Blood test results abnormal. But doctor says no... - Thyroid UK

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Blood test results abnormal. But doctor says normal! How?

DandyButch profile image
40 Replies

Last week I had some blood tests, however, once again, not all blood tests that were requested, were taken!!!I have results of some which are abnormal as follows....

Heaematocrit

0.483 0.37 - 9.47 abnormal

Red Blood cell distribution width

16.3% 11.5 - 15 abnormal

Iron

14 umol/L 14 - 30 normal

Transferrin saturation

21% 15-50 normal

Rheumatoid factor

28iu/mL <20 abnormal

TPA

486 ku/L unknown

FEV1/FVC

54% unknown

Any help on distinguishing these results would be brilliant.

My GP says they are normal - no action?????

Really?

Thankyou in advance .

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DandyButch
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FallingInReverse profile image
FallingInReverse

Gotta love anyone who can see an iron result at the minimum threshold and say “nothing to see here” with a straight face, especially with the other supporting indicators.

Do you have a ferritin result?

Iron is 0% through range, target is 55-70%

Transferrin is too low, optimal is 35 to 45%, with a minimum saturation of 30% required to successfully treat with T3.

Over range RDW definitely consistent with low iron, heaematocrit on lower end also consistent with low iron.

DandyButch profile image
DandyButch in reply toFallingInReverse

Hello, I don't think they've done ferritin at all, as with other vits and minerals for optimal thyroid. With the NHS, they don't know what they're doing. I had to ask for the iron blood test. I also asked for B12, but they didn't do that!!!!GPs and Endocrinologists don't understand thyroiditis, and associated deficiencies and conditions. One tablet, you're fixed!!!!!

I had looked these things up on-line because I didn't understand some of them. Some also indicate inflammation.

Surely they should advise you that your results are abnormal, or at the bottom of range, so that even if the NHS won't prescribe supplements, because you are 'within range', you can supplement yourself?

No wonder so many people stay ill or become ill, when they don't check the basics, with a simple deficiency being a cause.

I do think that what you said warrants awareness. But what do I now do?

SlowDragon profile image
SlowDragonAdministrator in reply toDandyButch

But what do I now do?

Iron is virtually deficient

Either politely insist GP test ferritin, folate, B12 and vitamin D…..plus thyroid TSH, Ft4 and Ft3

Or test privately

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Lulu2607 profile image
Lulu2607 in reply toDandyButch

Hi. Your Iron is low but what is your haemoglobin result. Technically you are not anaemic unless haemoglobin is low as well. My haemoglobin has been fine but iron at about 10 and I'm just told yeah it's a bit low but buy a multivitamin and eat more green leafy veg!

DandyButch profile image
DandyButch in reply toLulu2607

My haemoglobin estimation is156g/L range 115-165 normal

Lulu2607 profile image
Lulu2607 in reply toDandyButch

That's similar to mine,and it looks healthy enough, so maybe that's why the Dr is not overly concerned about your Iron result even though you need to keep an eye on it . There are so many components to an iron profile test it's quite confusing. I tend to take the (simplistic) view that if my haemoglobin is OK that's not too bad. Of course it depends on whether you have other comorbidities alongside hypothyroid that can complicate the matter. Everybody has different needs. Vitamin D is too low in just about everybody and in thyroid patients more so it seems so that's an obvious one to keep an eye on and it can make a real difference how you feel. Mine was 30, should be at least 50 so I now take vit D regularly. I think it's helped.

DandyButch profile image
DandyButch in reply toLulu2607

You're right. It is so confusing. I just thought that because iron serum was low that I needed to supplement. Maybe not?

DandyButch profile image
DandyButch in reply toFallingInReverse

Hi, I ve posted ferritin and haemoglobin results further down. Both normal.

SlowDragon profile image
SlowDragonAdministrator

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Meanwhile

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

Great replies from FallingInReverse

re ferritin and Three arrows

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great reply by @fallinginreverse

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Really interesting talk on YouTube, link in reply by Humanbean discussing both iron deficiency and towards end how inflammation can also be an issue

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:

Females 18 ≤ age < 40. 30 to 180

Females 40 ≤ age < 50. 30 to 207

Females 50 ≤ age < 60. 30 to 264l

Females Age ≥ 60. 30 to 332

Males 18 ≤ age < 40 30 to 442

Males Age ≥ 40 30 to 518

The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.

SlowDragon profile image
SlowDragonAdministrator

TPA 486 ku/L unknown

That’s TPO antibodies. High

Confirms autoimmune thyroid disease also called Hashimoto’s. Which you already know is the cause of your hypothyroidism

Have you had coeliac blood test

Or are you already on strictly gluten free diet and/or dairy free diet

SlowDragon profile image
SlowDragonAdministrator

Rheumatoid factor 28iu/mL <20 abnormal

mayoclinic.org/tests-proced....

DandyButch profile image
DandyButch in reply toSlowDragon

Thankyou Slowdragon for all the info. It'll take a while to absorb it all. Enlightening, the bits I've read. Why the hell aren't GPs and Endocrinologists trained in all of this????? Clearly, we have to find out for ourselves, but then they take no notice, because they are trained in medicine, and you aren't, so shut up.

