Should I be concerned about latest bloodwork

[Mattymix]

So I started feeling sick and run down in January with a bunch of random symptoms. My doctor has been running blood work with nothing turning up. Hhowever my latest blood results showed my wbc total doubled but still in normal range and my neutrophils went from 4500 to 7830 which quest labs says is out of range.
WHITE BLOOD CELL COUNT
9.8
3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT
4.40
4.20-5.80 Million/uL
HEMOGLOBIN
14.2
13.2-17.1 g/dL
HEMATOCRIT
40.7
38.5-50.0 %
MCV
92.5
80.0-100.0 fL
MCH
32.3
27.0-33.0 pg
MCHC
34.9
32.0-36.0 g/dL
RDW
13.2
11.0-15.0 %
PLATELET COUNT
253
140-400 Thousand/uL
MPV
10.0
7.5-12.5 fL
ABSOLUTE NEUTROPHILS
7830 H
1500-7800 cells/uL
ABSOLUTE LYMPHOCYTES
1009
850-3900 cells/uL
ABSOLUTE MONOCYTES
745
200-950 cells/uL
ABSOLUTE EOSINOPHILS
186
15-500 cells/uL
ABSOLUTE BASOPHILS
29
0-200 cells/uL
NEUTROPHILS
79.9
%
LYMPHOCYTES
10.3
%
MONOCYTES
7.6
%
EOSINOPHILS
1.9
%
BASOPHILS
0.3
%

[Ken_PA]

Thanks. But no, I'm not a doctor. When my father had lymphoma, I set about to learn as much as I could to help him - but I found it difficult to get my questions answered. So after he died, one day I came here to answer some questions from people who were new to it. That was over eight years ago...

Good luck with your appointment next week. Let me know how it turns out.

[Mattymix]

Will do.

[Ken_PA]

You're welcome, I'm glad to be of help.

Yes, you should want a CBC again to see if neuts have decreased -- if you feel that symptomatically you've improved a lot. Btw, after intense exercise, neutrophils temporarily flood into the muscle in everybody. In your case, you might have had chronic neutrophilia because of some immune process, or else the muscle cells being indepedently destroyed is what attracted the neutrophils and caused creation of more. A chicken or egg kind of thing.

[Mattymix]

Thanks. So are you a doctor? You are very knowledgeable.

[Ken_PA]

Well, if the buspar is affecting your liver, and liver dysfunction raises CK, (and buspar causes dizziness), hasn't any doc suggested stopping the buspar to see if there's improvement? That's especially so if the buspar was taken before symptoms started.

Is the low test from very low BF% and low SFA consumption, on top of lots of endurance exercise?

Maybe a lifestyle change is worth a shot. Or else you might be getting better anyway, and this will pass on its own.

Maybe a post viral syndrome is involved.

Maybe the antibiotics messed up your gut bacteria badly.

The blood glucose was probably just a white coat effect. A1C would tell better.

[Mattymix]

Yeah. Liver enzymes since then have been normal. I have been taking it easy and resting more. I tried to get off the buspar and the side effects were horrible. I have a appointment with a psychiatrist next week to discuss my meds. Do you think I should request another cbc to check my neutrophils and see if they went back 2 normal. By the way thank you for taking your time with me. I truly appreciate it.

[Ken_PA]

The next step would be to describe the January symptoms.

[Mattymix]

This all started in January when I went to walk in clinic not feeling well. They have me a antibiotic and sent me on my way. 3 days in I started have bad stomach pains and bloating at work. I went home with chills and fever. That lasted the night and next day I felt so so. After that I started have pale and floating stools, so Dr. Wanted to check pancreas and gall bladder. At same time I started getting these odd muscle pains all over at random times. Energy level was way down and my anxiety was at an all time high. I was taking buspar for anxiety and not sure if this is causing some of my symptoms. So at that point they started running all kind of test. 24 hour urine test, checked for myeloma, ct scan of abdomen, sent me to a hematologist and still nothing. I will send you my 1st bloodwork after I first got sick. My test levels and livers enzymes were off.

[Mattymix]

COMPREHENSIVE METABOLIC PANEL    
CURRENT RANGEOVER TIME
GLUCOSE
107 H
65-99 mg/dL
           Fasting reference interval
  
For someone without known diabetes, a glucose value ... Show More
UREA NITROGEN (BUN)
17
7-25 mg/dL
CREATININE
1.35
0.60-1.35 mg/dL
eGFR NON-AFR. AMERICAN
66
> OR = 60 mL/min/1.73m2
eGFR AFRICAN AMERICAN
76
> OR = 60 mL/min/1.73m2
BUN/CREATININE RATIO
NOT APPLICABLE
6-22 (calc)
SODIUM
138
135-146 mmol/L
POTASSIUM
4.6
3.5-5.3 mmol/L
CHLORIDE
103
98-110 mmol/L
CARBON DIOXIDE
22
20-31 mmol/L
CALCIUM
10.0
8.6-10.3 mg/dL
PROTEIN, TOTAL
7.7
6.1-8.1 g/dL
ALBUMIN
5.0
3.6-5.1 g/dL
GLOBULIN
2.7
1.9-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO
1.9
1.0-2.5 (calc)
BILIRUBIN, TOTAL
0.7
0.2-1.2 mg/dL
ALKALINE PHOSPHATASE
50
40-115 U/L
AST
49 H
10-40 U/L
ALT
50 H
9-46 U/L
   Out of Range TESTOSTERONE, TOTAL, MALES (ADULT), IA    
CURRENT RANGEOVER TIME
TESTOSTERONE, TOTAL, MALES (ADULT), IA
88 L
250-827 ng/dL
In hypogonadal males, Testosterone, Total, LC/MS/MS,
is the recommended assay due to the diminished
accuracy of immunoassay at levels below 250 ng/dL.  ... Show More
  TSH    
CURRENT RANGEOVER TIME
TSH
3.23
0.40-4.50 mIU/L
  T4, FREE    
CURRENT RANGEOVER TIME
T4, FREE
1.0
0.8-1.8 ng/dL
  CBC (INCLUDES DIFF/PLT)    
CURRENT RANGEOVER TIME
WHITE BLOOD CELL COUNT
6.2
3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT
5.19
4.20-5.80 Million/uL
HEMOGLOBIN
16.2
13.2-17.1 g/dL
HEMATOCRIT
47.1
38.5-50.0 %
MCV
90.8
80.0-100.0 fL
MCH
31.2
27.0-33.0 pg
MCHC
34.4
32.0-36.0 g/dL
RDW
13.9
11.0-15.0 %
PLATELET COUNT
360
140-400 Thousand/uL
MPV
9.6
7.5-12.5 fL
ABSOLUTE NEUTROPHILS
3993
1500-7800 cells/uL
ABSOLUTE LYMPHOCYTES
1383
850-3900 cells/uL
ABSOLUTE MONOCYTES
589
200-950 cells/uL
ABSOLUTE EOSINOPHILS
217
15-500 cells/uL
ABSOLUTE BASOPHILS
19
0-200 cells/uL
NEUTROPHILS
64.4
%
LYMPHOCYTES
22.3
%
MONOCYTES
9.5
%
EOSINOPHILS
3.5
%
BASOPHILS
0.3
%
  VITAMIN B12    
CURRENT RANGEOVER TIME
VITAMIN B12
495
200-1100 pg/mL

[Mattymix]

The pains I get are both shoulder, arms, and legs. They are odd pains. I do exercise a lot but that doesn't make the pain worse or better.

[Ken_PA]

This new info changes everything.

Right away it stands out that the muscle pain, elevated CK and elevated neutrophils are probably related to muscle breakdown. Do you do intense exercise?

What do you possibly do differently that sets the bad shoulder apart from the good one?

If by chance your urine gets dark, be very concerned about rhabdomyolysis.


Why did they test digestive enzymes?

[Ken_PA]

Hi, if you're worried about leukemia, then that doesn't fit. What does fit, for now, would be some infection.

Still, it's strange that your neutrophils became elevated only months after your first symptoms. Maybe it was a virus infection which paved the way for a bacterial infection to take hold. How are you lungs? Any coughing or shortness of breath?

[Mattymix]

No, lungs are fine. Has CT ot a abdomen and all was good. All blood work up to this point had been normal. That is why this surprised me. My energy levels have been coming back and appetite is good. Only symptoms that I'm still having is weird shooting pains and aches on my legs, arms, and shoulder and a lot of dizziness. So far all my doctors have no clue.

