Q&A – What’s causing my fatigue?

I had some CBC blood work done tests because I get really bad fatigue, nausea and a headache after walking for a short time. It can be as short as 10 minutes, and anything longer knocks me out for the rest of the day. I have some issues with my knees, possibly IT Anaemia band syndrome; the MRI came back clear. I do not tire from mental activity or an upper-body workout (this one is weird).

Results:

Ferritin is 36 ug/l (normal range, but a bit low?). I take 14mg of iron supplements twice a week. This is up from 19ng/ml earlier this year when I felt amazing. Knee issues started in the summer and brought on the fatigue.

  • MCV 101 fl (slightly elevated)
  • Mean platelet volume 13.1fl (slightly elevated)
  • Platelet distribution width 18.9fl (slightly elevated)
  • Haemoglobin estimation 138 g/l (normal)
  • ESR 2mm/hr (normal)
  • B12 wasn’t checked, unfortunately.

I thought the fatigue was caused by inflammation, but not. Hopefully, the GP will get back to me next week, but in the meantime, I would like to hear CBC opinions from the Internet.

Answer:

Unless checked, these are good indicators: vit D, vit B12, thyroid function, ferritin (stored iron, not the usual), and Anaemia or inflammation markers. Please note that the ‘normal range’ is an average indication of the population at large. It doesn’t mean it is your ‘normal’, especially if close to either end of the suggested normal range. It might be connected to your age, family history, lifestyle, unknown stuff, drinking, foods, work, sleep patterns, sleep quality, hydration, worries…

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Question:

Low platelet count and weak positive LAC result

Hi all! I’m currently around 8 weeks pregnant, and after two miscarriages last year, we did Anaemia blood work and found out I had a weak positive for the lupus anticoagulant check, negative for group ANA CBC exam and have low activated protein C resistance.

My entire life, I’ve had low platelets that at their lowest have been 90k and highest have been 150k. Before I got pregnant for the third time, I consulted both a haematologist and a gynaecologist. Neither expressed concern about my platelet count, and they both encouraged me to proceed with trying to conceive. Since finding out I’m pregnant, My gynae told me to take baby aspirin the first few weeks of pregnancy, and now I’m on clexane (blood thinning injections). I did my CBC platelet test a few days ago, and the number returned to 85, which has worried me. I’ve never had platelets this low!

I also have hypothyroidism, though I’m unsure if it’s related. However, I feel really confused about how I can experience a blood clotting issue while simultaneously having low platelets.

Has anyone ever had to be on blood thinners with a low platelet count? If so, what was their experience, and how did it turn out?

I also got a few tests to rule out Anaemia or APS.

And I would appreciate any help and advice since I’m so lost and alone in this.

I have booked another CBC appointment with the haematologist to find out why my platelets are so low, but I still just wanted to come out here to see if others have been through this or not.

Thank you 🙏🥺

Answer:

Blood thinners are generally well tolerated as far down as a PLT count of 30-50. Given the history of miscarriage and weak positive lupus anticoagulant, the right to consider thrombotic risk in pregnancy and to utilise something to reduce the risk of further miscarriage. This is usually LMWH (clexane in your case) +/- aspirin during the early trimester.

Lupus anticoagulant often causes a low platelet count because the overactive clotting process consumes your circulating platelets, so this all fits together.

Also, I’d like to point out that platelet count is reactive and will fluctuate, as will the lupus anticoagulant. Your blood volume will change during early pregnancy, causing counts to drop due to a dilutional effect.

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Question:

Worried about high lymphocyte count

29 F, non-smoker, BMI = 23.1, rarely drinks, no drugs or medication (except recent antibiotics, see below).

I just did my annual checkup, and my lymphocyte count returned high. After some googling, I’m really worried about having something serious (lymphoma/leukaemia/etc.}

Results in /uL with normal ranges in brackets:

  • Neutrophils: 2,920 [1,900-8,000] NORMAL
  • Lymphocytes: 4,260 [1,200-3,300] HIGH
  • Monocytes: 560 [340-940] NORMAL
  • Eosinophils: 210 [40-410] NORMAL
  • Basophils: 100 [10-100] NORMAL
  • Immature Granulocytes: 10 [1-100] NORMAL

Everything else is within the normal range (WBC, RBC, hematocrit, haemoglobin, platelets, lipid profile, blood sugar).

Could this be serious? I feel fine (no night sweats, weight loss, etc.) and will see my doctor next week about this, but I can’t help but imagine the worst. Two things about inflammation/infection came to my mind:

  • I was positive for chlamydia several weeks ago and finished my round of antibiotics (doxycycline) 4 weeks ago. Could it be linked to my body recovering from infection?

-I sprained my foot pretty badly 3 weeks ago and could barely walk for about 10 days due to pain and swelling. I didn’t take any medicine and just waited to get better. Can this type of inflammation cause high lymphocytes?

Answer:

There is nothing to worry about.Your result wouldn’t have caught the attention of the CBC scientists who conduct these tests. It would have processed automatically because nothing unusual required attention. You may have experienced an acute infection or an allergic reaction on the day you had your blood drawn. Don’t google stuff; you don’t understand what you’re reading. Listen to your doctor. You don’t need to worry if they haven’t said anything about it. Source – I am the scientist who does the Anaemia tests all day.

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Question:

High platelets

Hello, My platelets are 484, and doctors have found no signs of infection. I feel sick a lot and have extreme fatigue with a content dry mouth and really bad night sweats. It’s been 3 months, and my platelets have risen to nearly 500. Should I be worried? What could be causing this? Doctor said cancer could be a worry; what kind of cancer could this be??

Answer:

My platelets started getting high years ago and are generally 580. I think you shouldn’t worry. Thus far, nothing has been discovered by two different haematologists. They don’t seem to worry. Just go to a haematologist and ask for all the blood mutations checks, which is just a more Anaemia comprehensive blood panel test. If that’s ok, then monitor it.