High CRP; Gallbladder Stone and More

[Bernadette_Abraham]

Hi @DXB – thank you for sharing all of the details and his lab results. I was able to make out the markers even though they weren’t in English. I’m glad that he’s open to getting a second opinion.

The good news like you mentioned is that his CRP levels have come down significantly, which shows that the antibiotics and IV fluids helped reduce the infection/inflammation.

However, the doctors are right to want to investigate further because there are a few red flags that shouldn’t be ignored. His white blood cell count is still quite high, which means that his immune system is still likely fighting off an ongoing infection or inflammation. His hemoglobin has dropped even more, so the anemia is getting worse, and his albumin levels are low. Both of these suggest poor nutritional status that could slow down healing. His sodium is also low, which could be affecting his energy and mood.

And as you pointed out, his CA 19-9 marker is slightly elevated, which can sometimes indicate issues in the pancreas or bile ducts. This doesn’t necessarily mean cancer, but it does justify further screening, just to be sure. And operating while he’s still in a compromised state could lead to complications.

Now from a functional perspective, there were a few other markers of note:

-His fasting glucose and HbA1C are suboptimal. An HbA1C between 5.7% and 5.9% often indicates pre-diabetes. Ideally, it should be <5.3% so blood sugar regulation is definitely something to take seriously. This can impact liver/gallbladder health so from a root cause perspective, addressing blood sugar should be a key priority.

How is his diet? Does she consume a lot of sweets and flour based products (i.e. croissant, bread, pasta, crackers, muffins, etc)? How is his stress level normally?

-His T3 marker is also clinically low. This means he’s having trouble converting T4 to T3, which is nutrient dependent (iron, vitamin A, zinc, selenium) but also hormone dependent. Any kind of infection/inflammation and poor liver health will affect it as well.

If you take a look at our “Gallstones” handout in our Symptom Dictionary, you’ll see that insulin resistance and hypothyroid function are two primary drivers for the development of gallstones, which can explain his predicament.

And while CA 19-9 is usually used as a tumor marker to monitor certain types of cancer, particularly pancreatic cancer, there are however also other benign conditions that can elevate this marker and are worth investigating:

• Liver Dysfunction: Hepatitis, cirrhosis, or other liver disorders (MRI can rule this out)

• Gallbladder Issues: Cholecystitis or gallstones (Ultra sound and MRI can rule these out)

• Pancreatitis: Inflammation of the pancreas, which can occur due to various reasons, including infections, trauma, or genetic conditions. (MRI can rule this out)

• Cystic Fibrosis: A genetic disorder that affects the exocrine glands, including the pancreas. If he has respiratory or gastrointestinal symptoms, screening for cystic fibrosis might be warranted.

• Biliary Obstruction: Any blockage in the bile ducts (ultrasound/MRI can rule this out)

• Inflammatory Bowel Disease: If he has gastrointestinal symptoms such as abdominal pain, diarrhea, or weight loss, evaluating for Crohn’s disease or ulcerative colitis could be beneficial (does he have any digestive complaints?)

• General Infections or Inflammation: since his CRP has come down, he might want to remeasure with the more sensitive inflammation marker (hs-CRP). Ideally we want it to be <1. Given the high WBC and high neutrophils, it’s likely that he’s still fighting an infection/inflammation, and this alone can be driving up the CA 19-9 marker.

But given the insulin resistance and suboptimal GGT (liver function), taking a closer look at his liver and pancreas would be warranted. A simple MRI/ultrasound can rule this out. It would help rule out a lot that isn’t cancer related – so you can reassure him.

I completely understand why he’s hesitant, but without a proper scan to rule out anything more serious, it could actually put him at more risk during or after surgery.

Maybe you could gently explain it to him like this: The scan isn’t to look for bad news, it’s to make sure nothing is missed and to make the surgery safer. If it’s really just the gallbladder, this will confirm it and give everyone peace of mind to proceed with the surgery.

But hopefully he’ll still be willing to work on blood sugar/thyroid and liver health, because even if the gallbladder is removed, it doesn’t fix the reason why it became diseased in the first place.

I hope this is helpful, and gives you more to share with him.

[DXB]

Thanks so much for the comprehensive feedback Bernadette. Much appreciated

He is diabetic, I forgot to mention that. I can’t say he is great with his diet. And as you pointed out, it could be the underlying reason to this all.

Quick question, he had an abdominal ultrasound which had indicated the issues with gallbladder stone. The liver was found normal. I cannot see comments on pancreas.

The doctors had suggested performing comprehensive MRI, which triggered a massive push back and he left the hospital afterwards.

Do you think that an ultrasound is sufficient? I see MRI is noted in your response to rule out the potential reasons. I guess it is probably the safest way of investigating the matter

I will pass on your feedback to him. I am sure he will value your comments and advice

I may come back here with more updates and test results, as it progresses

Thanks so so much again

[Bernadette_Abraham]

@DXB yes, an MRI is the best way to go if you can convince him. And again, explain to him that it’s not necessarily to find out bad news, but to confirm if it’s in fact safe to proceed for surgery.

We’re here when you need us. I know how difficult it can be to deal with a family member who refuses care. Best of luck with your uncle’s next steps…

[DXB]

Thanks so much Bernadette

[DXB]

Thanks so much Bernadette

[DXB]

Hi again @Bernadette_Abraham

So, my uncle has decided to give himself a month before any medical treatment at the hospital. He is feeling quite down, so he decided to give himself sometime to lift up his spirit again. In the meantime, do you think the following supplements are ok to give to him to support his recovery:

– B12 (In drop form for better absorption)

– Methyl folate

– Magnesium glycinate (Nighttime before sleep)

– Inositol (Nighttime before sleep)

– Proflora – Soil based probiotics (Nighttime before sleep)

The gut and brain axis are so clear at the moment as I fear his stomach problems are leading to some sort of depression. Supplements to facilitate a deep resting sleep along with some good bacteria to support his gut are my initial thoughts. I was also thinking a good B complex as well, but thought less is probably better now for him.

Could you please let me know how you would feel about these supplements?

Thanks so much again for your help.

[Bernadette_Abraham]

Hi @DXB can you clarify what type of treatment he’ll be getting please in a month. Will there be any form of surgery or simply more imaging?

[DXB]

Hi @Bernadette_Abraham . Unfortunately he has made an executive decision for himself that he would be at home finishing his antibiotics and resting only.

I missed before – you had asked whether he has any issues with digestion; he seems to be fine handling his food.

He says he is not in a state of mind to get into an MRI machine or do more investigations.

So after 1 month, he wants to do the gallbladder surgery only.

Our hands tied here unfortunately, all I can offer now is to support his system and recovery as much as possible.

He lost a lot of weight, still not strong. Hence I suggested the supplements above in the meantime. Hoping to visit him in a month and will try to influence him for more tests.

<font face=”inherit”>Could you please let me know your thoughts on the supplements, if you can. I know there is lack of</font><font face=”inherit”> information about his current health. </font>

Thanks again

[Bernadette_Abraham]

@DXB please take a look at our Preparing for Surgery protocol for ways to support the body before and after surgery.

I would be careful giving him B vitamins at this stage because it might push liver detox which currently is compromised due to state of his gallbladder. It could make him feel worse.

[DXB]

Thanks Bernadette. Will check this out