I received a text from my GP surgery asking me to attend an NHS healthcheck. I called the surgery to ask what it entailed and the Receptionist did not know, so I looked on the NHS website: blood tests would be taken for Diabetes, Kidneys and Cholesterol. When I arrived for my tests, the HCA filled up about four test tubes, I was surprised and asked why she had taken so many, she then said she was taking B12, thyroid, I protested that I should have been warned as I had given myself a jab yesterday (I self inject once per week) and I also take biotin and it would skew the results. She said breezily "oh it shouldn't make any difference". Surprise, surprise, I received a telephone call from the GP receptionist this afternoon saying that my last B12 prescription is being declined, no reason given. I explained that I am going on holiday next week and that I need to take my B12 medication, if I become unwell on holiday as a result of not taking my medication my travel insurance may be invalidated, I will be away for three and a half weeks.
I just wanted to ask your opinion - does a GP have a right to take blood samples without telling you in advance what they are for? Had I known, I would have declined the healthcheck - I have not found out anything new anyway. I could have made the B12 blood test appointment at a more favourable time i.e. not the day after having a jab and I would have stopped taking my vitimins for a couple of days too.
Interestingly, I noticed on this set of blood tests that my red blood cell distribution width is just slightly below range - I believe this indicates deficiency or defective utilisation of B12 or folate. Sorry I should have mentioned that my B12 results were over 2000 (197 - 771).
Any thoughts?
Thanks.
Anne
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HKAnne
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the nurse was completely wrong and the results of both the B12 and thyroid panels were a waste of time. Biotin is known to cause false readings in thyroid tests (and think it can also give false results in relation to some tests to do with B12 - but not sure which ones).
I think you should be entitled to know exactly what blood tests are being done and why. If the panel was to do with aging then that should have been made clear - also the full range of tests that were being done - if only to avoid the waste on tests that were not going to be accurate in the circumstances.
Did the receptionist give you the option of speaking to the GP about why the prescription had been declined - if not then think that you are entitled to ask to speak to them directly.
I am glad that you agree with me that one should be entitled to know what they are being tested for.
When I was given my HealthCheck results by the Nurse yesterday, she asked me "how did you catch autoimmune disease?"
I have called the Receptionist (a different one) again, to see what the outcome is but apparently the doctor is still busy and has not had time to look at her earlier note.
If I don't have either a response or a prescription from the GP by lunchtime tomorrow, I shall be writing a letter of complaint to the practice manager. In fact, I am so annoyed I might write a letter of complaint anyway.
"does a GP have a right to take blood samples without telling you"
Not sure if GP has a right to take samples without telling you but I think patients have a right to refuse blood tests. However refusing tests could irritate a GP.
"What You Need to Know About Pernicious Anaemia and B12 Deficiency" by Martyn Hooper
Martyn Hooper is the chair of PAS (Pernicious Anaemia Society). Book is up to date with UK b12 guidelines.
"Living with Pernicious Anaemia and Vitamin B12 Deficiency" by Martyn Hooper
Has several case studies.
"Could it Be B12?: An Epidemic of Misdiagnoses" by Sally Pacholok and JJ. Stuart (USA authors)
Very comprehensive with lots of case studies.
My personal preference when I have queries about treatment is to write a brief, polite letter with relevant info eg symptoms, test results, extracts from documents etc.
My understanding is that in UK, letters to GPs are filed with a patient's medical notes so are a record of issues raised.
Have you considered getting copies of /viewing your medical records as there may be clues at to why B12 prescription was declined.
Thanks so much for all these useful links and advice.
I am a member of the Pernicious Anemia Society and I have Martyn's book What you Need to Know About Pernicious Anaemia.
I am in the process of drafting a letter of complaint to the Practice Manager. However, I am getting a bit bored with this as I sent a similar letter to the GP in January, it seems they either dont read the letters or discard the information after a couple of months.
When you write say that your letter must be kept on file . They should record letters and you have the right to view your records via appointment with the practice manager. The old BCSH guidelines i have state that once B12 injections start no further B12 testing is appropriate .
Many thanks, that is really useful information, I will have a look through the BCSH guidelines for that info.
I had already hand delivered the letter before I received your email, so did not get a chance to say that the letter must be kept on file.
However, I have still not heard back from the GP to say that he will be issuing my prescription - so I think I will have to go down the "buying my own route" - I always knew it might happen.
There is a doctrine of consent - which should be informed consent.
How much effort needs to be put into getting consent? Well, ethicists seem to think that it depends on what is being proposed. I have read that for a very low level - for example, taking blood pressure, temperature, pulse - simply holding your arm out or allowing an ear thermometer to have the device pointed could be deemed consent.
Blood tests, I suspect have two levels. First, as above, allowing someone to access your arm and push a needle in is one part. Second is accepting the testing they will be doing. Most of the time tests like full blood count are fairly uncontroversial. But some blood tests can be far more controversial. Obvious ones include HIV, pregnancy and possibly all genetic tests.
In my view, if you express an unwillingness for a particular test, then they must not perform that test. The reason need not be rational - just an expression of your choice. However, there are difficulties. Many of us might find it less difficult to cope if a test for a very serious disease had been almost hidden in a bunch of other tests. Possibly worrying less between blood draw and result? And the sheer number of blood tests done makes the idea of detailed and full explanation of every test would simply not feasible.
My NHS GP has told me that after even the first b12 injection there is no point having B12 blood tests as they always come back abnormally high after that.
So the test results should be disregarded. And blood count is what is used by my surgery to determine deficiency.
I would see a different doctor if you can, especially considering your out of range blood count.
As for doing tests that you have not been told about is wrong, possibly illegal. But I suspect that would be hard to prove.
B12d.org are a charity that could help you, it is free but they rely on donations. They can provide injectable b12.
Biotin only afffects the results if you’re taking very large doses.
RDW only indicates a problem if it is above range, when it indicates red cells thar are a mix of too large and too small. A low RDW says that all your red cells are very similar in size - not a bad thing at all.
Sorry to hear about your Daugter, it is very difficult trying to put your point of view accross to a doctor, because they have trained for so many years they feel they have to know everything. However, I have known myself for over 58 years, so nobody can know me or my body better than me and I know when I am not feeling well.
I am glad that your Daughter was treated properly at the next hospital - I can't believe they get away with it.
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