This Is MS Multiple Sclerosis Knowledge & Support Community

I'm really sick, and I'm really frustrated. I've been feeling worse and worse for 3-4 weeks now, finally cuminating this week with cough, fever, flu sx. I tested neg for strep, flu a+b.
Had full blood tests run, there are 2 levels that have me concerned
C-reactive protein is 5.1, and the reference range is 0-0.3
RBC sed rate is 29, range is 0-20.
Had the blood run by a Fam practice guy, He called me with the results that he saw significant, ana is neg. rheumatoid factor is slightly elevated.
The upshot is he wants me to go see a rheumatologist and an endocrinologist.
When did these guys become so specialized that no one takes responsibility for anything but moving the pt up the pike.
So, I sent the labs to the neuro by fax, did not hightlight the pages that were of concern to the GP 'cause I wanted fresh eyes.
Turns out the fax didn't get past one of his nurses who has the vast experience of 1 year under her belt.
In the meantime I have been unable to work since monday, and am thinking about calling in for tomorrow.
Anyone have expertise in reading blood tests? I've been weaning from oral steroids, which may be resposible for the increase in inflammatory factors, should I bump up the dosage??
Of course not it's the wekend, and I'm in no physician land......

Hey ms...
Sorry you feel so lousy. My hubby had the flu/strep thing, and it knocked him down. We're all better now, but it is no fun being sick on top of MS!

Your blood numbers look familiar. It was my husband's high ESR rate and high inflammation numbers that sent me looking for answers in the blood. Same as you, no ANA, no APL, no lupus...but thick, hypercoagulated blood. Alot of MSers have the same thing. My endothelial paper talks about stuff you can do to get your inflammation load down with lifestyle. I also think the chronic cerebrospinal venous insufficiency will prove to show us why MSers blood has "erythrocyte sludge"

From a paper by Dr. Franceschi, commenting on Dr Zamboni's research. A study showing that patients with MS had blood which showed a rise in red blood cell aggregation...another phrase used to describe blood which is more viscous, with more C-reactive protein and inflammation-

As many as 45 patients with multiple sclerosis were examined for rheological blood properties. As compared to controls, the group under examination manifested the rise of plasma viscosity, acceleration of red blood cell aggregation. 26.2% of patients demonstrated an appreciable increase of blood viscosity. It is assumed that these changes contribute to the deterioration of microcirculation and aggravate the demyelinating process.


http://www.ncbi.nlm.nih.gov/pubmed/1706550

Dr. Franceschi and Dr. Zamboni both believe this is due to reflux in the venous system. I'm thinking they're right....but not sure neuros will acknowledge this just yet.

Hope you feel better. Check out my paper by clicking on the blue words below...let me know what you think-
AC

msm, one piece of the puzzle: there is an inverse correlation between crp and magnesium...

http://www.nature.com/ijo/journal/v26/n ... 1954a.html
"...low serum magnesium levels are independently related to elevated CRP concentration"
http://care.diabetesjournals.org/cgi/co ... /28/6/1438
"...In age- and BMI-adjusted analyses, magnesium intake was inversely associated with plasma C-reactive protein (CRP) concentrations [and]... with systemic inflammation"

also, is that crp result 5.1 mg/dL?

http://www.ajcn.org/cgi/content/full/84/5/1062
Subjects with the lowest magnesium intake were 3–4 times more likely to have diabetes mellitus, hs-CRP ≥ 3 mg/L, and the MetS than those within the highest tertile of magnesium intake, after controlling for demographic, clinic, and environmental characteristics (Table 3Go). However, after additional adjustment for fiber intake, associations with diabetes and the MetS were no longer significant, whereas the association between hs-CRP ≥ 3 mg/L and the lowest tertile of magnesium intake was significant. However, fiber intake remained inversely associated with diabetes, hs-CRP ≥ 3 mg/L, and the MetS, after adjustments for age, sex, BMI, smoking habits, alcohol intake, physical activity, and intake of total calories, total percentage of fat, and magnesium (Table 3Go). The interactions between categorical magnesium and fiber intakes on diabetes (LR test: 2.74; P = 0.60), hs-CRP ≥ 3 mg/L (LR test: 2.89; P = 0.58 ), and the MetS (LR test: 3.68; P = 0.4) were not significant.

