1. < Blood Cancers & Disorders

MGUS been since 2015: Are these numbers normal?

Posted by ehicks2201 @ehicks2201, 1 day ago

Can anyone advice me if these numbers are normal doc says they are.
Ferritin 573,IGA 445, Immunofixation Interp, Serum abnormal, Kappa Free light chain 24.8, CO2 19, Alkaline Prosphatase 185, Alt 41,Hemoglobin 14.5, Hematocrit 41.6,Lumphocytes Absolute auto 3.31
Doc said numbers are good for MGUS, I am have fatigue after 9:00 am wiped out still work a full time job, ringing in ears, joint pain, green urine with bubbles, night sweats. Any advice would be helpful
thank you in advance

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jisca | @jisca | 1 day ago

I have also been diagnosed with monoclonal gammopathy and my major symptom is fatigue. Fortunately I am retired but I have to nap every day which kind of messes up my life. Feel very sympathetic to you. Don’t know how I would continue to work. Does anyone have suggestions for us?

REPLY
tias | @tias | 1 day ago

I was just diagnosed this year with MGUS. I wish I could be of help. I have peripheral neuropathy and trying to determine it's cause was how the MGUS was discovered. I do tire easily and if I overdo it one day, I usually can do very little the next.

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harty | @harty | 14 hours ago

Those numbers are far from normal. I would get a second opinion from a specialist.
I would also look into taking curcumin. Not a panacea.
Harty

REPLY
dcuste | @dcuste | 10 hours ago

Many people don't appreciate AI. But with that said, here is what ChatGPT thinks about your numbers...

Thanks for sharing those numbers. Let's walk through them in the context of **MGUS (Monoclonal Gammopathy of Undetermined Significance)** to see what's possibly important and what may need further attention or follow-up.

---

### 🔍 **Lab Results Breakdown**

| **Test** | **Your Value** | **Reference Range (typical)** | **Comments** |
| ------------------------------ | -------------- | -------------------------------------- | ---------------------------------------------------------------------------------------------- |
| **Ferritin** | 573 ng/mL | \~20–300 (men), \~10–200 (women) | 🔴 **High** — may indicate inflammation, liver issue, or iron overload (not usually from MGUS) |
| **IgA** | 445 mg/dL | \~70–400 mg/dL | ⚠️ **Mildly Elevated** — depending on lab, may suggest IgA MGUS or early progression |
| **Serum Immunofixation** | Abnormal | Normal | ⚠️ **Concerning** — confirms presence of a monoclonal protein; essential in MGUS diagnosis |
| **Kappa Free Light Chains** | 24.8 mg/L | 3.3–19.4 mg/L (depending on lab) | ⚠️ **High** — needs to be interpreted **with Lambda and ratio** |
| **CO₂ (bicarbonate)** | 19 mmol/L | 23–30 mmol/L | 🔴 **Low** — may suggest **metabolic acidosis**, possibly from renal stress |
| **Alkaline Phosphatase (ALP)** | 185 U/L | 44–147 U/L | 🔴 **High** — could be from bone turnover (watch in MGUS → smoldering myeloma) or liver issues |
| **ALT** | 41 U/L | 7–56 U/L | ✅ Normal |
| **Hemoglobin** | 14.5 g/dL | \~13.5–17.5 (men), \~12.0–15.5 (women) | ✅ Normal — no anemia currently |
| **Hematocrit** | 41.6% | \~38–50% (men), \~35–45% (women) | ✅ Normal |
| **Absolute Lymphocytes** | 3.31 K/μL | 1.0–4.8 K/μL | ✅ Normal — no lymphoproliferative shift seen |

---

### 🧠 **What This Might Mean for MGUS Monitoring**

* ✅ **You’re not currently anemic** or showing classic signs of marrow suppression.
* ⚠️ **Elevated kappa light chain** could suggest **progression risk**; the **kappa/lambda ratio** is key — if you have that, I can interpret more precisely.
* ⚠️ **Immunofixation abnormal** confirms monoclonal protein — expected in MGUS but monitored closely for changes.
* ⚠️ **ALP is high** — may indicate **increased bone turnover**, which can be relevant in **smoldering myeloma** or bone involvement.
* ⚠️ **Ferritin is high** — not typically related to MGUS unless liver inflammation or other metabolic stress is involved.
* ⚠️ **CO2 low** — suggests **acidosis**, which might point to **early kidney stress**, especially if light chains are being filtered out.

