could someone check my test results please to explain them to me?

[Milsean]

Hi, I am a long time member but first time poster. I really enjoy reading all the post on this site and people are so genuinely helpful. I would love if someone could have a look and explain them to me.

I am 64 and have pernicious anemia over 40 years. I am with a new surgery over 1.5 years and have never seen a GP face to face. I have had two days phone appointments during that time only apart from my B12 every 3 months with the nurse. Any test results I get is a text message saying results ok but no one explains them to me,

Family history includes pernicious anemia, several family members including my own daughter have under active thyroid. My daughter had 1/3 of her kidney removed due to diseased kidney. Family members have died of cancer.

Bone profile

EGRF using creatinine (CKD-EPI) per 1.73 square metresErythrocyte sedimentation rateSerum ferritin levelHaemoglobin A1c level - IFCC standardisedLiver function testsRenal profileThyroid function testSerum urea level

it said results Borderline

Bone profile  Serum albumin level 42 g/L [35.0 - 50.0]Serum calcium level 2.38 mmol/L [2.2 - 2.6]Serum adjusted calcium concentration 2.34 mmol/L [2.2 - 2.6]Serum alkaline phosphatase level 69 u/L [30.0 - 130.0]Serum inorganic phosphate level 0.91 mmol/L [0.8 - 1.5]

eGFR using creatinine (CKD-EPI) per 1.73 square metres  eGFR using creatinine (CKD-EPI) per 1.73 square metres 58 mL/min [> 60.0]; Renal function probably normal when eGFR >60 withno other evidence of kidney damage.Interpret with caution in elderly, pregnant andamputees. Advice by e-mail from:[e-mail] orrenal.orgProvided acute kidney injury has been excluded -this eGFR is consistent with CKD stage G3a Below Recommended Range

Erythrocyte sedimentation rate  Erythrocyte sedimentation rate 13 mm/hour [0.0 - 20.0]

Serum ferritin level 127.0 ng/mL [13.0 - 150.0]; PLEASE NOTE: There has been a change in Ferritinreference ranges for some age groups.Ferritin results should be interpreted togetherwith the clinical picture.

Haemoglobin A1c level - IFCC standardised  Haemoglobin A1c level - IFCC standardised 34 mmol/mol [0.0 - 41.0]; HbA1c >=48 mmol/mol is diagnostic of DiabetesMellitus (DM). If asymptomatic repeat HbA1c within2 weeks for confirmation. If repeat <48 mmol/molnon-diabetic hyperglycaemia is present, please seebelow.HbA1c 42 - 47 mmol/mol indicates 'Non-diabeticHyperglycaemia' (NDH) with high risk of developingType 2 DM. Lifestyle changes are advised andrecheck progression to Type 2 DM. If NDH resultis within the last year, please consider referralto the National Diabetes Prevention Programme.HbA1c < 48 does not exclude diabetes in patientsdiagnosed with plasma glucose testingHbA1c < 42 mmol/mol does not exclude ongoing riskof diabetes. If patient is clinically high riskfor developing DM, suggest repeat in 1 year.*** Please note anything that alters red bloodcell turnover will make HbA1c results unreliableeg anaemia, B12 deficiency, renal failure, recentblood transfusion ***

Liver function tests  Serum total protein level 69 g/L [60.0 - 80.0]Serum globulin level 27 g/LSerum bilirubin level 7 umol/L [0.0 - 20.0]Serum alanine aminotransferase level 14 u/L [0.0 - 32.0]Renal profile  Serum sodium level 143 mmol/L [133.0 - 146.0]Serum potassium level 5.0 mmol/L [3.5 - 5.3]Serum creatinine level 90 umol/L [44.0 - 80.0]; Above high reference limit

Thyroid function test  Serum free T4 level 19.3 pmol/L [11.0 - 22.0]Serum TSH level 1.37 miu/L [0.27 - 4.2]Serum urea level 5.2 mmol/L [2.5 - 7.8]

Full blood count

Full blood count  Total white blood count 6.1 10*9/L [4.0 - 11.0]Haemoglobin concentration 130 g/L [120.0 - 160.0]Platelet count - observation 226 10*9/L [150.0 - 450.0]Red blood cell count 4.1 10*12/L [4.0 - 5.2]Haematocrit 0.38 L/L [0.36 - 0.46]Mean cell volume 93 fL [80.0 - 100.0]Mean cell haemoglobin level 32 pg [27.0 - 32.0]Mean cell haemoglobin concentration 340 g/L [280.0 - 355.0]Red blood cell distribution width 13.5 % [11.8 - 14.8]Neutrophil count 3.78 10*9/L [2.0 - 7.0]Lymphocyte count 1.71 10*9/L [1.0 - 3.0]Monocyte count - observation 0.46 10*9/L [0.2 - 1.0]Eosinophil count - observation 0.12 10*9/L [0.0 - 0.4]Basophil count 0.04 10*9/L [0.02 - 0.1]Nucleated red blood cell count < 0.5 10*9/L [0.0 - 0.5]Mean platelet volume 10.5 fL [7.8 - 11.0]

I am so sorry it is such a long post. I am so tired lately and had hoped the blood tests would tell me something but all I got from GP was test results ok.

