Friday, September 11, 2009

NK Cells, Thyroid, Anemia

I had Dr. Kwak-Kim's office fax me over the results from my b/w on August 25th, so that I can prepare my questions for Monday's phone appointment.

They said they're still waiting on one test- and I think, just from looking, it may be the ATA (anti-thyroid antibodies) test.

But what I did receive was VERY interesting.

First, the CBC panel and Metabolic panel. Just your basic blood workup. It showed low red blood cell count, low hematocrit, and low creatinine. The first two seem to point towards anemia, which would DEFINITELY make me feel fatigued!

Second, my thyroid numbers. TSH was on the lower end of the normal limits, which is wonderful. But T3 was HIGH! That explains the other thyroid-like symptoms. FJIEJ and I were brainstorming about why it would be HIGH, but my symptoms are like my thyroid hormones are LOW... and she thinks my body is not converting the T3 properly. That makes total sense. Plus, I may have ATAs.

The most interesting findings were the NK Cell Assay. The first time I had this test done, with the Sher Institute, they found the percentage of my NK Cells that killing out of a ratio of 1:50 (1 target cell, a cell that mimics an embryonic cell, to 50 of my effector cells, or NK Cells). That percentage should be less than 10%. Mine were 6.7 in April.
And that was the end of it.

But Dr. Kwak-Kim's test included a variety of different TYPES of NK Cells- these tests were developed by her predecessor, Dr. Alan Beers, who pioneered the Reproductive Immunology field.

And the results blew me away. Especially once I was able to google what they meant, and found the Dr Beer's website with all of the explanations.

Trying not to get TOO technical for my poor readers, I will list below the results that were OUT OF LIMIT. Then I'll post what the normal range should be, and immediately after each result I will copy and paste what Dr Beer's website says about the result.

%CD3 - 96.8 (% Normal Limit: 60-85)

CD-3 (Pan T-Cells)
These cells are the most important in our immune system. They are low when the immune system is weak (suppressed) and normal when the immune system is healthy. Infertile patients and patients with recurrent pregnancy losses have values in the high normal range. These individuals have immune systems that are strong - even overactive. A strong overactive immune system is associated with a 5% incidence of autoimmune diseases for example, thyroiditis, lupus, rheumatoid arthritis.

%CD19 - 1.0 (% Normal Limit: 2-12)

CD-19 (B Cells)
These lymphocytes are plasma cells that produce antibody of all classes. What does this mean? IgM is the first antibody produced to anything that enters our body. This antibody stays in the blood and then as the immunity progresses it produces IgG (gamma globulin G) that resides in the lymph system. One IgM molecule has the immune capacity of 5 IgG molecules. IgG (Gamma globulin G) lives and repopulates itself in the lymph gland system. IgA (Gamma globulin A) is the last antibody made in an immune response and it resides in and protects the organs, skin and GI tract. When this antibody appears, it means that the immune response is completed and cannot go any further. When IgA responses (organ immunity) are present in any test for reproductive failure it usually means that the patient has an autoimmune process such as lupus, rheumatoid arthritis or other disorders.

CD-19 B cells are almost always high normal or very elevated in women with an immune cause for their infertility or recurrent pregnancy losses. There is often a greater than 12% elevation. This is one of the most important indicators of an immune problem and that the immune system is working overtime. Endometriosis also primes this system into greater hyper-reactivity.

(What's interesting is that mine was LOW out of limit, not high. But wait...)

%CD56 - 1.2 (% Normal Limit: 2-12)

CD 56+ Natural Killer Cells
These Natural Killer (NK) Cells include CD56+/16+ Natural Killer Cells and CD56+ Natural Killer cells with lack of a CD16 molecule. Natural Killer Cells are activated by a pregnancy that fails or a fertilized embryo that degenerates. CD56+/16+ Natural Killer Cells are produced in the decidua and they are even more geared up to kill than those from the bone marrow. They produce large quantities of Tumor Necrosis Factor locally that kills the placental cells and the fetal cells. The normal range of CD56+ Natural Killer cells is 3-12%. Levels of 18% or greater correlate with poor reproductive outcome.

(Again, mine were LOW out of limit... and my TH1:TH2 ratio was also well within range, but I'm wondering what it means to have these numbers LOW?)

