Advice on blood test result

[kahlan]

Hi everyone,

After my initial post in the thyroid forum I've been recommended to post here for some more advice. I have had RAI in 2012 after being diagnosed with Graves disease, and because I was beginning to feel rubbish again I had a private blood test in December 2016:

TSH = 0.711 (0.27-4.2)

Free thyroxine = 17.07 (12-22)

Total thyroxine T4 = 132 (59-154)

Free T3 = 4.13 (3.1-6.8)

Thyroglobulin antibody = 25.71 (0-115)

Thyroid peroxidase antibodies = 9.39 (0-34)

Vitamin B12 = 120 (191-663)

Serum folate = 1.54 (3.89-26.8)

Ferritin = 7.18 (13-150)

I was advised to consult my GP, who requested further blood tests in February 2017:

Serum B12 = 195 (150-99999)

Serum folate = 2.4 (4.2-19.8)

White blood count = 8 (4-13)

Haemoglobin concentration = 111 (115-165)

Haematocrit = 0.369 (0.35-0.47)

RBC count = 4.57 (3.9-5.6)

MCV = 80.7 (73-100)

Mean cell haemoglobin level = 24.3 (26-32)

Mean cell haemoglobin concentration = 301 (300-350)

RBC distribution width = 16.1 (11.8-14.8)

Serum ferritin = 6 (15-150)

Serum TSH = 2.11 (0.25-4)

Free T4 = 16 (12-22)

I am feeling awful. I am exhausted. My eyes are painfully dry and I've had a couple of episodes where there has been a small area of vision that has suddenly gone blurry which after 10 mins has passed. My skin is so dry. I drop things and my balance is sometimes off. My memory is rubbish - I forget things I've just read. I can't even remember if I listed all my symptoms to my GP.

I've not changed my diet at all and I am not vegan or vegetarian, although I don't eat much red meat. Until this year I was donating blood so I know my iron was acceptable (this year they tested and refused me as expected).

I finally had an follow-up appointment with my GP last week and she has given me iron and 5mg folic acid tablets. However she said my B12 is in range so that's nothing to worry about. Whilst it being in range is true is it near the bottom at 195 (150-99999) so should I still be concerned? Should I go back and push this? Any advice gratefully received.

Thank you all very much.

[taka Administrator]

Welcome!

It is good that your GP is acting on your folate and iron deficiencies. It is true that your B12 results are in range (I'm guessing the 2 different sets of results are even using different units?) but you are at a level where you may very well have symptoms of a B12 deficiency which may just be adding to you not felling well.

Symptom lists: pernicious-anaemia-society.... and b12deficiency.info/signs-an...

These are the guidelines for treating a B12 deficiency. In this they acknowledge that there are people who are symptomatic with "normal" B12 levels and it may be appropriate to treat them and/or do further tests to establish which treatment is appropriate. pernicious-anaemia-society.... Maybe discuss this with your GP?

It may also be worth checking your Vitamin D too as being low in this can cause you to feel pretty dire too. Unfortunately symptoms of B12, Vit D and iron deficiencies (and thyroid problems!) tend to have pretty similar symptoms so it may be hard to work out which is causing your symptoms.

It may also be an idea to get your eyes checked too if you haven't already done so.

Have a look at the pinned posts (on the right or at the bottom if you are on a phone) for more info.

[kahlan in reply to taka]

Thank you for your reply. I'll go back to the GP and push for further action on my B12 and get my vit D tested. I thought I was reasonably prepared but I see there are further things to consider!

[taka Administrator in reply to kahlan]

Good luck

[Maga1]

Ive underactive thyroid, low iron,folic acid vitamin d,but ive just recently got all these symptoms again so cos doctor says my b12 borderline I investigation the symptoms when deficit and I certainly fit the criteria so I ordered b12 as it appears perfectly harmless an u can oveedose on it so no harm done,im breathless too which is probably my anaemia but im continuing with my iron tabs and making sure ive iron intake daily in some way, any thg to feel better fatigue sucks lol!!!

[Maga1 in reply to Maga1]

Meant cant overdose.apologise for awful text but seems I cant even find my words lol