[Lillyput189]

Why are my IgA and M-spike levels different?

by Lillyput189 on Sun Jul 13, 2014 10:04 am

I'm a little (make that a lot) confused as to why my IgA is 4200 but my M-spike is 3.7.

Shouldn't they be equal? I mean, shouldn't my M-spike be 4.2?

I need to learn so much about all these tests.

Also, why are my IgG & IgM levels so very low? (230 & <6 respectively). Because there's so much IgA?

If anyone can straighten me out on the difference in the numbers I would be greatly appreciative. Thx!

[Multibilly]

Re: Why are my IgA and M-spike levels different?

by Multibilly on Sun Jul 13, 2014 10:46 am

Lillyput,

Please see this discussion thread:

What's the added value of immunoglobulin results?

Assuming you are IgA type multiple myeloma, your healthy IgA level = 4200 - 3700 = 500 mg/dL, which is in the normal range.

[Lillyput189]

Re: Why are my IgA and M-spike levels different?

by Lillyput189 on Sun Jul 13, 2014 11:07 am

Thanks again Multibilly. You know so much about this stuff.

So, I'm in a good range, if I read you correctly, and it's a good thing that my m-spike is low. I'm really trying to read as much as possible about multiple myeloma but it does get a bit heavy after a while.

Is it also a good thing that my K/L ratio is low (0.11)?

Thank you again for your replies!

[Multibilly]

Re: Why are my IgA and M-spike levels different?

by Multibilly on Sun Jul 13, 2014 11:19 am

Lilliput,

Glad I could help. I remember it being an "Aha! moment" when I first figured out this stuff.

Given what you've said so far, you must be IgA lamdba type multiple myeloma. So, for a lambda-involved person (like you and me), you want your FLC ratio to go UP towards the normal range (0.26 to 1.65), not down. For a kappa-involved person, it's the opposite, where they are hoping to DROP into the normal range.

This will all start to be be second nature to you after awhile ... really

[Lillyput189]

Re: Why are my IgA and M-spike levels different?

by Lillyput189 on Sun Jul 13, 2014 11:40 am

Thanks again Multibilly!

[angiebaldy]

Re: Why are my IgA and M-spike levels different?

by angiebaldy on Sun Jul 13, 2014 7:17 pm

How do you figure your "healthy IgA" if your IgA is 859 with an m-spike of 0.9? I am smoldering by the way.

My husband said it is because my paraproteins are in the beta region and are difficult to count. I don't know.

[Multibilly]

Re: Why are my IgA and M-spike levels different?

by Multibilly on Sun Jul 13, 2014 7:56 pm

Angie,

Obviously, you figured out that your healthy IgA level can't be negative ... 859 - 900 = -41

So, I will defer to somebody with more experience on that one.

But I'm going to guess that your M-Spike that involves your IgA isn't exactly 0.9 g/dL, given what you said about the difficulty in measuring it. It wouldn't take much of an error in the M-Spike reading to get your IgA reading to a normal range (which is 70-400 mg/dL, according to my lab), or to a slightly suppressed range??

This is just a wild guess by a layman, so please verify it with your doc.

[mikeb]

Re: Why are my IgA and M-spike levels different?

by mikeb on Mon Jul 14, 2014 11:00 am

Hi Lilyput189,

Multibilly has provided some good information in this thread (as he always does), but one of your replies concerns me a bit. You said:

"So, I'm in a good range, if I read you correctly, and it's a good thing that my m-spike is low."

Actually, looking at your numbers (M-spike=3.7, IgA=4200, and k/l ratio=0.11), all of those numbers are well outside of the normal range. I am not familiar with your history, but I would suggest that you have further tests performed if they have not already been done for you. These would include a bone marrow biopsy, and some imaging such as a PET scan, and tests checking kidney function such as creatinine level.

Also one other point, getting back to one of your original questions, it is typically the case that MGUS / myeloma patients have one high immunoglobulin (in your case IgA) that drives down the values of the others (IgG and IgM in your case) so that they are abnormally low.

I am not a physician, so, of course, you should talk with your oncologist about your test results if you have not done that before.

(I don't want to alarm you with my comments here. I just saw your numbers and your comment that I quoted above, and got a little concerned that you might be thinking everything is "normal" when that is not the case.)

[Lillyput189]

Re: Why are my IgA and M-spike levels different?

by Lillyput189 on Mon Jul 14, 2014 4:14 pm

Hi mikeb,

I thought with the equation used, that my IgA was healthy at 500. Geesh, I told you guys I'm bad at understanding this stuff. It's just so much to absorb after riding the quiet wave of MGUS for 3 years. Thanks for the info & sorry Multibilly that I misunderstood.

[Multibilly]

Re: Why are my IgA and M-spike levels different?

by Multibilly on Mon Jul 14, 2014 4:41 pm

Lilliput,

Mike makes some very important points. I strictly addressed why you want to follow your immuoglobulins, but Mike correctly emphasizes that you should not think that just because your "healthy" IgA level is OK, that you don't have an issue. You obviously do have an issue if you have an M-Spike of 3.7, etc. Like Mike, I also am not trying to alarm you, but to instead simply make sure that you understand what we are saying.

Take care.