Help with blood test results and symptoms please

[pixieforest]

Hi, everyone has been so helpful on here and I would be grateful for any comments on my latest blood test results. Sorry, but there is a lot! I have extreme fatigue/exhaustion, dizziness, weakness, neurological symptoms; numbness, tingling, memory problems and brain fog. I have low thyroid function and also many food intolerances (too late to test for coeliac as I’ve been gluten free for 16 months, although one test is included here). I’m taking NDT and alternating between 1 grain and 1 1/2 grains daily. I’ve also posted this in thyroid uk in case anything is relevant there.

I should say that the first tests were taken 2 weeks ago at the hospital and the second tests were taken at the surgery last week (after supplementing with B12 and Vitamin D for a few days). Everything has been marked as satisfactory but I’ll include where the lab has flagged anything up in case it’s relevant. Unfortunately my iron levels haven’t been tested despite being told they would be.

Serum B12 213 ng/l (120 – 625)

private active b12 test the same week was b12 207 pmol/l (140 - 724) b12 active 63.6 pmol/l (25.10 – 165)

Serum folate 11.1 ug/l - no range given

TSH 0.02 (0.34 – 5.6)

Free T3 6.4 (4.0 – 6.6)

Free T4 13.6 (7.9 – 20)

HbA1C 32 (20 – 42)

Full blood count;

WBC 5.25 (4.2 – 10.8)

RBC 4.01 (3.9 – 5.6)

HB 129 g/l (120 – 160)

HCT 0.383 (0.360 – 0.460)

MCV 95.6 fl (82.0 – 104.0)

MCH (marked as high) 32.1 pg (27.0 – 32.0)

MCHC 336 g/l (320 – 360)

PLTS 245 (150 – 400)

RDW 12.7 (11.5 – 16.0)

Neutrophils 3.11 (2 – 7.5)

Lymphocytes (marked as low) 1.34 (1.5 – 3.5)

Monocytes 0.32 (0.2 – 0.9)

Eosinophils 0.32 (0.02 – 0.5)

Basophils 0.5 (0.02 – 0.10)

LUC 0.11 (0.0 – 0.16)

U/E/CREAT

Sodium 138 mmol/l (136 – 145)

Potassium 3.9 mmol/l (3.5 – 5.0)

Urea 2.6 mmol/l (2.5 – 6.6)

Creatine 55 umol/l (50 – 100)

AKI RISK 0

Albumin 35 g/l (35 – 50)

Calcium 2.31 mmol/l (2.1 – 2.6)

Magnesium 0.8 mmol/l (0.7 – 1.0)

Phosphate (marked as high) 1.5 mmol/l (0.8 – 1.4)

Cholesterol 3.7 mmol/l

Triglycerides 1.6 mmol/l (0.6 – 2.0)

HDL cholesterol 1.2 mmol/l

LDL cholesterol 1.8 mmol/l (0.1 – 3.9)

Corrected calcium 2.44 mmol/l (2.1 – 2.6)

Estimated GFR >90 ml/min

Cholesterol HDL ratio 3.1

Non HDL cholesterol 2.5

Second tests (1 week later – after supplementing B12 and Vitamin D)

Tissu transglutaminase IgA - <0.5 u/mL (<15.0) Note; negative for coeliac disease unless on a gluten free diet

TSH 0.01 (0.34 – 5.6) - GP noted over treated and to reduce dose.

T4 17.8 (7.9 – 20)

T3 4.7 (4 – 6.6)

Serum total 25-OH vit D 27 nmol/l (<50 suggestive of insufficiency)

Serum C reactive protein level <1 mg/l (0 – 10)

Serum creatine kinase 26 u/l (25 – 165)

Serum cortisol 219 nmol/l (7 – 10 am range 185 – 624) Taken at 9.30 AM.

Erythrocyte sedimentation rate (flagged as low) 2 mm/h (3 – 9)

Full blood count;

Total white cell count 5.42 (4.20 – 10.80)

Red blood cell count 4.29 (3.90 – 5.60)

Haemoglobin estimation 135 g/l (120 – 160)

Haematocrit 0.413 (0.36 – 0.46)

MCV 96.3 fl ((82 – 104)

MCH 31.4 pg ((27 – 32)

MCHC 326 g/l (320 – 360)

Platelet count 244 (150 – 400)

Red blood cell distribute width 12.2 (11.50 – 16.00)

Neutrophil count 3.62 (2.00 – 7.50)

Lymphocyte count (Flagged as low) 1.14 (1.50 – 3.50)

Monocyte count 0.31 (0.20 – 0.90)

Eosinophil count 0.23 (0.02 – 0.50)

Basophil count 0.05 (0.02 – 0.10)

Large unstained cells 0.07 (0.00 – 0.16)

This last week I’ve had really bad water retention in lower legs and feet, especially the leg that is practically permanently semi numb, I don’t know if it’s related to anything, just thought I’d mention it.

Thanks so much for reading, if you made it this far!

[Sleepybunny]

Hi,

Serum B12 213 ng/l (120 – 625)

b12 207 pmol/l (140 - 724)

Both B12 results are normal range but it is acknowledged in "BSH Cobalamin and Folate Guidelines" that people who are symptomatic for B12 deficiency should start initial B12 treatment. This includes people who are within normal range.

My understanding of flowchart below (I'm not a medic) is that those who are symptomatic for B12 deficiency and who show a positive clinical response to B12 treatment should be diagnosed with PA or Antibody PA.

Flowchart from BSH Cobalamin and Folate Guidelines

stichtingb12tekort.nl/weten...

Link to complete BSH Cobalamin and Folate Guidelines

b-s-h.org.uk/guidelines/gui...

Point 5 in next link is about being symptomatic for B12 deficiency with an in-range B12 result.

b12deficiency.info/b12-writ...