---

### 📈 Summary

These results do **not confirm progression**, but there are some **red flags** worth monitoring:

* **Repeat and trend** light chains (kappa/lambda + ratio)
* Consider **bone scan or skeletal survey** if ALP remains high
* Watch for kidney function (CO₂, creatinine, eGFR)
* Ferritin elevation should be evaluated further — iron studies, liver enzymes, CRP

---

REPLY
2 replies
Mentor
John, Volunteer Mentor | @johnbishop | 5 hours ago
In reply to @dcuste "Many people don't appreciate AI. But with that said, here is what ChatGPT thinks about your..." + (show)
@dcuste

Many people don't appreciate AI. But with that said, here is what ChatGPT thinks about your numbers...

Thanks for sharing those numbers. Let's walk through them in the context of **MGUS (Monoclonal Gammopathy of Undetermined Significance)** to see what's possibly important and what may need further attention or follow-up.

---

### 🔍 **Lab Results Breakdown**

| **Test** | **Your Value** | **Reference Range (typical)** | **Comments** |
| ------------------------------ | -------------- | -------------------------------------- | ---------------------------------------------------------------------------------------------- |
| **Ferritin** | 573 ng/mL | \~20–300 (men), \~10–200 (women) | 🔴 **High** — may indicate inflammation, liver issue, or iron overload (not usually from MGUS) |
| **IgA** | 445 mg/dL | \~70–400 mg/dL | ⚠️ **Mildly Elevated** — depending on lab, may suggest IgA MGUS or early progression |
| **Serum Immunofixation** | Abnormal | Normal | ⚠️ **Concerning** — confirms presence of a monoclonal protein; essential in MGUS diagnosis |
| **Kappa Free Light Chains** | 24.8 mg/L | 3.3–19.4 mg/L (depending on lab) | ⚠️ **High** — needs to be interpreted **with Lambda and ratio** |
| **CO₂ (bicarbonate)** | 19 mmol/L | 23–30 mmol/L | 🔴 **Low** — may suggest **metabolic acidosis**, possibly from renal stress |
| **Alkaline Phosphatase (ALP)** | 185 U/L | 44–147 U/L | 🔴 **High** — could be from bone turnover (watch in MGUS → smoldering myeloma) or liver issues |
| **ALT** | 41 U/L | 7–56 U/L | ✅ Normal |
| **Hemoglobin** | 14.5 g/dL | \~13.5–17.5 (men), \~12.0–15.5 (women) | ✅ Normal — no anemia currently |
| **Hematocrit** | 41.6% | \~38–50% (men), \~35–45% (women) | ✅ Normal |
| **Absolute Lymphocytes** | 3.31 K/μL | 1.0–4.8 K/μL | ✅ Normal — no lymphoproliferative shift seen |

---

### 🧠 **What This Might Mean for MGUS Monitoring**

* ✅ **You’re not currently anemic** or showing classic signs of marrow suppression.
* ⚠️ **Elevated kappa light chain** could suggest **progression risk**; the **kappa/lambda ratio** is key — if you have that, I can interpret more precisely.
* ⚠️ **Immunofixation abnormal** confirms monoclonal protein — expected in MGUS but monitored closely for changes.
* ⚠️ **ALP is high** — may indicate **increased bone turnover**, which can be relevant in **smoldering myeloma** or bone involvement.
* ⚠️ **Ferritin is high** — not typically related to MGUS unless liver inflammation or other metabolic stress is involved.
* ⚠️ **CO2 low** — suggests **acidosis**, which might point to **early kidney stress**, especially if light chains are being filtered out.

---

### 📈 Summary

These results do **not confirm progression**, but there are some **red flags** worth monitoring:

* **Repeat and trend** light chains (kappa/lambda + ratio)
* Consider **bone scan or skeletal survey** if ALP remains high
* Watch for kidney function (CO₂, creatinine, eGFR)
* Ferritin elevation should be evaluated further — iron studies, liver enzymes, CRP

---

Jump to this post

Hmmm…
AI vs Ai

REPLY
Moderator
Colleen Young, Connect Director | @colleenyoung | 4 hours ago
In reply to @dcuste "Many people don't appreciate AI. But with that said, here is what ChatGPT thinks about your..." + (show)
@dcuste

Many people don't appreciate AI. But with that said, here is what ChatGPT thinks about your numbers...

Thanks for sharing those numbers. Let's walk through them in the context of **MGUS (Monoclonal Gammopathy of Undetermined Significance)** to see what's possibly important and what may need further attention or follow-up.

---

### 🔍 **Lab Results Breakdown**

| **Test** | **Your Value** | **Reference Range (typical)** | **Comments** |
| ------------------------------ | -------------- | -------------------------------------- | ---------------------------------------------------------------------------------------------- |
| **Ferritin** | 573 ng/mL | \~20–300 (men), \~10–200 (women) | 🔴 **High** — may indicate inflammation, liver issue, or iron overload (not usually from MGUS) |
| **IgA** | 445 mg/dL | \~70–400 mg/dL | ⚠️ **Mildly Elevated** — depending on lab, may suggest IgA MGUS or early progression |
| **Serum Immunofixation** | Abnormal | Normal | ⚠️ **Concerning** — confirms presence of a monoclonal protein; essential in MGUS diagnosis |
| **Kappa Free Light Chains** | 24.8 mg/L | 3.3–19.4 mg/L (depending on lab) | ⚠️ **High** — needs to be interpreted **with Lambda and ratio** |
| **CO₂ (bicarbonate)** | 19 mmol/L | 23–30 mmol/L | 🔴 **Low** — may suggest **metabolic acidosis**, possibly from renal stress |
| **Alkaline Phosphatase (ALP)** | 185 U/L | 44–147 U/L | 🔴 **High** — could be from bone turnover (watch in MGUS → smoldering myeloma) or liver issues |
| **ALT** | 41 U/L | 7–56 U/L | ✅ Normal |
| **Hemoglobin** | 14.5 g/dL | \~13.5–17.5 (men), \~12.0–15.5 (women) | ✅ Normal — no anemia currently |
| **Hematocrit** | 41.6% | \~38–50% (men), \~35–45% (women) | ✅ Normal |
| **Absolute Lymphocytes** | 3.31 K/μL | 1.0–4.8 K/μL | ✅ Normal — no lymphoproliferative shift seen |

---

### 🧠 **What This Might Mean for MGUS Monitoring**

* ✅ **You’re not currently anemic** or showing classic signs of marrow suppression.
* ⚠️ **Elevated kappa light chain** could suggest **progression risk**; the **kappa/lambda ratio** is key — if you have that, I can interpret more precisely.
* ⚠️ **Immunofixation abnormal** confirms monoclonal protein — expected in MGUS but monitored closely for changes.
* ⚠️ **ALP is high** — may indicate **increased bone turnover**, which can be relevant in **smoldering myeloma** or bone involvement.
* ⚠️ **Ferritin is high** — not typically related to MGUS unless liver inflammation or other metabolic stress is involved.
* ⚠️ **CO2 low** — suggests **acidosis**, which might point to **early kidney stress**, especially if light chains are being filtered out.

---

### 📈 Summary

These results do **not confirm progression**, but there are some **red flags** worth monitoring:

* **Repeat and trend** light chains (kappa/lambda + ratio)
* Consider **bone scan or skeletal survey** if ALP remains high
* Watch for kidney function (CO₂, creatinine, eGFR)
* Ferritin elevation should be evaluated further — iron studies, liver enzymes, CRP

---

Jump to this post

@dcuste, AI can be very useful when doing research. In an online community like Mayo Clinic Connect, AI generated answers can be a conversation stopper. And as @johnbishop points out, AI generated answers can contain errors and incorrect information.

For this reason, we have developed guidelines around the use of AI on Mayo Clinic Connect. See the section called Guidance about the use of AI. https://connect.mayoclinic.org/blog/about-connect/tab/community-guidelines/

I encourage you to read the whole section. The part I'd like to underline is the importance of human connection here on Mayo Clinic Connect. Mayo Clinic Connect is first and foremost a space to share your health experiences to help and support others with similar health issues. When replying in a discussion, think about conversation first. Share your real-life, first-hand experiences.

Do not post long AI generated answers without sharing
a) the question you asked ChatGPT because answers will vary depending on what you asked it.
b) your experience.

@dcuste, do you, like @ehicks2201, experience fatigue related to your diagnosis of MGUS? What helps you manage it?

REPLY
Mentor
Lori, Volunteer Mentor | @loribmt | 4 hours ago

Hello @ehicks2201 and welcome to Connect. It can be incredibly frustrating if you’re not feeling heard by your doctor. You know your body better than anyone and you’re obviously having symptoms that are troubling you.
Having seen the results of your latest labs, you’re questioning why some of them are out of the normal ranges and yet your doctor is dismissive to the results and your symptoms.
Frankly, if this were me, I’d be looking at getting a 2nd opinion. Your current doctor doesn’t seem very helpful.
You mentioned having been diagnosed with MGUS ten years ago. How often do you have labs done and are these changes in your blood numbers new?

Is the doctor you’re seeing a hematologist/oncologist? Are you in an area where you have options to seek a 2nd opinion?

REPLY
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