I have tried to Google but it only confused me more. I live in UK.

Thank you for taking the time to read this.

[Nackapan]

I think its best to book an appointment

I'm in the same predicament give you results without any explanation.

So those I understand, okay.

but I have questions on a couple of results in my eyes significant changes. And on one says clearly . Out of range

Iron has to be looked at collectively by a medic.

in the past I questioned my ferritin as a drop and had symptoms that seemed relevant.

That result said 'no further action

when I finally was able to ask Gp she prescribed iron!

symptoms went and repeat blood tests

So good to question 🤔 hey!!!!

They shoukd explain results.

They used to ????

When well no need to scrutinise results but we all just want to get as well as possible.

work on any information .

I was asked recently why I went over things so much.

Well what can you say to a healthy person full of energy??

perhaps they would if felt like........most if the time 😡

[Milsean in reply to Nackapan]

Thank you Nackapan. It is almost impossible to get a face to face appointment with my surgery. You cannot book in advance only phone on the day which I did for my last appointment. I was told F2F booked with GP for 12 midday. An hour later had a call GP had an emergency and appointment now by phone. The text you get says rest results ok no further action needed.

[Nackapan in reply to Milsean]

Yes. I didn't even get that text.

kep pushing.

we end worrying about needless things but it's their job to explain.

I used to take everything as they said.

But no more since querying things csn get the treatment you need at times.

[Dilly_blue]

hello, i am in no way qualified, and I am hoping someone more knowledgeable will be along soon. Do you have any kidney problems diagnosed? I mention that because of the result for creatinine (CKD/EPI) of 58ml/min, which they have identified as below the reference range of above 60. The info also says that advice received by email says that “provided acute kidney injury has been excluded this eGFR is consistent with CKD stage G3a. Below recommended range”

You need to go back to your GP, and tell them your family history and ask whether the results mean you have Chronic Kidney Disease stage G3a, and if so, what needs to be the next step (tests / referrals / treatment / lifestyle changes etc etc). Especially within the context of your longstanding PA.

Wishing you all the best - and hope someone else will be along soon, with more knowledge / experience of these things…

D_b

[Milsean in reply to Dilly_blue]

Hi Dilly_blue, thank you for your reply also. My previous blood test results also had CKD stage 3. This was one I tried to Google and got more confused. I made a point of telling the GP about my daughters kidney problems and was so disappointed that I was not even offered a phone call to discuss the results. You have to phone at 8am to try and get either a phone or F2F appointment on that day. They no longer offer appointments in advance only on the day. Thank you for taking the time to reply.

[Sleepybunny]

Hi,

I'm not medically trained.

"eGFR using creatinine (CKD-EPI) per 1.73 square metres 58 mL/min [> 60.0]"

"this eGFR is consistent with CKD stage G3a Below Recommended Range"

What has your GP said to you about your kidney function?

Red blood cell count 4.1 10*12/L [4.0 - 5.2]

Your red blood cell count is only just within range.

What has your GP said about this?

"Any test results I get is a text message saying results ok but no one explains them to me,"

I suggest you make an appointment with NHS GP to discuss your results or consider making an appointment with a private GP.

I wondered if a local pharmacist might be worth talking to.

Might be worth putting your results on Thyroid UK forum along with outline of your story.

It's a very active, supportive forum.

[Milsean in reply to Sleepybunny]

Hi Sleepybunny, thank you for taking the time to reply to me. I was not sure if I was reading too much into the results trying to understand them with Dr Google 😂. That was why I wondered if people more knowledgeable than me could have a look to see if I was worrying unnecessary. Yes I will also add the post to Thyroid UK support forum. I will need to make an appointment to have them explained to me as it raises more questions to me than answers them. Thank you so much.