Our results suggest a correlation between dietary fiber and magnesium and GGT[{gamma}-glutamyl transferase] values... Prevalence of diabetes, MetS and its components (with the exception of low HDL cholesterol), hs-CRP ≥ 3 mg/L, and subjects within the highest GGT tertile significantly decreased from the lowest to the highest tertile of magnesium intake, and from the lowest to the highest tertile of fiber intake (Table 2Go). ...GGT has been reported as a marker of fatty liver deposition (a condition clearly related to insulin resistance) but also to oxidative stress...

msmything-- Everyone here will have different suggestions based on his own beliefs and experiences; here are mine: Since I believe in an insulin hypothesis, I encourage you to take your family doctor up on his referral to an endocrinologist. I think many of your problems can be traced to excess insulin.

It is good that you are following up on your blood test results. The C-reactive protein test measures the general level of inflammation in your body; the high sensitivity-C-reactive protein test (hs-CRP) is more specific to inflammation of the heart and is recognized today as a better indicator of potential heart problems than high cholesterol levels; in fact, many annual physical exams these days include a C-reactive protein test. In keeping with my preoccupation with insulin, I think higher levels of inflammation can be attributed to insulin levels.

I am not a physician, and no one can address your particular issues over the Internet; find a compassionate doctor, who is willing to work with you. Perhaps with the help of your family doctor, you can find just such an endocrinologist.

Steroids are very strong drugs and I doubt that anyone would recommend that you "bump up the dosage" without thorough knowledge of your case. From your description, I really think you need to see a doctor.

In a cross-sectional study conducted among participants in the Women's Health Study, an ongoing US primary prevention trial of cardiovascular disease and cancer, we evaluated the correlates of elevated fasting insulin, a marker of insulin resistance, among 349 healthy, nondiabetic women who remained free from clinically diagnosed type 2 diabetes mellitus during a 4-year period from biomarker assessment. Fasting insulin was strongly associated with body mass index (BMI) (r=0.53, P<0.001), C-reactive protein (CRP) (r=0.38, P<0.001), and interleukin-6 (r=0.33, P<0.001). Physical activity level, alcohol consumption, and use of hormone replacement therapy were also related to fasting insulin. However, in multivariable linear regression analysis, BMI and CRP were the only independent correlates of log-normalized fasting insulin. Overall, the final model explained 32% of the variance in log insulin level. In multivariable logistic regression, the fully adjusted odds ratio (OR) for elevated fasting insulin (>=51.6 pmol/L) increased with tertile of BMI, CRP, and IL-6, such that the ORs in the highest versus lowest tertile of each parameter were 9.0 (95% confidence interval [CI], 4.4 to 18.7), 4.4 (95% CI, 1.9 to 10.1), and 2.0 (95% CI, 0.9 to 4.2), respectively. Furthermore, increasing levels of CRP were associated with a stepwise gradient in odds for elevated fasting insulin among both lean and overweight women.

here ya go LC
http://atvb.ahajournals.org/cgi/content ... t/23/4/650

Thank you for your kind replies everyone.

Lyndacarol I do need to see a doctor, however I've seen3 in just this week.
the problem is that will anyone take control of this ship in the storm, puit all the data together

I used the ship metaphor for you Jimmylegs...

My sugar, insulin and countless other results are normal. Serum calcium was low normal, i've begun to address that with increase of my daily supplements and threwin some additional magnesium just in case.

I don't require the hs crp, the likelihood of cardiac involment is very slim.

My lipid profile, and ct calcium scoring have caused my doc to remark
that I'll be one of the people Willard Scott will say happy 100th to on the today show.

As far as your report Cheerleader, Ive read it before thank you for the reminder. iprinted it out today.
Curiously, the best I've felt in many days was tuesday when I had a liter of fluids put in iver 45 minutes, the nurse and doc said it looked like day and night.
I thought I continue to feel better rather than worse. I am pushing fluids, I stay very close to the BR.
With strep, and flu out of the pucture and totally normal WBC count, I'm puzzled..

MS-
Docs will tell you that high CRP and high sed rate show inflammation, and that this is part of having an autoimmune disease. You have MS...therefore, these numbers will be high. This is what the docs said to my husband. Like you, all of his other numbers (glucose, lipids, cholesterol) were normal- (with the exception of liver enzymes.) It's the chicken and egg scenario, which came first, inflammation or MS? We believe that by keeping inflammatory numbers down, you can slow down MS.

We've managed to get his inflammatory marker numbers down with diet, supplements and exercise, and he remains in remission and in pretty good health for a guy with MS.

