight hypochloremia and various other things that were slightly off. E.g. high renin, high urinary cortisol, and various other electrolytes.

If it were something with the stomach, why would this state persist? I stopped taking the aspirin 5 months ago.

Maybe I am allergic to aspirin?

I also uploaded the endoscopy results. It has a few pictures. The text is in Romanian.

Answered by Dr. Ilir Sharka (4 hours later)

Brief Answer:
I would explain as follows:

Detailed Answer:
Hello,

Welcome on HCM!

I passed through your medical history and uploaded tests and could explain that the reason why you are experiencing those uncommon symptoms (excess thirst, chest discomfort, shortness of breath, dizziness, etc.) are primary related to high cholesterol and plasma renin levels.

All the other lab findings are consequence of the above hormonal imbalances.

With this I mean increased urine electrolyte levels [potassium, magnesium and chloride] caused by elevated absorption of sodium and water by the kidneys and also increased excretion of the other ions, mediated by increased cortisol levels.

These effects, coupled with increased plasma renin activity lead to increased blood pressure values, which may be responsible for some of your complaints (chest discomfort, shortness of breathing, edema, etc.).

But the main issue to be considered is finding the responsible cause of high renin and cortisol levels.

Coming to this point, several reasons maybe implicated such as:

- Adrenal gland hyperplasia or tumor(s),
- liver & renal dysfunction, such as nephrotic syndrome, etc.

Pain located to lower back and decreased 25 (OH) Vit D3 increase suspicions on adrenal/renal processes.

Also, other extra-renal or -adrenal processes may be responsible for such hormone imbalances.

I recommend consulting with an internist or endocrinologist for a comprehensive differential diagnosis of your actual hormonal imbalance, also investigating for the presence of possible diabetes and hypertension.

Additional abdominal imagine studies (ECHO, CT, MRI, etc) may be necessary to identify possible structural disorders.

You should discuss with your attending doctor on the above mentioned issues.

Hope to have been helpful to you.

In case of further uncertainties, feel free to ask me again.

Kind regards,

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar