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- Sep 18, 2014
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There's more questions than answers.
Firstly, the use of androgens/anabolics isn't going to push your erythrocytes (red blood cells) to that level. Even with the adjuvant use of GH which can stimulate erythropoiesis (production of red blood cells) to a lesser degree than AAS.
Given your calculated osmolality (BUN, glucose, sodium and potassium) at 298 mOsm/kg is a telltale sign on this particular set of labs, you're insufficiently de/hydrated.
As we all know, insufficient de/hydration will raise the values of erythrocytes (RBC), hemoglobin and hematocrit. Moreso hematocrit, as denoted on your labs. As there's a loss of plasma volume and the blood viscosity increases. However, you're not severely dehydrated given your albumin and calculated osmolality.
Again, there's more questions than answers. How did you become Iron deficient-WITHOUT-anemia. The -without-part is by your quite elevated erythrocytes. Have you overdone the good deed of donating blood, thalassemia trait, ect?
Given your indices (analytes of MCV and RDW), as previously aforementioned, this is microcytic anemia and anisocytosis (differing shapes and sizes of your erythrocytes).
There's no need to chastise you for smoking, cuz you know the potential consequence. However that may be. Smoking in and of-itself can cause premature destruction (hemolysis) of red blood cells, as well the nasty byproduct of carboxyhemoglobin. Purely speculation on my behalf, the possibility of hemolysis of your erythrocytes -may- be associated with your atrociously high erythrocytes?? No speculation on this, smoking increase erythropoiesis due to >carboxyhemoglobin and insufficient oxygen exchange. As previously aforementioned, iron deficiency also revs up erythropoiesis.
If you're like the rest of the population under the current situation taking in copious amounts of zinc prophylactically to help ward off thee virus that lurks amongst us. I'd suggest cutting back on supplemental zinc until you get this current situation at hand addressed.
In some cases where there's not enough iron to be sufficiently synthesized into hemoglobin (red blood cells) and there's abundant zinc in circulation, this can lead to ZPP (zinc protoporphyrin). This subsequently leads to faulty hemoglobin molecules (deoxyhemoglobin and carboxyhemoglobin-reduced tissue oxygenation) as the incorporation of zinc in red blood cells cannot bind to oxygen, nor transfer it appropriately. The longer you're iron deficient, the more this will stimulate erythropoietin, further producing erythropoiesis (red blood cells) by-way of hypoxia inducible factors, therefore continue to see erythrocytosis (elevated red blood cells) in the presence of iron deficiency.
As far as importance, everything else is meaningless to a degree until you get this address. Iron deficiency likes to bastardize our DNA. So keep this in mind.
Have a chitter-chatter with your treating clinician to at a minimum pull an iron panel and a ZPP assay.
Thank you for this Stewie, I was diagnosed as anemic at a very young age it runs in the family we always joke that we need our 10 ours of sleep, it was long before I ever started smoking. Dehydrated I'm thinking was just a product of being fasted, I didn't even drink any water and that is something easy enough to correct. I haven't donated blood in years, I was doing it regularly for a little while until doing some researching and finding out it wasn't helping.
As for the zinc thank you so much for that piece of information, I have indeed been supplementing with zinc I suppose it's time to stop that.
Haven't seen my doc in years but he's a good guy and a smart doctor, a real one that tries to fix the problems instead of just throwing pills at you. I'm going to make an appointment to see him in regards to the iron panel, thank you again Stewie I appreciate it a lot.