I wonder if anyone could offer some advice on my recent blood test results. Doctors have said retest in 1 year?! My background:
I have hashimoto's - diagnosed 3 years ago but probably had for 20 years! About 1 month ago I had the flu, self diagnosed but it felt like flu. Since then I have been exhausted, low in mood headachy and suffering from random joint pain, on and off. I went to the doctors and asked for a thyroid check. They also test lots of other thing but ironically forgot to ask for the thyroid so I have to go back tomorrow for this! Anyway these are the results - my are borderline and suggest PA but am I overthinking this
So everything is in range apart from a couple but this was the same with my thyroid for 2 years before I was finally diagnosed. I could barely function by that point and I don't want to get there again!
Sorry posted all results as not sure whats relevant.
Thanks xx
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Thisgirl1973
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People with autoimmune disorders (especially thyroid disorders such as Hashimoto’s thyroiditis and Grave’s disease) are at an elevated risk of becoming Vitamin B12 B12 deficient.
Both your B12 and Folate levels are at the bottom end of the scale.
Symptoms of B12 deficiency tend to develop slowly and may not be recognised immediately. As the condition worsens, common symptoms include:
Weakness and fatigue
Light-headedness and dizziness
Palpitations and rapid heartbeat
Shortness of breath
A sore tongue that has a red, beefy appearance
Nausea or poor appetite
Weight loss
Diarrhoea
Yellowish tinge to the skin and eyes
If low levels of B12 remain for a long time, the condition also can lead to irreversible damage to nerve cells, which can cause the following symptoms:
Numbness and tingling in the hands and feet
Difficulty walking
Muscle weakness
Irritability
Memory loss
Dementia
Depression
Psychosis
If you are manifesting any of the neurological symptoms your doctor should be treating you in accordance with The British Society for Haematology guidelines which say on the Diagnosis of B12 and Folate Deficiency "In the presence of discordance between the test result and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment".
I am not a medically trained person but I've had P.A. (a form of B12 deficiency) for more than 45 years.
Thank you. Ive been feeling depressed but not sure of thats because i am so tired and feel unwell all the time! Found christmas a real drag and had to be fake happy.
Sadly I think that because "Christmas" starts in October by the time we get to the "day" itself it all become a bit of an anticlimax instead of a celebration of the birth of Jesus.
I think Clivealive's advice is good. Maybe you could print it out and take it with you? Also, it seemed that your Haematocrit was too low to register - which is not normal at all - indicating aneamia. "Haematocrit (X76tb) Below range 0.353 l/l [0.36 - 0.46] Below low reference limit." Can you take a friend with you to the doctor's? Good luck.
waiting for a call back from doctors but receptionist has said hes marked my results as normal! I asked if this was taking in to account my symptoms and Hashimoto's but she obviously didnt know the answer! i feel a battle coming on
Retest in 1 year. Wow. That’s too long in my opinion. You need to get your medical records from this dr and find a new one. You have my deepest empathy. I have felt the same way. I hope you feel better soon.
Thank you. They've previously been really good so I will wait until Ive spoken to them. I know though 1 year - I wont be able to get out of bed for a retest!
Just spoke with GP and she wont do anything. She said retest in February and if its gone down more she will do IF test. I did ask her to do it now but she said my symptoms wont be from this as its in range. She did prescribe Vit D.
Not sure what to do? Supposed to start training for a marathon next week, have no energy for anything!
suggest you write to your GP pointing them at the BCSH guidelines on the diagnosis and treatment of cobalamin and folate disorders which can be found here but your GP can access them through the BNF
in particular draw their attention to the following
a) serum B12 is not a gold standard test and will miss 25% of patients who have B12 deficiency if taken as a single measure
b) macrocytosis (larger rounder red blood cells) is a symptom of B12 deficiency, not a defining characteristic and isn't present in 25% of patients presenting with B12 deficiency
could also be useful to point out that
c) it is possible to be both iron and B12 deficient and the mix of micro and macrocytosis to both be present and to mask each other if looking at full blood count.
d) there is a strong link between hashimotos and autoimmune gastritis - 40% of patients with PA will go on to develop hashimotos and studies give ranges between 10% and 40% for hashi's pateints developing gastritis. Generally the first sign is iron deficiency.
private testing wouldn't solve the problem of your GPs choice only to act on the basis of test results.
You don't necessarily have to 'challenge' them- you are just saying you are concerned that following the test could result in people not being treated properly and these are the guidelines that show why - supported by tested evidence.
You could also try contacting the PAS directly for support but I don't think anyone will be around until after new - year
Just wanted to thank you your advice. Doctor called me yesterday following the letter and said come in next week for an IF test. She said if that’s positive they will start injection but if it negative and result are same or worse they will refer to a hemotologist. It’s a shame it got to this point but I’m glad to be moving forward xx
*UPDATE* just thought I would post that tomorrow I am having my first loading dose of B12 and that is mainly due to all the advice i have received via the forum - thank you!
I was referred to a haematologist and she did more tests and agreed I need to have B12 injections.
What to expect I dont know but hoping to just feel more 'normal'!
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