instruction: hi doctor my symptoms include a chest cold for approximately one month 12 pound weight loss nausea dry heaves excessive bowel movements shortness of breath muscle aches left side rib pain fatigue I had normal labs except mildly elevated alkaline phosphate my doctor is now running a all isoenzyme test do I have multiple myeloma am I too young what are my chances what else besides my liver could make that test elevated
output: hi after reviewing your complaints and your blood investigation I can draw the following conclusions it is highly unlikely that you have multiple myeloma as your globulins in blood report are normal though it is a rare scenario before 40 years it can happen to people your case seems something else there is however abnormally low carbon dioxide level in your report this occurs because of hyperventilation anxiety some lung pathology more importantly your medication are the most likely reason for your anxiety sometimes these can cause diarrhea as well raised all can be from many causes liver uncommon if you do not have jaundice bone intestine and placenta being most common isoenzyme assay that your doctor is doing will help isolate the source to some extent given your age and your month old respiratory problem I would suspect a lung infection including tuberculosis to can also cause the left sided chest fatigue and weight loss pain itself can lead to hyperventilation moreover your all is only mildly raised which is against the diagnosis of multiple myeloma where it can be in thousands mildly raised all can be due to vitamin deficiency as well given you live in montana low sunlight please discuss with your doctor regarding need for a chest ray and possibility of to and vitamin supplementation do not worry the reason you might feel anxious is most probably your medications take a healthy balanced diet try some meditation as well