POZ Community Forums
Main Forums => Living With HIV => Topic started by: Pecker on August 02, 2010, 02:16:25 pm
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Hey, I recently had an appointment with my doctor and for the last 6 months prior my CD4 was rising. I had gone from 157 to 364. I was really excited about that and was taking care of myself really well. I was exercising on a regular basis and eating well and things like. What I'm really disappointed about is that after doing all of that and going to my doctor this last time, my cd4 count went down to 326. I'm really disappointed, I was expecting them to go up and not down. Can anyone explain?
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CD4 counts can fluctuate upwards of a hundred points in a single day. Stress, hunger, all sorts of things can impact them. That is why we tend to stress the value of trends over time, as opposed to single readings, to determine one's state of health.
It sometimes helps to make certain that all possible variables are eliminated on the days you get your blood drawn. Say, you get your blood drawn in the morning, when you are well-rested, and have fasted. If you do this every time (and this is nearly impossible) you will eventually get a FAR more reliable set of markers.
In short, your dip was not large, and totally expected for such a fluctuating number.
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I like to think of it that some days I kick the shit out of those little bastards....and some days I can't really be arsed and they kick the shit out of me....hence the change. I swear one day I'm gonna kick those bastards so hard they won't get back up and I'll be cured!!! lol
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I like to think of it that some days I kick the shit out of those little bastards....and some days I can't really be arsed and they kick the shit out of me....hence the change. I swear one day I'm gonna kick those bastards so hard they won't get back up and I'll be cured!!! lol
Fabulous!
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;)
if it works I'll be a millionare-ess ha ha
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Knowing our luck they will just learn to bite our ankles instead if they can't get up.
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Knowing our luck they will just learn to bite our ankles instead if they can't get up.
lol - then I'll kick my ankles!!! Fight the good fight!
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During my early visits to my doctor, I often wondered why my cd4 counts were going up and down. They were low enough to begin with (264). They have had jumps and several set backs. The doctor definitely let me know that this is natural and you have to trust the professional. Gradually, over the past two years, it has risen. That, I am thankful for. Just take it in stride. I have a terrible fear of needles and hate the blood work and want the numbers to jump every time (due to the fact that I've almost passed out because of my fear)... but I live with it.
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"Sexually transmitted diseases: epidemiology, pathology, diagnosis, and treatment" (http://books.google.com/books?id=k_9sjs-n0nIC&pg=PA254&lpg=PA254&dq=cd4+highest+in+the+evening&source=bl&ots=Jduea7O-Hc&sig=5LwL7USmNfQpi9tZRPkEbQkZDQU&hl=en&ei=gNxYTN3SE8-JOP74zPQI&sa=X&oi=book_result&ct=result&resnum=1&ved=0CBUQ6AEwAA) By Kenneth A. Borchardt, Michael A. NobleTake
"CD4 counts show diurnal variation, being lowest in the morning and highest in the evening. In normal individuals the evening CD4 cell count can be nearly double what it is in the morning."
I couldn't find my link but I seem to remember that cd4s are lowest around 8:00-10:00 in the morning, and highest 8:00-10:00 at night. (It's a shame most clinics aren't open at 10:00pm :D ) Since you can't reasonably get your blood taken at the "best" time of night, getting your labs done around the same time of day every time is the better way to get the results of how your numbers are trending.
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"CD4 counts show diurnal variation, being lowest in the morning and highest in the evening. In normal individuals the evening CD4 cell count can be nearly double what it is in the morning."
:o Really?? My first and only labs were taken at 8 am, right when the office opened!
My next labs are next Thursday at 4:30 pm...
I guess we'll see if I follow that statistic. ;D
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I guess we'll see if I follow that statistic. ;D
to get a true feel for the trend of your cd4 counts you would either have to have blood drawn at the same time of day for something like 3 to 5 times (at every 3 months it could easily take a year to determine the trend) or blood drawn are random times of the day maybe 7-10 times.
because so many factors can affect your cd4 count (time of day, stress, illness, amt of sunshine, food, rest, etc, or even none of the above*) the difference between two and only two test results doesn't prove much one way or the other.
*speaking of "none of the above"-
my best, most consistent labs ever started happening over the half a yr time span when my life was falling apart. During that time, my partner was hospitalized, found out he had AIDS and died, and then I lost our house in the aftermath and nearly became homeless. To make matters even worse, although I had quit smoking for nearly 6 months, I was back up to 3 packs a day; skipped too many meals to count; hardly slept but a few hrs a night; ran myself to exhaustion taking care of errands, caring for my partner, and then trying to find a new home and move; and worst of all, became only about 30% compliant to taking my meds for about 4 months. From that time till now (2 yrs and 2 months), my VL has stayed undetectable (that's the longest stretch in 18 yrs!) and my cd4 count actually reached an all-time high of 318!
So sometimes even the most terrible things won't neccessarily have a negative effect on your counts.
Because of med side effects and resistance issues, and the low points my cd4s have hit (5, 12, 22), now 18 years later, my cd4s have only recovered to barely over 300. However, that's not a bad thing per se. Only averaging 176 cd4s over the last decade, I haven't been back in a hospital with an OI in 12 years. Over the last 5 yrs, my cd4 average has climbed to 247 and I've become healthier than I have been in 20 yrs.
it's not about how many cd4s you have, it's about how well they work. ;)
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it's not about how many cd4s you have, it's about how well they work. ;)
I keep telling myself that, but being a newbie to all of this it still messes with my mind sometimes! ::)
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I keep telling myself that, but being a newbie to all of this it still messes with my mind sometimes! ::)
it still messes with my mind too LOL :D
that's why I keep pointing out that it's how well your immune system works, not how big it is. It helps me remember that 318 IS enough to keep me alive and well ;)
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CD4 levels reflect what is going on in your body.
As has been stated the slightest things can impact on your levels.
Stress most assuradly does it for me, but also diet & exhaustion.
Having a cold or any other minor ailment can all impact on your results.
If our bodies are busy fighting disease then it takes its toll.
But try not to get too bogged down on the numbers - what is more important surely is how you are feeling in yourself. If you are feeling drained then rest - listen to your body.
At least that is the approach I take and I have been HIV+ since at least the mid 90's. and on combination therapy for at least 12 years and have had a CD4 count which stays floating around 200.
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Dental is another important and oft neglected area.... so make sure to keep you teeth happy.
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I keep telling myself that, but being a newbie to all of this it still messes with my mind sometimes! ::)
I only had 92 T cells as of my last blood draw yet somehow I'm healthy as a horse, so take that as you will.
Edit:
<----- that big ole grin over there isn't the smile of a sick man.
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I only had 92 T cells as of my last blood draw yet somehow I'm healthy as a horse, so take that as you will.
It's those poppers you keep having for breakfast, sugah.
Have you made it to 200 yet? Don't think I've seen a recent update from you.
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It's those poppers you keep having for breakfast, sugah.
Have you made it to 200 yet? Don't think I've seen a recent update from you.
92 was the recent update (May), I went down from 101, I get checked again in September. I'm still hanging in there :)
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92 was the recent update (May), I went down from 101, I get checked again in September. I'm still hanging in there :)
It takes time so don't despair... patience is the order of the day today, tomorrow and thereafter.
I was really surprised when I was on EI's that it took so long for an increase to take place....
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It takes time so don't despair... patience is the order of the day today, tomorrow and thereafter.
I was really surprised when I was on EI's that it took so long for an increase to take place....
I beat the shit out of my immune system with a jumbo sized ass beating stick so I'm under no impression that the route back up is going to be quick and/or painless.
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I beat the shit out of my immune system with a jumbo sized ass beating stick so I'm under no impression that the route back up is going to be quick and/or painless.
Well, there other things to do with a stick besides beat your immune system, and they are normally more fun.
Next time try a can o Whoop-Ass(tm) For a guaranteed knock-down, drag-out, trailer park style ass kickin.
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It's those poppers you keep having for breakfast, sugah.
Have you made it to 200 yet? Don't think I've seen a recent update from you.
Are you sure that it's just poppers (http://i1007.photobucket.com/albums/af197/bedstuy65/728751.jpg) he's having for breakfast?
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Are you sure that it's just poppers (http://i1007.photobucket.com/albums/af197/bedstuy65/728751.jpg) he's having for breakfast?
Shit I thought I did a better job of hiding my resume photos than that.
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This is intersting. The differnce in CD count between day and night.
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Being in the low end of the spectrum of cd-4's (as far as 12 at one time) you have to also check the other cells cd-45, cd8 and so on...many tmes these other cells also take part in defense agaist the virus. and yes, stress plays an important role in the depletion of the cells...[img]
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http://www.hopkins-hivguide.org/management/laboratory_testing/cd4_cell_count.html
Factors that Affect CD4 Count:
- Seasonal and diurnal variation (lowest at 12:30 PM, highest at 8:30 PM)
Which is why I've started getting my labs drawn between 7 and 8 AM.
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I always get my labs done around 4 to 5 pm right before they close.
I've read the average person who is neg has a CD4 of 1000 and percentage between 30 to 50%. However, I've noticed many Am I Infected questions where the person says they have tested negative several times but their CD4 is like 650 with a percentage in the 20's. I've seen this several times. If these people are actually telling the truth, would their CD4 of 650 at say 26% be the same as an HIVer with the same numbers? I suspect the answer would be "No" since we have the virus doing damage that they don't. If they are telling the truth, I'm kinda surprised by their percentage. Kinda got off topic there, but just curious.