Lab Tests/UA HGB
QUESTION: My result came back as 0.03 (1+) mg/dl. What does this mean?
ANSWER: Hi Jessica,
Hematuria can result from multiple causes from accidental cross contamination of the urine specimen from menstrual blood to UTI (Urinary Tract Infection) to kidney disease to trauma to malignancy to adverse reactions to Rx medications, blood thinners such as Coumadin, etc. The most common cause of hematuria is cystitis (bladder infection).
To differentially diagnose the cause, the physician will do a clinical assessment to determine symptoms, e.g., if the patient reports pain upon urination and blood in their urine, their doctor may order a UA and a Urine Microscopic to rule out or confirm the diagnosis of a UTI and if confirmed, prescribe an antibiotic.
UTIs are more common in women due to cross contamination of the urethra by bacteria from the colon, typically E. coli which make up most of the normal flora of the colon, though rarely the cause may be from other bacterial species. However, since 90% of the time, the cause is E. coli, the prescribed treatment is typically an antibiotic to which E. coli is sensitive, e.g. Ciprofloxacin.
Since the causes of hematuria vary, to differentially diagnose a specific patient's cause, their doctor will first do a clinical assessment of symptoms to narrow down the possible causes. If the patient's symptoms indicate more than one possible cause, the physician may then order diagnostic testing to differentiate among more than one possible cause.
For example if the patient reports bladder pain upon urination and blood in the urine, and there are bacteria, RBCs, and WBCs in the Urine Microscopic and the UA is Nitrite positive and Leukocyte Esterase positive which is symptomatic of a UTI, their Dr. may prescribe an antibiotic.
However, if the patient reports blood in the urine with no pain upon urination but the Urine Microscopic shows specific types of renal casts indicative of kidney disease, additional diagnostic testing will be done to rule out or diagnose kidney disease.
Since without knowing additional clinical symptoms or other lab testing results other than the UA Hgb it's not possible to identify potential causes in your situation, this website may provide useful information that may be helpful to you in identifying possible causes based on other lab results and/or symptoms and follow-up questions to ask your doctor:
"Assessment of Microscopic Hematuria in Adults - American Family Physician Assessment of Microscopic Hematuria in Adults - American Family Physician The causes of hematuria are varied and can range from Urinary Tract Infection, kidney disease, traumatic injury, etc. Since urine normally contains a few red blood cells, and microscopic hematuria generally is defined as one to 10 red blood cells per high-power field of urine sediment.2
The American Urological Association (AUA) defines clinically significant microscopic hematuria as three or more red blood cells per high-power field on microscopic evaluation of urinary sediment from two of three properly collected urinalysis specimens
Urine dipstick evaluation may be misleading because it lacks the ability to distinguish red blood cells from myoglobin or hemoglobin. Therefore, a positive finding of microscopic hematuria on urinary dipstick testing requires follow-up examination by microscopic technique to confirm the presence of red blood cells.
The most typical clinical scenario for finding microscopic hematuria is during the evaluation of patients with suspected urinary tract infection. The urine dipstick may reveal blood as well as the leukocyte esterase, nitrites, and bacteria consistent with the patient's symptoms. In such cases, treatment with antibiotics should lead to resolution of microscopic hematuria as demonstrated by follow-up urine studies six weeks after therapy. When microscopic hematuria resolves in this scenario, no further evaluation is necessary.1
Transient microscopic hematuria can be caused by vigorous physical exercise, sexual intercourse, trauma, digital rectal prostate examination, or menstrual contamination. If transient microscopic hematuria is suspected, follow-up urine studies should demonstrate resolution 48 hours after the discontinuation of these activities. It should be noted, however, that renal cell carcinoma and urothelial tumors also may present with transient microscopic hematuria.2"
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QUESTION: It's probably menstrual blood since it was during my menstrual cycle. My OB GYN ordered this test because I was having burning pain on my left side lower where my ovary area is. I'm not having any pain urinating or whatever. This burning pain was consistent for 5 days that started the same day as I finished my last menstrual cycle. And this menstrual cycle, the burning pain started on the 2nd day of my cycle and only lasted one day. My menstrual cycle comes every 19 days. The dr thinks a cyst in my ovary ruptured. Did this test result connect to any of my problems I mentioned above?
Although it's impossible to confirm with only the available information provided, just based on the information you provided above, if you were having your period at the time you provided the urine sample, and you have no UTI symptoms such as pain and burning upon urination, cross contamination of the urine sample with menstrual blood would appear to be a more likely explanation than a UTI since Hemoglobin is a protein that is the oxygen carrying component of red blood cells which is also responsible for their red color.
You didn't mention whether or not you are trying to get pregnant or not, but if you are, are you undergoing fertility treatment with fertility drugs such as Clomid or Pergonal to induce ovulation? If the pain is transient and in the area of the ovary, it may be due to ovulation.
Is your menstrual cycle always every 19 days? If so, you may want to ask your doctor if you have a short luteal phase which may be caused by a deficiency of progesterone in the last half of your monthly menstrual cycle.
If so, are you seeing a fertility specialist? Not all OB/Gyns are fertility specialists.
If you regularly have 19 day cycles, and you are trying to get pregnant, you may want to consider consulting a fertility specialist (i.e. not a regular OB/Gyn who treats gynecological conditions and delivers babies but an OB/Gyn who specializes in and exclusively treats fertility cases since a 19 day cycle is a common symptom of a shortage of progesterone production in the luteal phase which may require e.g. a regimen of fertility drugs, and/or HCG and progesterone supplementation which would best be managed by a Fertility Specialist.
For example, my brother in law is an Ob/Gyn and delivers babies, but mentioned that when he has an infertility patient, he refers them to an Infertility Specialist because although as an Ob/Gyn, he's qualified to treat the patient, since an Infertility Specialist sees nothing but patients with infertility issues, they see and treat many more patients with infertility problems than he does and therefore are much more experienced at it.