The Fitness Zombie Gets Another Lab Report

I wish I could say my latest bloodwork came back with a clean bill of health, a gold star, and maybe a coupon for a celebratory protein shake.

It did not.

Instead, the lab report showed up like another zombie survival checklist. Blood sugar? Still growling. Liver numbers? Still waving a little flag. Iron? Apparently trying to become a villain origin story. Red blood cells? Showing up like they heard there was overtime available. Platelets? Quietly backing away from the group.

So, once again, the Fitness Zombie is standing in the middle of the health graveyard, holding a stack of lab results, trying to figure out which monster is making noise and which one is just a raccoon in the bushes.

The Good News, Because We Need Some

Let’s start with the part that does not make me want to crawl back into the dirt.

My blood sugar story is still far better than it was when things first went sideways. Back in 2024, my A1c was a terrifying 14.7. That was not a warning light. That was the dashboard catching fire.

The latest A1c came in at 6.8.

Is that perfect? No. It is still flagged high. But compared to where I was, it is a huge improvement. The zombie may still be dragging one foot, but at least he is not face-down in the glucose swamp anymore.

This is also where the medication question starts to matter. I take Farxiga and glimepiride to help manage blood sugar, but other medications can complicate the picture. Hydrochlorothiazide and pravastatin can sometimes nudge glucose in the wrong direction. So my question is not just whether the number is high. It is whether the number reflects diabetes control, medication effects, lifestyle, or some undead combination of all three.

My kidney numbers also looked better than they did in the previous round. Creatinine and eGFR had both looked rough in 2025, but they came back into normal range this time. That does not mean I get to ignore them, but it does mean I can take a breath before assuming the undead kidneys have filed for early retirement.

Farxiga, hydrochlorothiazide, and benazepril can all affect kidney-related numbers, especially when hydration is part of the equation. A fasting blood draw, diuretics, and fluid balance can turn a lab report into a haunted math problem.

Still, improved kidney numbers count.

Small win. Big zombie energy.

The Liver Is Still Muttering in the Corner

The liver numbers are still part of the story.

I was diagnosed with fatty liver many years ago. I have not followed up on it recently, and I quit drinking alcohol a few years ago, hoping for a little liver resurrection. Apparently, the liver does not run on my preferred schedule.

My ALT was high last time at 101. This time it improved to 55, but it is still above the normal range. AST came back down into range, which is good, but ALT still being high means the liver probably deserves more attention than I have been giving it.

Pravastatin may also belong in that conversation. It can sometimes affect liver enzymes, so I want to ask whether this looks like fatty liver still muttering in the corner, medication stirring the pot, or both.

Somewhere back when the fatty liver diagnosis first entered the chat, I was told to take B12. I have been taking it since then, so B12 deficiency is not my first suspect. But taking a supplement and knowing what is actually happening in the body are not always the same thing. My undead digestive system may or may not be reading the instructions.

That does not mean I am diagnosing myself from a lab report. I am not qualified to do that, and my medical degree is still written in crayon on the back of a protein bar wrapper.

But the numbers are clues. When a clue keeps showing up, I probably need to stop pretending it is background noise.

The Iron Number Got Weird

The iron result is the one that really jumped out.

My serum iron went from normal in 2024 to high in 2025, then to 272 Alert in 2026.

That is not the kind of number I want casually hanging around the lab report like it owns the place.

At first, the easy question was whether my multivitamin contained iron. That would have been a nice, simple explanation. But assuming the multivitamin is not the cause, the next question is whether this is tied to the old fatty liver issue, a true iron overload problem, or something else entirely.

This is where the medication question gets tricky. Some medications can shift lab values directly. A diuretic can reduce fluid volume, which can make some numbers look more concentrated. A diabetes medication can lower glucose. Another medication can affect kidney numbers without meaning the kidneys are falling apart.

But the iron number does not have an obvious medication explanation.

That is annoying, but useful. It means I need better questions.

For this one, the next reasonable discussion with my doctor is probably a full iron workup, not just staring at one serum iron number and hoping it gets bored and leaves.

