Hematology/Consistently high D Dimer
About 6 weeks ago I had leg pain and chest pain. I was worried about blood clots since I had been on Yaz a combined birth control pill up until a week prior to leg and chest pain. My D Dimer came back as 1.69 microg/ mL (<0.5 being normal range). I had an ultrasound to rule out DVT and chest CT scan to rule out PE. About a week later my pains had resolved on their own, but I was confused about why I had high D Dimer. I had another D Dimer done about 4.5 weeks ago to see if it was normal since I was feeling better. That one came back at 0.77. My family doctor said it seemed to be decreasing, which was good, but she would refer me to hematologist if I wanted. I had appointment with hematologist one week ago and D Dimer was 0.72. From all the medical studies I have read, this is still quite high for a woman of my age (I am 27). My hematologist doesn't think this warrants further investigation. She said we can retest again if I go off the minipill (progestin only birth control) for a month and see if that decreases the D Dimer. Please note that my first two D Dimers were both when I was off birth control and the 0.77 was when I had been off birth control entirely for 3 weeks. So I am not optimistic that going off minipill will decrease D Dimer. My doctors do not seem worried because D Dimer is not specific. But I have done my research. It is true there is a long list of things that can cause high D Dimer. But with the exception of pregnancy, age, and combined oral contraception, all of which do not apply in my case, all of the causes are worrisome! My doctors have mentioned inflammation, but shouldn't they be looking for the source of the inflammation? From the medical literature I've read, it seems like there would need to be major inflammation in order to cause a D Dimer as high as mine. I feel like my doctors should be ruling out thrombophilia mutations, autoimmune disorders, cardiovascular issues, and cancer before simply concluding that my high D Dimer is benign. Do you think my consistently high D Dimer warrants further investigation?
Do you exercise? How intense it is? Any infections in the recent past? When you had leg pains did you have unilateral or bilateral leg pain? Any other symptoms you had 6 weeks ago other than chest pain and leg pain? cough? Any change in bowel movements/ color of feces etc? Definitely further investigation is required. What is your weight? My suggestion is just use some other contraceptive method for a while and retest after 3-4 weeks. And while testing next time, mail me I will guide you what else investigations you have to get done.
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