[Mattymix]

Specimen: TM477636W
Requisition: 0001919
Report Status: FINAL / SEE REPORT
Collected: 04/11/2018 09:36
Received: 04/11/2018 09:49
Reported: 04/14/2018 21:30
Client #: 66008201

   Out of Range IMMUNOGLOBULINS    
CURRENT RANGEOVER TIME
IMMUNOGLOBULIN A
96
81-463 mg/dL
IMMUNOGLOBULIN G
813
694-1618 mg/dL
IMMUNOGLOBULIN M
27 L
48-271 mg/dL
   Out of Range CREATINE KINASE, TOTAL    
CURRENT RANGEOVER TIME
CREATINE KINASE, TOTAL
206 H
44-196 U/L
  TRYPTASE    
CURRENT RANGEOVER TIME
TRYPTASE
4
<11 ng/mL
The Tryptase test, fluorescent enzyme immunoassay
(FEIA), measures both the Alpha and Beta forms of
Tryptase. Measuring both forms of Tryptase increases ... Show More
  CBC (INCLUDES DIFF/PLT) WITH PATHOLOGIST REVIEW    
CURRENT RANGEOVER TIME
WHITE BLOOD CELL COUNT
6.7
3.8-10.8 Thousand/uL
RED BLOOD CELL COUNT
4.78
4.20-5.80 Million/uL
HEMOGLOBIN
15.2
13.2-17.1 g/dL
HEMATOCRIT
44.2
38.5-50.0 %
MCV
92.5
80.0-100.0 fL
MCH
31.8
27.0-33.0 pg
MCHC
34.4
32.0-36.0 g/dL
RDW
13.7
11.0-15.0 %
PLATELET COUNT
296
140-400 Thousand/uL
MPV
9.8
7.5-12.5 fL
ABSOLUTE NEUTROPHILS
4730
1500-7800 cells/uL
ABSOLUTE LYMPHOCYTES
1260
850-3900 cells/uL
ABSOLUTE MONOCYTES
556
200-950 cells/uL
ABSOLUTE EOSINOPHILS
127
15-500 cells/uL
ABSOLUTE BASOPHILS
27
0-200 cells/uL
NEUTROPHILS
70.6
%
LYMPHOCYTES
18.8
%
MONOCYTES
8.3
%
EOSINOPHILS
1.9
%
BASOPHILS
0.4
%
COMMENT (S)

Leukocyte counts are within reference limits. Neutrophils are mature
segmented forms and leukocyte morphology is unremarkable.
The platelet count is within reference limits and platelet size
appears to be  normal.
The hematocrit is normal and red cells appear to be normochromic and
normocytic..
.
Reviewed by Glen Hortin, MD PhD Show Less
  LD    
CURRENT RANGEOVER TIME
LD
164
100-220 U/L
  AMYLASE    
CURRENT RANGEOVER TIME
AMYLASE
29
21-101 U/L
  LIPASE    
CURRENT RANGEOVER TIME
LIPASE
7
7-60 U/L
  RETICULOCYTE COUNT    
CURRENT RANGEOVER TIME
RETICULOCYTE COUNT, AUTOMATED
1.4
%
RETICULOCYTE, ABSOLUTE
66080
25000-90000 cells/uL
  FERRITIN    
CURRENT RANGEOVER TIME
FERRITIN
370
20-380 ng/mL
  VITAMIN B12    
CURRENT RANGEOVER TIME
VITAMIN B12
371
200-1100 pg/mL
Please Note: Although the reference range for vitamin
B12 is 200-1100 pg/mL, it has been reported that between
5 and 10% of patients with values between 200 and 400  ... Show More
  FOLATE, SERUM    
CURRENT OVER TIME
FOLATE, SERUM
12.4
ng/mL
Reference Range
Low:           <3.4
Borderline:    3.4-5.4 ... Show More
Performing Sites
AMD Quest Diagnostics
CREATINE KINASE, TOTAL
Creatine Kinase Test
Creatine kinase is an enzyme found in muscles, including the heart. Higher levels often indicate muscle damage. Learn more from the Health Library provided by New York-Presbyterian Hospital.
Go to the Health Library website
CBC (INCLUDES DIFF/PLT) WITH PATHOLOGIST REVIEW
AMYLASE
LIPASE
RETICULOCYTE COUNT
FERRITIN
VITAMIN B12
FOLATE, SERUM
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[Mattymix]

This is my previous bloodwork

[Mattymix]

Yew