DandyButch profile image
DandyButch in reply toSlowDragon

Hi, I found serum ferritin blood test result.

318ug/L range 30-400

SlowDragon profile image
SlowDragonAdministrator in reply toDandyButch

was this test at same time

Have you had CRP test for inflammation

High inflammation can result in high ferritin

DandyButch profile image
DandyButch in reply toSlowDragon

Hi, no CRP Test.

DandyButch profile image
DandyButch in reply toSlowDragon

Yes ferritin at same time

DandyButch profile image
DandyButch in reply toSlowDragon

Is it possible to have low iron, but normal ferritin? What does this indicate?

humanbean profile image
humanbean in reply toDandyButch

Is it possible to have low iron, but normal ferritin? What does this indicate?

Yes, it is possible to have low iron but normal ferritin.

What it most likely indicates is a condition called "Anaemia of Chronic Disease (or Chronic Inflammation)", which is extremely common in people with chronic diseases like thyroid disease or with poor gut health.

If you were to supplement iron what is most likely to happen is that your ferritin would get higher and your iron would stay low.

Some useful links on the subject :

irondisorders.org/anemia-of...

In the following link, see page 8 :

web.archive.org/web/2020021...

And for info on various forms of anaemia :

irondisorders.org/wp-conten...

...

To get over the problem of the Anaemia of Chronic Disease can be difficult because it isn't always clear what causes the problem.

I would suggest optimising the nutrients that you can i.e. vitamin B12, folate, vitamin D. Also take vitamin C daily.

Test your zinc and copper if you can. If one is high then the other is low. So you could have low zinc, high copper, or alternatively high zinc, low copper. Low zinc is much more common than high zinc.

If zinc is low and copper is high then supplementing zinc should raise zinc and lower copper.

If zinc is high and copper is low then supplementing copper should raise copper and lower zinc.

Other supplements I would suggest trying are magnesium (if your kidneys function reasonably well), selenium and a B Complex.

This is worth reading :

thyroiduk.org/role-of-vitam...

...

I would also suggest that you go 100% gluten-free as an experiment. If you have had no benefits after three months then go back to eating gluten again and see if you feel worse or no different.

After making up your mind whether or not to continue eating/not eating gluten you could also try giving up milk products made from animal milk. Just remember eggs are NOT dairy and if you give up animal-sourced dairy you don't have to give up eggs too.

Giving up any foods for your health should only be done as a last resort. Cutting things out of your diet increases your risk of low nutrients. If you don't get a benefit from giving something up then start eating it again.

DandyButch profile image
DandyButch in reply tohumanbean

Hello, I am currently taking B12 3000mcg Methylcobalamin, Thorne Basic B complex, Thorne Vit C with flavonoids Vit D & K2 4000iu/100ug, Super Omega Fish Oil, selenium 200ug, Magnesium 500mg, plus sporadic soluble Vit C and Zinc.I don't feel that my liothyronine is optimal following my last blood test, but endocrinologist won't increase due to low TSH. My next appointment is Sept 2025!

So, I'm trying to sort out vits and minerals.

DandyButch profile image
DandyButch in reply tohumanbean

Hello, again, I've just read the link re anaemia of chronic disease. It states for this, you have low iron serum and low ferritin serum. Although my iron is low, my ferritin is 318ug/L range 30 - 400. Transferrin saturation is 21% range 15-50. The link states that if iron is low, but ferritin is high, iron deficiency anaemia is most likely the cause and not anaemia of chronic disease.

humanbean profile image
humanbean in reply toDandyButch

I've just read the link re anaemia of chronic disease. It states for this, you have low iron serum and low ferritin serum. Although my iron is low, my ferritin is 318ug/L range 30 - 400.

That is weird because this link says serum iron is low and ferritin is high :

irondisorders.org/wp-conten...

Both that link and the one about anaemia of chronic disease come from the same website.

DandyButch profile image
DandyButch in reply tohumanbean

I've just checked. Yes, they do contradict each other. So, none the wiser??!!??

humanbean profile image
humanbean in reply toDandyButch

I think if serum iron is low and serum ferritin is low it suggests that iron is deficient and supplementing is required.

If serum iron is low and serum ferritin is high then it suggests that someone probably has Anaemia of Chronic Disease (ACD) and supplementing might not be a good idea.

There are plenty of other sources of info on ACD on the web.

Wikipedia has this link :

en.wikipedia.org/wiki/Anemi...

You could try supplementing iron for, say, 4 - 8 weeks and then do another iron panel at the end of it to see what happens. If your ferritin rises but your serum iron stays low then it would suggest you don't have classic iron deficiency and are more likely to have ACD.

DandyButch profile image
DandyButch in reply toSlowDragon

So, does this mean my iron is OK?

