“Lab results are all normal. Come back in one year”

[Anonymous]

It sounds normal to me. Source: am a Dr.

[Anonymous]

Anonymous wrote:I need ideas on how to respond to the pediatrician and dermatologist who ignore borderline and above normal range lab results. I’ve been fuming about this.
For example, liver enzyme ALT upper limit for labs now is 40 but in reality should be 25, as it was many years ago. Labs moved it to 40 because so many people have liver disease. An ALT lab result of 22 is not perfectly normal.
Hg A1c of 5.8 is not perfectly normal.
Triglycerides results above 100 is abnormal, NOT perfectly normal for kids.

Ugh

Lifestyle changes would be the recommendation for a mildly high A1c.

I don’t know what you’re on about re the AST/ALT- do you think your kid has some silent liver disease? fatty liver disease?

Triglycerides are elevated if not fasted.

OP, you need help for your health related anxiety.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I need ideas on how to respond to the pediatrician and dermatologist who ignore borderline and above normal range lab results. I’ve been fuming about this.
For example, liver enzyme ALT upper limit for labs now is 40 but in reality should be 25, as it was many years ago. Labs moved it to 40 because so many people have liver disease. An ALT lab result of 22 is not perfectly normal.
Hg A1c of 5.8 is not perfectly normal.
Triglycerides results above 100 is abnormal, NOT perfectly normal for kids.

Ugh

Lifestyle changes would be the recommendation for a mildly high A1c.

I don’t know what you’re on about re the AST/ALT- do you think your kid has some silent liver disease? fatty liver disease?

Triglycerides are elevated if not fasted.

OP, you need help for your health related anxiety.

Putting the “anxiety” label on people who know their bodies lead to negative outcomes. FIL passed five weeks after being diagnosed with cancer. His PCP had labeled him with “anxiety”.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I need ideas on how to respond to the pediatrician and dermatologist who ignore borderline and above normal range lab results. I’ve been fuming about this.
For example, liver enzyme ALT upper limit for labs now is 40 but in reality should be 25, as it was many years ago. Labs moved it to 40 because so many people have liver disease. An ALT lab result of 22 is not perfectly normal.
Hg A1c of 5.8 is not perfectly normal.
Triglycerides results above 100 is abnormal, NOT perfectly normal for kids.

Ugh

Lifestyle changes would be the recommendation for a mildly high A1c.

I don’t know what you’re on about re the AST/ALT- do you think your kid has some silent liver disease? fatty liver disease?

Triglycerides are elevated if not fasted.

OP, you need help for your health related anxiety.

Putting the “anxiety” label on people who know their bodies lead to negative outcomes. FIL passed five weeks after being diagnosed with cancer. His PCP had labeled him with “anxiety”.

I bet his PCP needs help for the inaction.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Folks, OP is talking about a child's lab test results.

Yep, sounds like Munchausens by proxy.

+1 it does. She will probably drag her DC to 15 doctors until they can either misdiagnose DC or they do a battery of invasive tests that give DC lifelong health anxiety.

[Anonymous]

Anonymous wrote:You need to feed your kid a better diet.

+1 more fruits and vegetables and less chips, ice cream and cookies.

[Anonymous]

+1 it does. She will probably drag her DC to 15 doctors until they can either misdiagnose DC or they do a battery of invasive tests that give DC lifelong health anxiety.

NP. My daughter's pediatrician diagnosed her with anxiety and disordered eating and referred us to a nutritionist and psychiatrist. None of this sounded right, and thank God I kept pushing, because my daughter's symptoms were caused by a cluster of autoimmune diseases, including celiac, autoimmune thyroid disease, and mast cell activation syndrome. The "anxiety" and weight loss were caused by elevated autoantibodies, which were first not tested and later dismissed. But you know, teenage girl with anxiety, fatigue, and weight loss automatically has mental health problems. No need to dig further or question anything. The pediatrician didn't even listen for hoofbeats, just assumed. I am grateful it didn't require a medical crisis (like thyroid storm) to get a diagnosis.

[Anonymous]

Anonymous wrote:I need ideas on how to respond to the pediatrician and dermatologist who ignore borderline and above normal range lab results. I’ve been fuming about this.
For example, liver enzyme ALT upper limit for labs now is 40 but in reality should be 25, as it was many years ago. Labs moved it to 40 because so many people have liver disease. An ALT lab result of 22 is not perfectly normal.
Hg A1c of 5.8 is not perfectly normal.
Triglycerides results above 100 is abnormal, NOT perfectly normal for kids.

Ugh

If not satisfied, get reports printed and seek second opinion. It would only cost a $30 or so deductible but you'll sleep better.

[Anonymous]

Did you make an appointment to discuss the results with the Dr? I assume what you have in quotes is a communication through whatever portal they use. Make an appointment and bring your concerns and see what they say specifically about the levels you are concerned about.

[Anonymous]

Normal liver enzyme results are normal. Lab result reference ranges are set to reflect population norms. This isn’t a conspiracy to make us all sick; it’s a reflection of better data and analysis. People with liver disease do not have *slightly* elevated enzymes. They have very elevated enzymes over repeated testing over time. Also, some percent of the population has elevated enzymes out of the reference range that have nothing to do with disease or liver injury. Viruses and immunizations push up enzyme readings in some folks too. Finally, if your child really had non-alcoholic fatty liver disease, Tylenol poisoning, or hepatitis, they would have other symptoms you would notice, would show up on exam, or would show in labs.

If you’re worried about A1C, you can control your child’s diet and exercise. If you’re worried about T1diabetes, trust that you’d see symptoms if your child were falling ill. I suppose you can always send a portal message to ask if re-testing in 6 months might be appropriate.

How high over 100 are your child’s triglyceride levels, and is your child older than 10? Absent other issues, like obesity, high LDL, or pancreatitis, a slightly elevated level isn’t a concern. Also most of the time slightly elevated levels are predicting future lifetime risk, not an immediate health crisis. If you are concerned, a reasonable diet at home is always the first line of defense.

Many people over-read their lab reports. Docs look not only for results outside of reference range but for pairs or groups of results that run together when there are certain illnesses or disorders in play. And normal really is normal. Despite what some websites will tell you, “low normal” and “high normal” results are not a thing unless there are accompanying symptoms.

[Anonymous]

What exactly do you think is wrong with your child?

[Anonymous]

Why was the doctor even checking your child's hbA1C??

[Anonymous]

Can you get a referral to an endocrinologist? Your pediatrician maybe at the edge of their expertise. Also, most docs are not looking to optimize your health. They call you healthy til you cross the threshold of unhealthy. So you have to be pretty persistent if you think there is an issue.

[Anonymous]

Anonymous wrote:You sound like a hypochondriac

dp. labs make mistakes. My dc had a scary number in his bloodwork, which led to another, larger blood draw and, then, a frenzied search for an auto immune specialist. Turns out, the original lab was using a range for adults. My kid was fine.

[Anonymous]

How old is your kid? Sometimes puberty causes little abnormalities that are actually fine