And finally, here's the big shocker:

%CD19+ cells, CD5+ - 40.00 (% Normal Limit: 5-10)

CD 19+/5+ (B-1 Cells)
When this population of cells is activated, they produce polyclonal antibodies to hormones, hormone receptors and neurotransmitters. The hormones most usually attacked by these antibodies are thyroid hormones, estrogens, progesterone, gonadotropins and growth hormone. Women with elevations of these cells may be at risk for thyroiditis and the premature menopause. Patients whose levels are 80-90% often stimulate poorly with gonadotropins. Women with high levels often complain of immunological symptoms when stimulated with gonadotropins. These symptoms include joint pain, finger stiffness, headache, lethargy, malaise, fever, depression and occasionally urticaria and hives. These cells like the CD 3/IL-2R+ cells are elevated in autoimmune disorders and in situations where a person is rejecting a bone marrow transplant from a compatible donor. There is no question that they are involved in early embryonic loss or damage.

Holy. Crap.

OK, so mine aren't up to 80-90%, which explains why I have been able to respond well thus far to ovulation meds. But, attacking hormones and hormone RECEPTORS??? Makes sense! And how about that last line?? "There is NO QUESTION that they are involved in early embryonic loss or damage." Whoooooaaaa. Blows me away.

As if MTHFR wasn't enough! Now I have some more to fix.

I'm actually pretty psyched about it, because (and I know I sound like a broken record), this all just MAKES SO MUCH SENSE TO ME!! DH and I were talking about it last night, and he said, "You know, honey, I can't remember the last time you had a cold, or a sore throat, or anything!" It makes a lot of sense to him, too. My immune system is overactive.
Not to mention my poor blood. I was googling anemia, and causes of sudden iron deficiencies, and they said frequent blood-giving can cause it. In parenthesis they said (more than 3 times per year). HA! How about more than 3 times per month? Yeah, of COURSE I have anemia, how could I not??!!

So, Monday I'll have a plan of action. But before then, I'd like to close with some more great news... drumroll please...


Yes, I had some brown bleeding (2 days of spotting CD 5 and CD 6), but a 6-day AF is UNHEARD OF FOR ME!!! I am sooooo excited!!! Plus, it would seem that the brown bleeding may not necessarily be connected to the Chlamydia anymore. I think it has more to do with the immune issues/blockage of blood flow in my endometrium. I am sooooo happy to not have a 10 day period, this is a miracle!!

I love getting healthier, woo hoo!


Sew said...

I want that TEST NOW!!!!!!!!!!!!!

This is great! I am going to have to read it in chunks to process it, because I am to fatiuged to concentrate and soak it all in. :)I'm not lieing!

LifeHopes said...

I am completely floored!
What is the treatment(s) and success rates?

micasgirl said...

Awesome, awesome, awesome! That is all so fascinating! I can't say enough how proud I am of you that you have been fighting so hard, and I'm glad that Dr. K-K is helping you...big hugs - can't wait to hear about treatments!

E said...

Thanks for the shout-out. I am interested in what the dr. has to say about it all.

the misfit said...

You're starting to take iron pills today, right? Going around anemic is no fun. What can they do to knock down this massively overactive antibody that you have?

barbie said...

some reasons you can feel hypo with high free 3 is low B12 and low vitamin D or low getting those on track will allow your body to properly use the thyroid hormones.

I need to read over the b/w again, to understand all you posted. Very interesting.

Sew said...

Your comment on my last post comforted me to tears.... :) Thanks for helping me carry my cross....

... said...

That is an impressive test. How fascinating. I must admit, I feel slightly qualified to attend medical school after reading all that (oh wait, I was never good in science).

Thank you for the sweet comment! You start follistem next cycle? Good luck & God Bless !

mrsblondies said...

Wow, I'll be praying that Dr. K-K can help get all your immune issues sorted out. I'm very interested to hear about your treatment plan. The 6 day AF is awesome, I would like that too (you've seen my chart and know).

Hannah's Song said...

TCIE: I have been reading your blog for a few months now! Thanks you for all of your wonderful words...your story has been helpful to me. glad you found my blog!

Russell Moris said...

Desiccated bovine thyroid is a blessing as far as I'm concerned. I am 54 years old and my thyroid seemed to come to a painful halt. I was recommended desiccated bovine thyroid by my husband's nutritionist and I have had very good success with it.