A bit about me

[FlipperTD]

I worked in a Haematology laboratory for over 40 years until retirement. In that time I saw the introduction of automation into Blood Counting, Coagulation testing, and later, B12, Folate, Ferritin, Intrinsic Factor antibodies and Erythropoietin assays. In addition to routine laboratory work, I participated in various research studies, with quite a few on blood loss, and including a big one [the biggest in the World at the time] on the measurement of menorrhagia and treatment options. [Don't ask.]

[Gambit62 Administrator]

Thank you

[FlipperTD in reply to Gambit62]

😀

[deniseinmilden]

Superb insight, thank you!

I love seeing your posts and look forward to hearing from you more.

[Hidden]

Being a haematologist (in your honest opinion) would you trust blood test 100% ?.

[FlipperTD in reply to Hidden]

As a scientist, not a medic, I'd say 'It all depends on the test!' Some tests, yes, but other tests, it depends. Much of the time the quality of the sample can affect the test far more than our users think it will. It's important to consider the process end-to-end, from needle to result. If everything's done to the correct standard, then most things are good. A good starting point is for the doctor to 'Listen to the patient telling you the diagnosis!' Some tests are grossly over-requested, and as a consequence of little, if any value.

[Hidden in reply to FlipperTD]

Thanks, I've also questioned whether having blood tests at different times of the day affects results.Similar to blood pressure, goes up and down!

[FlipperTD in reply to Hidden]

You're absolutely right. You've discovered diurnal variation. It depends on what we measure but some things do vary a bit. Enough to move into and out of reference ranges.

[Hidden in reply to FlipperTD]

Never heard of this!

It just happened one day I had bad stomach in morning and in the past told too drink flat coke,

Drank one can and had blood test later... high sugar level, which of course went back down to normal levels.

My brother had blood tests in morning , had high potassium.... retested was fine. He had had dates the night before.

So I guessed that some results were misleading due too what one had consumed with in hours prior to the test.

Anyway I appreciate your reply, I just have an inquisitive mind !

[Hidden]

Thank you Flipper I’ve always enjoyed your posts too you seem a very level headed person who enjoys sharing his expertise in a nice civil way and that’s really appreciated because after all, there are a great many ill and vulnerable people here and trust me when I say a cross word,in any context ,dictates the rest of our day so it’s lovely when we feel supported by the other members so a big thank you again. X

[FlipperTD in reply to Hidden]

Thank you. I try to help, but sometimes it seems to have a different effect!

[Hidden in reply to FlipperTD]

Well I can’t honestly say I’ve seen any evidence of that in your posts or responses,you usually give a good scientific answer tapering off with trust in your doctor,some do some don’t but it’s said with the best intentions isn’t it.Just keep doing what your doing your an asset here.thank you.take care

[FlipperTD in reply to Hidden]

My role was as an intermediary. Doctors asked me for stuff, which I then reported back to them. Sometimes I had to explain what it meant to them, and generally they accepted the advice. If I'd intervened and communicated with a patient without the doctor's say-so, I'd have been liable to being struck off. That approach stays with me, hence the 'trust your doctor'.

[Hidden in reply to FlipperTD]

"trust your doctor"

Oooooooooh I wish I had your confidence like many on this website have been let down by Doctors. The big difference between you and the rest of us is your knowledge of the ins and outs of different results. ( I congratulate you on that, not a criticism at all). The fact that we fail to ask questions for example blood test results and leave this solely to doctors is a mistake I made.

Also the fact many doctors are really lacking in knowledge about b12 deficiency is a real handicap.

Many are here because doctors either do not listen or take us seriously !

[FlipperTD in reply to Hidden]

Scientist, not medic, about to give a famous fictional politician's answer:

'You might think that, but I couldn't possibly comment!' GPs are effectively the gatekeepers, are under a lot of pressure, and generall do their best. Good luck. If you don't believe or trust the person you have, then you could always consider someone else...

[Hidden in reply to FlipperTD]

I love your politicians answer 👍

Ah I am with a different surgery now, and the difference between them is completely different,

Also I am not afraid to question them on things, where before I would say yes sir yes sir.

Anyway keep up the good work!

[eclilley]

That's good to know, good to understand people's expertise.I have some bloods on Friday, after asking for them, Vit D (never been checked in 4.5 yrs of being investigated & B12D being found etc), I have asked for full iron panel (but am expecting they'll only do ferritin), and folate again. They said B12 & I have again said I do NOT want B12 to be done, again, & quoted from NICE/BSH/BNF saying unnecessary & unhelpful once treatment is started....

In your view, should any of those really be done as a fasting test to be most accurate? I have it at c.4pm, so could have breakfast then fast, if necessary.

[FlipperTD in reply to eclilley]

The old 'Scientist, not medic' comes into play here.

Knowing how labs and hospitals work, I would generally recommend that it's best to avoid having bloods taken on Friday, and certainly in the afternoon. Not knowing where the tests will be performed it's hard to be specific, but in general, the sooner they're tested the better. When 'fasting' samples are required, then you would be told. However, virtually everything tested is better on a fasting sample.

There's no reason to repeat B12 once therapy has started, but some lab systems are set up so that if one test is requested, you get both B12 and Folate.

[eclilley in reply to FlipperTD]

Hmmm, thank you. Yes, I did wonder, but I already had an appt for B12 jab on Fri, managed to get them to add in doing bloods then too. Otherwise would have been much later in Aug.I want to know now how my ferritin is esp, as I am about to start on weekly (or more) SI.

I thought so, re fasting, so will have early breakfast only.

Thank you!

[Damn-it]

@FlipperTD, I often wonder about IF and PA antibody tests. Would they be different blood was drawn when fasted vs having eaten?

[FlipperTD in reply to Damn-it]

Scientist, not medic's answer: probably no difference fasting vs not fasting for IFb and Parietal Cell Abs, but as I've said before, fasting samples tend to be 'cleaner' in the lab. Nothing for you to worry about!

[pitney]

😀Thank you

[Foggyme Administrator]

👍🙂

[lynxis]

I love your contributions and insights and I'm glad you're here. 🙂❤️