High Albumin and Folate w/hypertension

[joelcoqui]

I dont know which forum to post this question. So many entities... Neuro, Cardo, Endo ????Fit 22 year old athletic male, taking toprol for Hypertension and Cardizem for preventing a-fib. Went to neurologist because of numb sensation on left side, tingling on left foot, feels like lazy eye developing. My mind feels foggy and lightheaded alot. Had several rounds of blood work month after month . Had a negative EEG and MRI of brain. The latest is Albumin at 5.2 and Folate is 20 which is high. Does this tell me anything?? I work out regularly and like to take a little extra protein added to my diet. No steroids involved. No one knows whats wrong and why I have Hypertension to start with but I would love to get to the bottom of this. Help. thank you.

[Londres70]

There is something not correct with your posting in reference to the labs.  A range for creatinine is NEVER 30-200.  That sounds like the GFR.  

I asked you all this before about labs related to your kidneys and you stated they were ok.  

I would recommend repeating these abnormal labs.  You all can reconsult the Endo if you like.  

Well, after getting this info, sounds once again like a kidney issue.  My guesses are you are dealing with a vascular issue or a kidney issue.  

[joelcoqui]

If Im reading it right its the creatinine. the range is 30-200. Seems Im way over. Lab typed  Estimated GFR:101 ml/min/1.73 non african-american  male.

AVE GFR for 20-29 yr. age group 116md/min/1.73sq.m. Chronic Kidney disease less than 60 ml/min/1.73sq.m.

Next to the high albumin its hand written repeat e protein electrophoresis.
My Mom is doing these posts with me and she is at a loss too.
I really appreciate all your help and advice. Mom thinks I should see an endo again to rule out any thyroid issue or pheocromocytoma.

[Londres70]

Well, to find a "physician who thinks outside the box" you will need to find him/her.  That will involve more time and seeing more physicians, which you are against.  So, if you aren't willing to more physicians, I don't see how what I recommend will be of much help.  If you live in the NY area I would recommend going to a teaching hospital and having them take your case.  There are a great deal of teaching hospitals in NY and NYC.  

I saw the bloodwork; that really doesn't tell me much.  Your CPK was a bit raised.  This is an enzyme from brain, heart and skeletal tissue.  When it is raised, this usually indicates some type of injury or damage to these tissues has occured.   So, if I don't know which specific CPK was drawn, I can't tell you much.  Plus, I have no idea about the glucose and hgb labs if you don't give me a number with the lab's normal ranges; can't help you there.  

I didn't mention anything about any Nephrologist in my last post as you stated nothing significate was found when you went.  I did suggest getting an MRA and I believe your Primary/Cardio can order this, but will he is the question.  I did ask you if you have every seen a Vascular Specialist, however, I received no reply from you about that.  

Like I stated, sometimes medical problems can be solved only after long, hard and thourough investigation.  Sometimes the problem is solved after the progression of the disease/disorder and/or after patients present with more and more symptoms.   I have seen a few cases in my career that were not able to be solved.  So, that could be your situation.  Everything unfortunately can't be explained.  

[joelcoqui]

Thank you but havent I done all the recommendations? It is very discouraging to find the medical field not finding an answer. We need a Dr. to think outside the box. Did you see the blood work results I posted? Please dont give up on me. I really need someone elses input. What other test can be done in the vascular/nephrology area? My renins are normal.

[Londres70]

Sorry that you are "giving up" on your situation.  You are correct; I can't do anything else for you if you are giving up.    

I tried to offer the above recommendations as I think this is a vascular issue somehow involving your kidneys.  

I work in the medical field and sometimes we don't have "quick and simple" answers for everything unfortunately.  The only thing we can do in these situations is keep investigating.  

Best of luck.  

[joelcoqui]

Meant to say it took 30 min. for heart to decrease from 187 to 109 in recovery. report also said BP went to 190/92 at peak exercise.& had exercise related arrhythmia.  I just looked at all my bloods from all different labs. Seems the albumin has been high a few times in the past few years.  I found the glucose low 2 times and the CK is 297 and another CPK at 297 where the range should be 30-200. I dont know what that is but it was circled by the MD. Also Hemoglobin was high 2 xs but last year. OK. do we have some ideas?  

[joelcoqui]

Im not a smoker. I sometimes drink socially on weekends. I really cant often because I have to be on the athletic field early in the morning. ElectroCardio Dr at NYU med center said to first control my high BP to see if I go into A-fib and then put me on a monitor. My BP is borderline/average after cardizem was added. My BP has been ok for a year under these meds.. My Cardio who is also my primary takes various bloods every 3 months I see him and does an Electrocardiogram, an Echocardigram each time. Also had done a stress test, carotid sonogram. The stress test says it took more then 10 minutes to get back to normal heart rate. (the stress test was done a year ago) everything else was done recently. The x-ray taken was for my neck and spine. I was shown the misalignment and when Im laying flat on the table one leg is longer then the other. My mom was there to see it too. I personally do not want to go on a maintenance and I dont have time. My mom wants me to at least try the chiro. Did the endo, did the neuro, did the nephro.........Im DONE. I bet I need the ablation surgery but both heart doctors say NO. Cardio says its a risk for a benign condition....nothing wrong with my heart. He is totally against it.It would be different if I go into A-fib once a month but its been good for a year now.  I just have hypertension. I dont beleive it. Im the fit of health at age 22. Thanks so much for your input but there is nothing else you can do. No one can find anything. .

[Londres70]

I have in an earlier post explained about the MRA; an MRA of your head of course.  It will view vessels in the head, etc.  This is NOT an MRI.  

Yes, you have mentioned the PVCs before.  Actually "throwing" PVCs isn't an issue if it is NOT often.  If you are having them often, then that is an issue.  Have you been THOUROUGHLY tested/assessed by this Cardiologist?  What exactly is your diagnosis in regards to your heart?  

What kind of IMAGING did this Chiro do?  Plain flat x-ray or MRI?  And WHAT is "out of alignment?"  To be honest, I personally don't deal with Chiros.  

When was all this testing and labs done?  In the last year or has it been years?

Please tell me you are not a "drinker" or a "smoker."  

[joelcoqui]

an MRA of what?  I feel palpitations but the Cardio Dr. says its premature heart beats. Nothing wrong with my valves...a circulation issue?  blood not getting to my brain?

[Londres70]

I don't think this was any TIA, not to say this wasn't, but I don't think so.  Usually an MRI will show something, but not always.  That's why I recommended the MRA.

I would be careful with "adjustments."  What kind of imaging was done by the Chiro?  i.e. plain flat x-rays or an MRI.  I wouldn't recommend adjustments, especially with the neck.

[joelcoqui]

Chiropractor took x rays and I am out of alignment. I was told to stay away from getting adjusted by them. Is it possible that I had a mini stroke?  Can that show on an MRI? I was told that you really cant tell. I think my A-fib caused a little mini stroke. Whats strange is the cardio net monitor found all normal except that I was having pre-mature beats. What do you think?

[Londres70]

I am not 100% sure if anything will "show up" on the MRA, but at this point if the insurance will cover it I would recommend doing this.  Not sure if the problem is 100% vascular in nature or if it is secondary to something else.  Seems like the possibility of it being Neuro in nature has been ruled out.  I still think your kidneys are tied into this somehow.  

Have you seen a Vascular Specialist already?  

Any imaging of your spine done?  i.e. Cervical or thoracic?  

Any other abnormal labwork other than the Albumin and Folate?  When were these last Albumin and Folate labs drawn and what were the normal ranges for that lab?

[joelcoqui]

echocardiogram, yes.  an MRA no I have. I did have a carotid test on my neck area. Do you think the MRA would show something? I dont know if my insurance co will cover that after just having an MRI.

[Londres70]

Also, have you ever had an Echo of the heart done?  

[Londres70]

Any MRIs of your cervical spine?  

Have you ever had an MRA of the head/brain?  This is different from an MRI; it images the vessels of the head/brain in more detail.  

[joelcoqui]

Thanks so much for trying to help. I feel its a lost cause. I started the toprol after my first a-fib episode which was due to a night of heavy drinking. I learned from that and had a few more hospitalizations due to the a-fib but for no apparent reason...once I choked on food and once I didnt take my meds for 3 days. I have been a-fib free for a year and was also monitored for 2 weeks with a cardio net. The EP said it was normal an no need to ablade.My BP was still a bit high 148/90 so they started the cardizem a year ago.I had a doplar/sono of the kidneys....negative. I have been on and off the protein shakes for over 4 years. I usually take them after a work out. When I run out, I sometimes try a different brand. No difference in my feelings.These drinks are sold in health food stores and everywhere, There is nothing unusual in them. All MDs said it was fine.The high BP actually started when I was 17 but I was in denial so I ignored what the pediatrician told me. It was after the a-fib thing when I started toprol. I went from 100mgs to 50mgs. I went to chiropractor (a trustworthy, smart friend of my moms) and xrays show I am totally misaligned. Im thinking that is next, but I dont want to have a maintenance..The other supplements Im taking are a multivitamin and an Omega-3 fish oil. I eat healthy. I really dont like this sensation on my head like a pressure pushing my eye feeling like Im going to have a lazy eye, I become a little lightheaded and dizzy. When that happens I take my BP and its normal. I had my eyes checked and I have 20/10 vision. What gives????

[Londres70]

I can completely understand how you feel about seeing physicians and specialists.  I went through a medical nightmare myself of no answers, however I am older than you.  I work in the medical field and unfortunately there are NOT "clear-cut" answers for every patient nor is every patient's problems figured out "quickly."  Sometimes it involves in-detail and long investigation.  

Imaging of the kidneys done?  Imaging of the adrenals done?  

In my opinion, I would stop these protein drinks.  What exactly is in "this drink?"  I can't believe that a physician is "ok" with you drinking them.  

Any other supplements that you are taking?  

How long have you been on the Toprol and the Cardizem? Did all this happen before or after starting these meds?  

Sorry to ask so many questions; just trying to help you figure this out.  

[joelcoqui]

Yes had thyroids checked T 2 3 and 4.
Creatinine, BUN, also did the 24 hr urine for catacolamines....checked to see if I had Pheocromocytoma. They also checked for cushings. Because the urine was done 4 times in a year with different results, they called it psuedo cushings as a diagnosis. I went to another endo and they repeated the tests and they found nothing too. I have symptoms of having the pheo tumor but nothing proves it. I have occasional flushing of the face, and occasional  hot sweats. I was on a heart monitor for two weeks to rule out if I need to get ablated because of the past a-fib. I have pre mature flutters but no a-fib now.  I am tired of seeing doctors and specialists...not fair. Im too young for this ****. I need to enjoy life a little. My girlfriend is tired of hearing me complain. Leg tingles, head fogginess, etc... I am losing faith in the medical field.

[Londres70]

This doesn't make sense.  Something is being missed with these physicians.  
The renal panel  I am suggesting is:  BUN, Creatinine, 24 hour urine Creatinine Clearance, GFR, Urinalysis for lytes.  

Thyroid panel done?  That's a basic blood draw.  

Had imaging already of the kidneys?  Correct.  

Your primary physician should be able to order all the above.  

[joelcoqui]

some of the bloodwork on kidneys were renin activity, aldo,basic metabolic panel. Which are you thinking I should get done because there are too many to list that I did already more than once.  Thank you.

[joelcoqui]

yes! saw nephrologist for kidneys
and neurologist for brain and nerves. I see my internist every other month because I need a referral to see another specialist.  I know the stuff. My frustration is no one can find anything. Top Nephrologist from NYU says the extra protein shakes is not an issue and recommended an endocrinologist. Saw him, and nothing wrong there. Its a web, when no one and pin point the problem, they send you to another specialist... Im tired of it.

[Londres70]

I wouldn't be doing any more protein supplement until you discuss this with your physician.  This stuff can be terrible on your kidneys.  

[Londres70]

You saw a Kidney Specialist already?  A Nephrologist?  

A doppler and sono of what?  Your kidneys?    

You stated you saw a Neurologist.  A NEUROLOGIST AND NEPHROLOGIST is NOT the same.  I am talking about a kidney specialist.  

Trust me, it sounds like a kidney issue.  

What blood work have you had in regards to your kidneys?  

[joelcoqui]

Went through that already thank you. They did a doplar and regular sono and its all negative. I went through it all. Had a heart monitor hook up to me for a week too.