Thoughts on blood results and next steps please

[Wispymisty]

Blood test resultsI have had most of my results in today and would appreciate some thoughts on the following results please Serum CRP - 6.5 mg/L (<5.0) marked as satisfactory

Rheumatoid factor 12 IU/mL (<14.0)

Serum folate 3.0 ug/L (2.0-18.7) marked borderline- retest needed

Serum B12 1540 ng/L (197-771) had B12 inj on

TSH 4.3 mU/L (0.27-4.5) marked borderline

eGFR using creatine (CKD-EPI) per 1.73 square m 82 mL/min (90-200) marked borderline

ESR insufficient- need to repeat

Serum n-terminal Pro b- type naturetic peptide concentrate (UOM ng/L) 40 ng/L needs repeat

FBC need to repeat as

Haemoglobin 154 g/L (117-149)

Hematocrit 0.454 (0.347 - 0.445)

My ANA was (frustratingly) negative but there is no reference range given against the result

There were also cholesterol (top end of range) liver function which was fine, hba1c within range, u&es all fine and a negative cytoplasmic ANCA which was negative.

Thanks for any thoughts 🙂

I think there are a couple more to come back but the main thing is that I now need some repeated - this has changed since I looked at 13:00 when it just said I needed to discuss results.

I wonder if I can/should ask for any others to be added on when I reattend?

I also have Empty Sella Syndrome (no pituitary) but was discharged by endocrinology as apparently no related issues?!

My main issues are my eyes - really dry and gritty and often woken by eye socket pain or stabbing pain - slowly being eased by use of heated eye mask and daily drops; widespread pain especially hands (which also swell) and wrists; facial flushing - possibly Malar but hidden a bit by rosacea; fatigue which has been steadily increasing over the last 3-4 years. Also have past episode of pleurisy, blocked parotid/salivary glands; bilateral painful knees, disc issues in neck and lumbar spine, TMJ, tgn and skin issues such as pompholyx.

I was diagnosed with fibromyalgia in 2010 although GP did suspect SLE and/or Sjogrens - again a negative ANA.

I have a history of reynauds, migraine and chronic blepharitis since early teens, IBS and gynae issues since early 20s

Family history of rheumatoid arthritis on my maternal side and my daughter showing signs of possible EDS.

Am just feeling lost as I know it's more than the fibromyalgia but tests don't show it 😕

[KnitSewPurl]

Hi , please get your eyes seen by a specialist especially by a cornea specialist they will do a test to check tear duct . They will also look at the back of your eyes to see if it is dry / crackling if it needs moisturising. This is part of Sjögren's. What you described about your eyes is exactly what I feel when I don't hv any moisture in my eyes. The eyes gets very painful.

You will need to hv day time drops and night gel Xailin .

Hope you get it sorted out

[Wispymisty in reply to KnitSewPurl]

Thanks for your reply KnitSewPurl - I've only ever seen the people at Specsavers but more and more think I need my eyes looking at properly. I'm hoping I can persuade my GP to refer me to Dr Price as she has a special interest in Sjogrens - but would I need a separate referral for my eyes or would that be something the consultant needs to arrange? I'm not sure how successful I'll be getting more than one referral at the same time (!)

I'm currently using Thealoz drops during the day but have nothing specific for nighttime - which is probably why I'm getting woken more frequently by my eye pain...

[Tiggywoos in reply to Wispymisty]

Dr Price sounds fantastic but ideally you would want to be under the care of NHS eye clinic as well in the case of needing an appointment really quickly in the future if that makes sense . X

[Tiggywoos]

hey lovely please ask your GP to refer you to the hospital eye clinic . Don’t want to worry you but it’s really important to get them checked out by the clinic . I had pain like you and it was scleritis , then had several episodes of episcleritis . Your GP will happily refer you 😘xx

[Wispymisty in reply to Tiggywoos]

Hi, thanks for your reply Tiggywoos- I've mentioned it to my opticians before but other than telling me about eye drops they didn't seem unduly worried- in fact I'd actually asked the Practice nurse about uveitis and she passed me to the opticians 🤔I'm calling into the GP surgery later today to try and book an appointment with the Dr - I'll definitely mention this and research it a bit in the meantime.

Thanks again