Itchy red bumps with rash on face, normal TSH, CREATININE.

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Started with rash on face over a year ago. small red bumps itcy and carried fluid. I always had good skin. This is not acne. I went to a dermatologist and was told I have rosacea. Medicines made it worse so I started self treating with Tea Tree oil. Rash went away. Rash comes back about once a month. No certain pattern to it . This week it came back and I decided to get an allergy blood test to Dust mites and Dog dander. Both negative except the Immunoglobulin E, serum is 165.00- Normal is 2-114. I decided to get a general work up. WBC 11.5 Normal range is 4.0-10.5 MCH 31.07. Normal is 27.0-31.0 . Creatinine 0.50 Normal is 0.60-1.20.
T3 TOTAL 116 NORMAL . T3 UPTAKE 41.1 NORMAL Free T4 0.61 NORMAL (FT4 INDEX) calc. 3.2 NORMAL. bUT THE MY TSH 3RD generation is 12.036 High Normal range should be 0.340-5.600 Thyroid AB (ATA,AT,TPO) TESTED. TPO Is 2826.0 Normal should be 0-59 Thyroglobulin auto ABA IS 226 High normal should be 0-59. and Thyroglobulin is <0.20 low . These lab results were done this Friday 12/19/14

I have chronic diaharrea for at least 2 years now. Dr. said it's probably IBS and nothing to worry about. Other symptoms for at least a year exhaustion, motled skin when I am cold and I am always cold. Dizzyness , can't focus . I forget where I am going when I am driving or I don't recognize where I am for a few miuites . Chills on and off. Vision has gotten worse. Gained about ten pounds in the last year. Rashes on my face feels like i am getting stung and then it itches. Rash does not simulate a butterfly rash though and eases up with Prednisone or Benadryl . Rash comes on quick and can disappear just as fast but this last week it is still there. I work for a lab so I ordered myself an ANA test and it is still pending. I feel like I have the flu everyday of my life. What should be my next step ? I don't have health insurance so I need some guidance. Seems every Dr. I go to blows me off with no answers.

Submitted: 4 Days
Category: Nephrologist

Expert:  Dr. Sree Bhushan Raju replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com
I understand your concern.
Increased blood clotting has a lot of independent risk factors one of them being high hemoglobin. The others are prothrombotic factors which are controlled by Heparin/ Warfarin.
So yes independently it could be a risk factor, however 1 or 2 mg/dL does not increase the risk significantly.
Dialysis patients are given erythropoietin therapy too, to increase the levels of hemoglobin, and if you are on EP, probably that is why your nurse suggested to keep hemoglobin levels around 11.5 mg/dL.
I understand that you require to be in warfarin related to your cardiac condition.So its a must for you and keep a watch on your activity and the dose of the drug. It's important to keep the INR between 2 to 2.5 and preferably not more than that. If INR exceeds there is a chance of bleed any where especially while on hemodialysis where you will receive heparin. A sudden rise in BP during and after HD also would increase the risk of bleeding. If INR is low, then clotting tendency would harm not only the fistula but also the other parts of the body. Fistula clot can be due to several factors like velocity of blood flow , injury to blood vessel endothelium , erythropoietin therapy , smoking , sudden occurrence of low blood pressure etc. warfarin alone would not prevent ( that's what the data proved so far )
Feel free to discuss further,
Regards.

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