[TallDoode]

Hi everyone,

So in one of my Rheumy's lab tests, my calcium was high (10.6) so he sent me to my PCP to follow up on possible hypercalcimea. My doc ran a standard calcium and an ionized calcium test. Both came back completely normal (9.7 and 5.20 respectively). Also had a chest x-ray that was normal. Tracking my labs back to a year ago, my calcium has been rock solid at 9.6/9.7 through five blood tests with my PCP.

A month later I am back at my Rheumy and he runs another set of tests. Again my calcium is high (10.9). The blood goes to two different labs. Now my Rheumy wants me back in because "he was not happy with the way the tests were run" at my PCP and he wants to have them run "correctly".

Just in case it matters, my TSH w/RFL Free T4 came back at 1.26 (normal) so it doesnt appear as though my Thyroid is tweaked. So how can the tests vary so much between labs? I am going nuts with the back and forth from the docs - my PCP saying "dont worry about it" and my Rheumy with his knickers in a twist over what is probably a false reading.

Anyone familiar with the way labs work have any idea how such readings can vary so much? Calcium isnt something that comes and goes. It is either in your blood or it isnt.

Thanks,

dave

 

[keebler]

Hi Dave,

Maybe the normal range for that lab is different for each place?
When I went to an er one time the lab they ran was slightly higher than normal. They sent me on to a bigger hospital and there it was considered in the normal range.

When I get told what the lab test is I try to remember to ask what they consider the normal to be.

Take care,
Lyn

 

[TallDoode]

Well, that is true from a range perspective. The normal range for Quest is 8.6 - 10.2. For St. Rose it is 8.0 - 10.5. Either way, my PCP is saying normal at 9.6 and my Rheumy is saying high at 10.6 last month and 10.9 this month. Even if my PCP saw a 10.6 or 10.9 based on a "high" of 10.5 he wouldnt panic. My Rheumy seems to think I have hypercalcimea or some other thyroid issue and now wants another battery of tests. Sort of tired of getting lab bills in the mail every week.

Personally, I want to wait till I am off the Pred to get retested as who knows what the Pred is doing to me.

Makes you wonder how many things are misdiagnoses/treated when lab tests come back wonky when there doesnt seem to be much cooperation between the labs about normal ranges, and tests apparently.

Thanks for the reply.

dave

 

[T. A. Bossmeier]

Hi Dave,
What Keebler said is probably very true. I know when I have a cbc done at the hematologist office it is usually one full point higher than when I have it done at the lab.

I also found when trying to get a dx with a biopsy that the first lab told the doctor that it was consistent with the use of drugs. When the same slide was sent to the Mayo Clinic they said it was a classic example of lupus rash.

So, things get mixed up and sometimes the norms are different but either way it is confusing for us.

Hang in there and keep after it.

Wishing you better health, TAB

 

[Maia]

I have had lab discrepencies between Quest Diagnostics (in the US) versus my normal university lab where my rheumy runs things. I actually mistrust Quest as it is a for profit lab and one day I just happened to have blood drawn on the same day (regular visit then in emergency room that night) and the results were wildly different. Quest's labs were all normal, and the blood sugar value I knew had to be wrong based on what I had eaten shortly before.

I would go with your rheumy's advice in your shoes given my experience with the lab discrepencies too. I won't send my blood to Quest again...

 

[KarolH]

This is interesting. I use Lab Corp and typically that is the only place I have my blood drawn so I have not had experience with this happening to me.

Crazy that different labs can report different results.

 

[ATS]

this is so interesting! one of the weird things that has happened to me in the past two years is that my labs have suddenly appeared way more 'normal'. and two years ago i was switched from Quest to Lab Corp! wonder if that has something to do with it... hmmmm....

 

[TallDoode]

I have had lab discrepencies between Quest Diagnostics (in the US) versus my normal university lab where my rheumy runs things. I actually mistrust Quest as it is a for profit lab and one day I just happened to have blood drawn on the same day (regular visit then in emergency room that night) and the results were wildly different. Quest's labs were all normal, and the blood sugar value I knew had to be wrong based on what I had eaten shortly before.

I would go with your rheumy's advice in your shoes given my experience with the lab discrepencies too. I won't send my blood to Quest again...

Actually, my rheumy uses Quest and they are the ones with the "high" reading. My PCP uses St Rose (private) lab which has been quite accurate on things like my liver and other tests (I have fatty liver so my ALT/AST tends to run high).

So not sure if I trust Quest or not. Unfortunately my insurance almost dictates that I use Quest but they do pay the other (I just have to pay a bit more).

Thanks

dave

 

[Maia]

I forgot to mention one thing... the fact that the values are different and the ranges are different can be "normal". Different labs can use different testing methodologies/substrates, etc which is why they can have different normal ranges too. But... one method may be "better" than another for detecting certain things in terms of the statistics/technical side of things.

The fact that the values are different is not so much a problem... the problem here is that under one lab they consistently come back as "normal" and the other lab they consistently come back as "abnormal". Perhaps your rheumy knows the specific method his lab is using is better for blood calcium testing? Or he has had bad experiences with his patients with the other lab (much like my bad experience with Quest!).

A high blood calcium level can cause quite a few problems, and is often related to the parathyroid gland instead of the thyroid gland. Have they run a vitamin D level on you too yet? I do see more lab bills in your future unfortunately!

 

[TallDoode]

Interesting question on the Vitamin D. No, they have not tested it but I take a 1000mg Vitamin D suppliment each day (think that is the dose, small white pill but I am too lazy to get up and check) although I dont know that I need to. I read that Pred can cause bone loss so that is why I take it. I have been doing some "Googling" today and found a few sites that indicate that Vitamin D can cause a higher Calcium reading in the blood. I have been on Vit. D since before the first tests he ran. Probably time to stop taking it and see if it makes a difference in the lab tests.

I agree that some labs may be better at some tests but for heavens sake you would think they would standardize or something. False positives can ruin a person's life. I went to a "new" Rhemy for a second opinion on the Lupus and the treatment from my first one (I posted about it in another forum) and the new Rheumy is even questioning my diagnoses based on the labs he is seeing. Now he wants the entire panel run again (8 more vials of blood) so he can see his own results. I want the non-Quest lab to run these tests as it was Quest that was used to run my first series that diagnosed me.

Man I get tired of blood tests. I added it up and I have "donated" like 30 vials of blood in the last six weeks and need to give 8 more Monday. My grandfather lived to 85, never had a blood test and was an alcoholic for 35 years (he stopped drinking 30 years before he died). Seems like every time a blood test is "off" the freaking docs want to throw another pill at you. I am typically a "lets wait for a month and re-run it and see what the results are" kinda guy.

But I digress

Cheers,

dave

 

[KarolH]

Hi Dave,

Your post makes me laugh, the part about another blood test leads to another pill that the doctors throw at you.:rotfl::rotfl::rotfl:

Gosh this really is so true. And your grand father being a alcoholic and living until the ripe age of 85. Maybe we all need to drink more, we'd be healthier.:hehe:

Anyway, I just wanted to interject here to try and make you feel a little better. I was at a follow up with my Rheumy once and he wanted to re-test my blood. They took 23 vials of blood from me.

Afterwards they had me drink orange juice before they let me get up and walk out. I have NEVER had that much blood taken in one shot.

I do hope you get things situated and maybe another lab to send the blood work to is a good idea. A new set of eyes so to speak.:wink2: