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d-dimers always raised.

15 replies

kimlo · 11/09/2020 21:13

I've had these tested twoce. Once was random when I wanted to change pill because I have a family history of blood clots. That time they said I had raised d-dimers and fibrin.

The second time I had to have a ct scan to check for blood clots.

Nobody seems bothered by it, but what could it be?

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Pacif1cDogwood · 11/09/2020 21:19

Where in the world are you based?
That seems complete diagnostic overkill tbh.
But I'm in the UK/NHS where evidence based medicine is practice, not profit based.

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kimlo · 11/09/2020 21:20

I'm in the uk.

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ChristmasSnowball · 11/09/2020 21:20

OP
Im the same, In the UK, NHS...

No idea why... Same as you, once had to have a scan to rule it out

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kimlo · 11/09/2020 21:21

the forst time they wouldn't change my pill from the mini pill due to the family history of blood clots, the second I had chest pains.

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ChristmasSnowball · 11/09/2020 21:22

This is very often tested in 'normal' practice @Pacif1cDogwood

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kimlo · 11/09/2020 21:23

so just one of those odd things?

Thats really strange.

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Ohthereyouarepeter · 11/09/2020 21:25

A negative d-dimer can be used to exclude a DVT or VTE, a positive result does not mean that you have a clot, it means further investigation is required (doppler US) to exclude a clot.
A raised fibrinogen is seen in inflammation/infection.

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Pacif1cDogwood · 11/09/2020 21:26

I was under the impression that 'random' D-dimer testing is pretty non-specific?
I suppose a higher level may inform a decision whether to take the risk of a combination pill, but D-dimer can be raised for all sorts of reasons.

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Pacif1cDogwood · 11/09/2020 21:28
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kimlo · 11/09/2020 21:29

Infection would explain the last one, since the chest pains were caused by a chest infection.

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Ohthereyouarepeter · 11/09/2020 21:32

NHS Scotland here but I have never carried out a random d-dinner test in the lab, only ever for exclusion of clots or to we have added it on as a test to aid diagnosis of DIC. I’m not sure what the acceptable range would be for deciding on whether a pill is ok or not.

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Pacif1cDogwood · 11/09/2020 21:44

kimlo, I've just reread your first post.
Surely you must have a haematologist who could explain all of this to you?

I am not an expert.
D-dimer can be raised for many reasons, as can fibrinogen.
Infection/inflammation are common causes.
I expect yours may have been done in the context of looking for a familial or inherited clotting disorder?
It gets v complex there, and you best address your (v valid) questions to an expert in the field.

What I meant with 'diagnosic overkill' (I like a bit of hyperbole and flippancy, me Blush) is that IME it would not be used to inform that change of a pill or used as a 'routine' blood test. There's usually a very specific indication.

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kimlo · 11/09/2020 22:17

no I don't have a heamotologist. It was the gp for the pill and she seemed fine with it, but did say I was at risk from blood clots.

Then that was that, nothing more done.

The hospital did the test when a different gp refered me for chest pains, did a ct scan and sent me off with antibiotics.

No one seems bothered by it. I'm just wondering what it is.

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DrFoxtrot · 11/09/2020 22:25

I've never ordered this test for someone starting the pill Confused - if there were risks, I'd be following guidelines for less risky options.

My local area works similar to what @Pacif1cDogwood suggests, using the test only as a diagnostic aid in specific circumstances.

You might have a minor underlying clotting problem which is of little consequence in day to day life, but the only way you'd know is for a haematologist to assess you and even then you might not get a definite answer.

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GrumpyHoonMain · 11/09/2020 22:28

Raised fibrin can be seen with pcos too which is why fertility clinics often offer to test for clotting disorders - because raised fribrin with certain clotting disorder mutations and pregnancy can be a nightmare.

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