Endothelial dysfunction is real, it is all about the blood vessels. Endothelial dysfunction has been linked in research to saturated fats, low vit D, viruses, toxins, metals, and stress/cortisol. Especially since all your other numbers are normal- it is worth it to examine how your diet, lifestyle and nutritional profile might be keeping your inflammatory numbers high. There's much you can do. The additional fluids is getting your system moving, helping your kidneys process toxins. Keep hydrated, keep reading.
best,
AC

Hi
I am a nurse but of course I don't know everything. I do know that both Sed rate and C reactive protein are non-specific tests used to measure inflammation. That's all. More testing is needed to figure out what exactly is going on. I am actually not sure that they are elevated with MS. Have you had an infection recently? Headaches?

I also consider myself healthy, despitea couple of dang autoimmune things, I swim as often as I can manage, sometimes 5xweek. I have always eaten a diet very swankish, which probably explains why I remained without a dx of ms till 5 years ago. the Doc estimates 30 years or more of attacks.
The pcp recommended an endocrinologist to monitor how much , if any, my own adrenal system is picking up the slack as I withdraw the oral prednisone I've been dependent on for 15 years due to pemphigus.

headaches are huge for me,and have been worse lately, however that was my presenting symptom that got me into the ER where MS was the resultant dx.

I understand the lifestyle impact on disease prgression, and truly believe that I have more control over MS than any Dr, or DMD.

I just feel SOOO bad, for days now, weeks even

One other weird sx. that us guys might not write of as quickly as a doc. There is a really weird smell coming from my pores. I'm bathing and doing landry constantly trying to escape it.
It was suggested my olfactory nerve may be doing something funky, as none else seems to smell it.

I know I'm just a litany of complaints but there are a lot of good minds here and I'm hoping someting will resonate with someone.

You're doing everything right. The endocrinologist should be able to see if your adrenals are kicking in. 15 years is a long time to be weaning steroids. Some MSers have high ESR and CrP numbers when tested, although it is not "typical" -it is considered part of the inflammation profile. The steroids probably kept those numbers down.

Quercetin and EGCG are terrific anti inflammatory supplements. A milk thistle supplement will keep your liver healthy. Curcumin, garlic, ginger and curry help. Keep up the additional fluids. Body odors can sometimes signal trouble with liver and kidneys processing toxins, proteins and fats and a hormonal imbalance (which you may have coming off the steroids). But (if no one else can smell it-describe what you smell, and have someone get really close...) it may be your MS and the olfactory nerve.

Hang in there...the endo should answer more questions.
best,
AC

here's another one LC
http://www.jacn.org/cgi/reprint/22/6/533.pdf
The Association between Magnesium Intake and Fasting Insulin Concentration in Healthy Middle-Aged Women
eat yer dark leafy greens! anyone read 'tree' by david suzuki? that's where i learned it's the magnesium in chlorophyll that makes it green.

Ms Legs, I'ma doing ya proud, I made a vat of vegetable barley stew, kale, collards, turnip greens, green beans...
Also when this weird odor strted I started to take a supplement called chlorella, hoping to deoderize my self from the inside out. not wroking, but probably not hurting either.
I still smell like a hyena, or some other carrion eater, but no one else seems to notice. I'm puzzled with this particular clue as usually humans can no longer smell their own odors after awhile, even a perfume, and obviously some folks can't smell their own bad breath or body odor.
I hope I'll be able to speak to my neuro tomorrow and have a plan to get to the other side of this.
However, I've begun to prepare myself for the inevitablity of being unable to continue working. Also, I have a staircase in my apt that is just too scary anymore.
Then agin felling better will give me a better atitude I'm sure...
Thanks you..

yum!

i missed this earlier, lol

will anyone take control of this ship in the storm, put all the data together.. I used the ship metaphor for you Jimmylegs...

i don't know what hyenas smell like... i'm guessing sour? metallic? does your pee smell different too?

lol, I'm not really sure about the specifics of hyena odor, but if it's as ugly as they look that maybe comes close.
I can't really describe the smell, neither sweet or sour, not 'sick' person smell, or nursing homish.
I've taken to soaking in an oatmeal bath, with a dash or 2 of Jean Nate, remember that stuff? it was on sale at walgreens...
Within an hour or so, I'm aware of the smell returning.
I can't link it to any change in diet, medication or lifestyle. I'm sure there is a link to some metabolic change, but I can't figure it out..Liver enzymes as well as all the other 'ases' are within normal limits.
There is no change in my pee smell, nor change in color, freq. etc of bowel or bladder.
I feel as if I would love to sit in a very salty sea somewhere with ocean breezes blowing, the poor people downwind...
the smell started about a month prior to me feeling sick. I'm sure there's a connection somewhere?!?!
Puzzles as with much of MS....