Lab abnormalities frighten patient

DEAR DR. GOTT: My most recent lab work, from October of last year, indicated a sudden increase in my platelet count to 446 as compared to 369 in December of 2009. My monocytes increased from 7 to 10 during that same 10-month period. The doctor said not to be concerned, but after reading your article “Low Platelet Count Concerns Reader,” I am concerned! I’m a 55-year-old African-American female. I have been a diabetic since 1998. Should I seek further testing?

DEAR READER: A platelet count measures how many platelets you have in your blood. Their purpose is to help blood to clot. The normal range is between 150 and 450 per microliter of blood and can vary slightly between different laboratories.

An abnormally low count can be an indication of hemolytic anemia, leukemia, and some forms of cancer, inflammation and infections. The count can also be low because of receiving a large blood transfusion or because of specific medications. High counts might be a normal lab variant or be an indication of polycythemia vera, anemia and several other causes.

Your count is not out of the normal range, so if your physician has indicated there is no concern and he or she knows your medical history, I would put my trust in that fact and proceed accordingly.

Monocytes are white blood cells with a single nucleus; they help keep the immune system intact. They make up 1 to 3 percent of the total white blood cells in the body. Modifications can be an indication of changes in a person’s health. Generally speaking, a low count is a good sign, while a high count could indicate a potential problem.

The normal range of monocytes is between 0 and 10 percent. Without knowing your total white blood count, referred to as WBCs, I can only surmise this count is within a normal range.

A difficult experience for a physician is when results are shared with a patient who may not completely understand that slight abnormalities may result from totally benign situations. I am not at all implying you shouldn’t receive a copy, nor am I indicating you shouldn’t question modifications. I am simply stating that levels can change without the occurrence of a medical condition.

Bring your questions to your doctor’s attention and demand answers that meet your expectations. Request that your counts be monitored. If they continue to rise, further investigation is necessary.

Readers who would like related information can order my Health Report “Blood Donations and Disorders” by sending a self-addressed, stamped No. 10 envelope and a $2 U.S. check or money order to Dr. Peter Gott, P.O. Box 433, Lakeville, CT 06039-0433. Be sure to mention the title when writing, or print out an order form from my website: www.AskDrGottMD.com/order_form.pdf.