That means asking about ferritin, TIBC, transferrin saturation, and whether hemochromatosis needs to be ruled out. Not because I am trying to collect scary medical words like trading cards, but because one high iron result might be noise, while a rising trend deserves a closer look.

The Red Blood Cell Crew Showed Up Loud

Another thing that stood out was the red blood cell side of the report.

My RBC was slightly high. My hemoglobin was high. My hematocrit was high.

In plain English, that means my blood has a higher concentration of red blood cells than expected. That can happen for several reasons, including dehydration, medication effects, sleep apnea, low oxygen, or other causes my doctor may want to check.

This matters because my hematocrit was 55.5, and that is not a number I want to shrug off.

Farxiga may be part of this conversation because it can affect fluid balance and hematocrit. Hydrochlorothiazide can also affect hydration because it is a diuretic. So I need to know whether these numbers are being pushed by medication and hydration, or whether they point to something deeper in the blood-production department.

Could medication be part of it? Maybe. Could hydration be part of it? Maybe. Could sleep apnea or some other oxygen issue be part of it? Also maybe.

Welcome to the glamorous part of being a Fitness Zombie, where every answer comes with three more questions and a billable follow-up appointment.

The Platelets Are Drifting the Wrong Way

Then there are the platelets.

Mine have been low for a while, but the trend is not my favorite. They went from 145 to 142 to 124.

Platelets help with clotting, so when they are low, it is worth paying attention. This does not mean panic. It means I should ask my doctor whether we need a repeat CBC, maybe a manual smear, and whether this connects to liver issues, medication effects, or something separate.

The reason this caught my attention is that platelets can sometimes be part of the fatty liver conversation, especially when doctors are looking at fibrosis risk. Again, not a diagnosis. Just another clue on the trail.

Low-dose aspirin probably affects platelet function more than platelet count, but with platelets already low, it is still worth asking whether it remains the right choice for me. Hydrochlorothiazide and glimepiride can rarely be associated with platelet issues, so those belong in the medication review too.

And apparently this trail is uphill, rocky, and patrolled by undead lab technicians.

What I Am Taking From This

The big picture is not that everything is falling apart.

The big picture is that some things improved, some things are still off, and a few things need real follow-up.

The better news:

• A1c is nowhere near the disaster zone it was in before.
• Kidney numbers improved from the last report.
• AST normalized.
• ALT improved.
• MCV came back into range.
• I quit alcohol years ago, so that box is checked.

The watchlist:

• A1c is still high.
• ALT is still high.
• Iron is now flagged Alert.
• Hemoglobin, hematocrit, and RBC are high.
• Platelets are lower than before.
• The old fatty liver diagnosis needs attention again.
• Medication effects need to be reviewed carefully.
• B12 may be worth checking instead of assuming the supplement is doing its job.

That is enough for me to take seriously. Not enough for me to write my own dramatic medical thriller, but enough to bring clear questions to my doctor.

The zombie translation is this: some of these monsters may be shadows caused by the campfire, but a few may be actual monsters. I need the doctor to help sort out which is which.

What Comes Next

The next step is not panic. It is follow-up.

I want to ask my doctor about:

• A repeat CBC, ideally when I am well hydrated
• A full iron panel
• Ferritin
• TIBC
• Transferrin saturation
• B12, folate, and possibly methylmalonic acid
• Follow-up on fatty liver
• Whether a liver ultrasound, FibroScan, or other fibrosis check makes sense
• Whether Farxiga and hydrochlorothiazide could be pushing hematocrit higher
• Whether my medications could explain the kidney-number swing
• Whether pravastatin could be part of the ALT story
• Whether the low platelets need a manual smear or hematology review

That is the plan for now.

The Fitness Zombie is not cured. He is not polished. He is not bounding up mountains with perfect labs and inspirational music playing in the background.

He is still limping through the fog with a stack of test results, a suspicious liver, iron numbers acting weird, medications that may or may not be stirring the pot, and enough stubbornness to keep asking questions.

The corpse is still moving.

And for now, that counts.