Hi @mtnlife, we’re often our own worst enemies when it comes to all things medical. I don’t know why we tend to think of the most negative possible outcome but that’s just the way we’re built! That just feeds into the anxiety, when in reality most of what we fear never materializes. So i hope I can help tamper down your anxiety over the bloodwork and having essential thrombocythemia.

From the Mayo Clinic site:”Although there's no cure for essential thrombocythemia, treatments can control symptoms and reduce the risk of complications. Life span is expected to be normal despite the disease.”

Like you mentioned, the CBC is obvious because your doctor is suspecting a blood disorder, in your case too many platelets. So it stands to reason they’ll want a full peek at your blood levels; Red blood cells, white blood cells and the subtypes such as lymphocytes, neutrophils, etc., and platelets (size and amount)

You’re concerned because a metabolic panel and LDH test were ordered and not sure why. Basically, the comprehensive metabolic panel (CMP) is a series of blood tests that give your doctor a snapshot of your body’s liver and kidney function and electrolytes. That’s actually a fairly routine lab to run so it’s not out of the norm at all for your doctor, when trying to narrow down a diagnosis for you, to order these tests. They give a good picture of the function and health of your body’s operation. I have blood draws every 2 months for a CBC with differential, LDH, CMP, magnesium. Just routine.

The LDH is lactate dehydrogenase and that blood test can show if there is any tissue damage occurring in the body. Having an elevated amount doesn’t necessarily mean you have a medical condition. It can also be affected by an injury, disease or an infection, and even some medications. So the fact that yours was just slightly elevated isn’t anything to cause alarm.

We have to look at blood work from the perspective of our doctors. Those tests are a means of unraveling a mystery that needs solving. An example is if your red blood and white counts are normal but your platelets are high, then your doctor can dismiss certain other disorders and narrow it down to the platelets. If your LDH is high they may look for liver or kidney damage by ordering other tests to narrow that down. Our bodies are incredibly complicated and it’s amazing the amount of information our blood and cells hold. The only way to know is by sampling. So don’t be afraid if there are more blood draws in your future. They are essential to diagnosing.

From reading some of your previous replies, you’re already on a low dose blood thinner. If that is keeping your platelets from being sticky and causing blood clots, that may all that’s needed for you. There are other medications available that can help slow the progression and side effects of ET.

What are you fearing the most?

I ran high LDH for the first few years after diagnosis. Normal in the 5 yrs I have been taking HU. LDH + EGFR+ metabolic panel + CBC are just part of the routine blood tests. I think most hemos will run some or all of these tests more frequently when you first start HU to monitor its effects. Abundance of caution? Doesn't mean they think there are additional problems. I think as time goes on, anxiety goes down. Outside of a stroke or coronary/pulmonary thrombosis, none of what goes on with ET is an emergency. But it's anxiety making when you are first diagnosed.