SlowDragon profile image
SlowDragonAdministrator in reply toDandyButch

At the moment suggest you retest again in 3 months

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Lulu2607 profile image
Lulu2607 in reply toDandyButch

From my experience, I've been told that ferritin is not always a reliable indicator as it can be high due to inflammation. Also, if your haemoglobin is healthy I would not think iron supplements are necessary if you could get your iron up through iron rich foods. I'm no expert but that's just going off the results you've provided. Mine has improved a bit but my diet could be better. I no longer enjoy food like I used to as I'm conscious of trying to eat unadulterated food all the time and avoid gluten, always packet reading and keeping my weight at a good level.

DandyButch profile image
DandyButch in reply toLulu2607

I just don't understand why iron serum is so low, and not a problem!! What is the point of it?

Lulu2607 profile image
Lulu2607 in reply toDandyButch

Maybe low iron is due to poor absorption in the gut due to hypothyroidism. I understand hypothyroid means our gut is not efficient at extracting nutrients from foods which is probably why we end up supplementing certain vitamins and minerals.

FallingInReverse profile image
FallingInReverse

There is no single measure for iron that you can use to detemine if something is wrong or what you should do. And even with all the blood tests done at once, you still need to do periodic testing - anywhere from 4 weeks through a year depending on whether you are fixing iron or maintaining it.

So iron is one measure at one point in time.

Blood iron results are fairly fast moving, up and down. It can be impacted by an iron rich meal the night before the test. It is also completely and totally individual - some peoples can jump and others can drop in a few weeks time.

Here is one recco for what you might consider tracking when it comes to iron:

Iron

Total iron-binding capacity (TIBC)

Transferrin saturation

Ferritin

High Sensitivity CRP (CRP-hs)

What you should do is to make sure you are consistent with whatever iron supplements you are taking, keep on a steady regiment u til your next test, and then as recommended above you need to plan for a retest in 6-8 weeks.

The good news is your iron indicators are mixed with some positive leaning indicators. Your terrific ferritin is what most of us struggle to increase, so you’re starting off with a great platform.

I’ve been doing similar in my house for me and my daughter and our results are different - underscoring that everyone is different.

You have to learn about your own absorption and levels.

Don’t forget, excess iron is toxic and over time will create permanent and irreversible organ damage. If you supplement, test regularly..

DandyButch profile image
DandyButch in reply toFallingInReverse

I understand that high ferritin can be a symptom of inflammation. As I have hashimoto's and rheumatoid arthritis, could this be significant?

FallingInReverse profile image
FallingInReverse in reply toDandyButch

I’m not sure how significant the impact, but 100% yes, that’s why we test CRP-hs.

Ferritin is reactive to inflammation so we test together to see if inflammation is at play.

But I don’t know the scale of impact - like, if there was or wasn’t inflammation what your Ferritin would be.

With no iron supplements - take advice above , do a full iron panel in 4-8 weeks. FYI - there was a time my iron went from above range to below in about 5 weeks. Also, my ferritin has been in single digits/teens. So your profile right now does not look horrible : ) So just get a full panel and then you can figure out what to do.

DandyButch profile image
DandyButch in reply toFallingInReverse

My CRP serum was 16mg/L 0-5 range

So, high.

FallingInReverse profile image
FallingInReverse in reply toDandyButch

Can you also confirm that the iron, ferritin, transferrin saturation and the CRP were some at the same time.

I know you didn’t think you had them at the start of the post, and so just making sure.

Assuming yes - also confirm you haven’t been sick, had a cold/flu/virus etc recently before this test.

Either way - advise the same. Wait and redo the full iron panel all together. Personally I’d like to see if inflammation changes and if ferritin subsequently changes.

Hypo (and hypo related anemia) are all long haul races… there is no quick fix or short cuts. Gather your data and then assess.

Caveat/disclaimer- all responses are personal opinion based on my own personal experience : )

DandyButch profile image
DandyButch in reply toFallingInReverse

Currently, I am not taking any iron supplements.

DandyButch profile image
DandyButch

Iron, ferritin and transferring saturation all done last week. CRP serum last taken August 2022. I had a slight cold a few weeks ago, but nothing major.

FallingInReverse profile image
FallingInReverse in reply toDandyButch

Well, that CRP won’t be helpful for the iron/ferritin/saturation : ) It will be helpful when done all together.

I just re-read the replies above again, and they are so good! You’ve got to sort out the low iron & transferrin saturation against what seems to be high in range ferritin. You can’t do that without a CRP at the same time.

DandyButch profile image
DandyButch in reply toFallingInReverse

These tests were requested by different sources within the NHS for different reasons.

Trying to get the GP to do anything at the same time is almost impossible. Remember, they cannot multitask. One symptom, one illness, more than one symptom, mental health problem. One illness can not possibly have lots of symptoms.

Things frequently are not explained to you. Frequently I have asked for various tests, but they have only done some!!!!!

Computer says no.

But, surely the fact that I have hashimoto's, inflammation exists?

FallingInReverse profile image
FallingInReverse in reply toDandyButch

SD reply above has Medichecks link…

also - no, I have hashis and no inflammation.

(edit- meaning, no inflammation that is measurable by CRP-hs, at least)

DandyButch profile image
DandyButch in reply toFallingInReverse

Cannot afford private testing.

FallingInReverse profile image
FallingInReverse in reply toDandyButch

Take some time then and increase iron rich foods in your diet.

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