[Milsean]

I have found my test results from 23/05/2022 which I will add here also

tests were for

eGFR using creatinine (CKD-EPI) per 1.73 square metresLIPID PROFILELiver function testsRenal profile

Pathology InvestigationseGFR using creatinine (CKD-EPI) per 1.73 square metres  eGFR using creatinine (CKD-EPI) per 1.73 square metres 58 mL/min [> 60.0]; Renal function probably normal when eGFR >60 withno other evidence of kidney damage.Interpret with caution in elderly, pregnant andamputees. Advice by e-mail from:[e-mail] orrenal.orgProvided acute kidney injury has been excluded -this eGFR is consistent with CKD stage G3a Below Recommended Range

LIPID PROFILE  Serum cholesterol level 6.2 mmol/LSerum HDL cholesterol level 1.31 mmol/LSerum triglyceride levels 1.4 mmol/L [0.0 - 1.6]; In patients at very high cardiovascular risk(established CVD, type 2 diabetes, type 1 diabeteswith target organ damage, moderate to severe CKDor SCORE equal or greater than 10%)target concentrations:- LDL cholesterol less than 1.4 mmol/L- HDL cholesterol ideally greater than 1.2 mmol/L- Non-HDL cholesterol less than 2.6 mmol/L- Fasting Triglyceride less than 1.7 mmol/LSerum cholesterol/HDL ratio 4.7Serum LDL cholesterol level 4.3 mmol/LSerum non high density lipoprotein cholesterol level 4.89 mmol/L

Liver function tests  Serum total protein level 72 g/L [60.0 - 80.0]Serum albumin level 42 g/L [35.0 - 50.0]Serum globulin level 30 g/LSerum bilirubin level 7 umol/L [0.0 - 20.0]Serum alkaline phosphatase level 77 u/L [30.0 - 130.0]Serum alanine aminotransferase level 13 u/L [0.0 - 32.0]Renal profile  Serum sodium level 140 mmol/L [133.0 - 146.0]Serum potassium level 4.3 mmol/L [3.5 - 5.3]Serum creatinine level 90 umol/L [44.0 - 80.0]; Insufficient historical creatinine data to assessAKI risk; Above high reference limitGeneral InformationService Type: NewStatus: UnspecifiedProvider Report ID: 1-22B50115411-444Report Date: 23 May 2022

Not sure if this makes any difference? This was the first time I was aware of CKD stage 3 but due to my age was not sure what it meant? I have never had. Any kidney injuries.

Thank you

[Sleepybunny in reply to Milsean]

CKD stands for Chronic Kidney Disease

Please be aware that links I post may have details that could be upsetting.

NHS link about CKD

nhs.uk/conditions/kidney-di...

I am not medically trained but did see that CKD was mentioned with your blood test results.

I really think you need to talk face to face with your GP.

You could also ask your local pharmacist to explain CKD.

NICE guidelines CKD

nice.org.uk/guidance/ng203

The guidelines explain symptoms and causes of CKD, blood test results and when a person with CKD should be referred to a specialist.

I suggest putting concerns about treatment/diagnosis into a short letter to GP as harder to ignore.

Renal profile Serum sodium level 143 mmol/L [133.0 - 146.0]Serum potassium level 5.0 mmol/L [3.5 - 5.3]Serum creatinine level 90 umol/L [44.0 - 80.0]; Above high reference limit

Your most recent results say that serum creatinine level is above range.

Link about creatinine test

labtestsonline.org.uk/tests...

I can also see that your most recent sodium and potassium levels are quite close to the top of the range.

If you feel your health issues are urgent, you could contact NHS 111

111.nhs.uk/

If it's an emergency, ring 999.

[Milsean in reply to Sleepybunny]

Thank you so much Sleepybunny. I had checked out the link on CKD ands that was why I wondered if I was reading it right as I had thought further action or at least a discussion should have been had with me. I will contact th3 GP surgery and se if I can get @ F2F appointment. Thank you all so much for taking the time to reply to me. I do appreciate it.

[Gambit62 Administrator]

You really need to discuss any concerns with your GP - I'm not medically qualified but this may provide some context of what to talk through - at least in relation to creatinine

Raised creatinine may indicate CKD but it would really depend on the ratio to MMA which doesn't seem to have been mentioned. The level is only slightly high and it is consisitent between the two results with no change in serum levels.

Creatinine can also be raised by B12 deficiency - in which case MMA would also be high but both would tend to be sky high in that case, as opposed to slightly out of range.

The normal range is a statistical measure of where 90% of people normally sit - some people naturally sit above or below the normal range. As your test results seem consistent that could just be an indicator that you are someone who naturally has a slightly higher number.

(My diagnosis of B12 deficiency came from sky high creatinine levels during treatment for a broken ankle in hospital - which is why I am aware of the links between creatinine, MMA and B12).

[Milsean in reply to Gambit62]

Thank you so much Gambit62. When trying to Google to try and understand the results I was getting more anxious as I did not understand anything I was reading. I will read up some more on this before I discuss with my GP. Thank you for taking the time to respond. Everyone has been so nice and super helpful on this site. 🥰❤️🥰

[Sleepybunny]

HI again,

"apart from my B12 every 3 months with the nurse"

If you have neurological symptoms then my understanding is that injections should be every two months.

BNF Hydroxocobalamin link below outlines two patterns of treatment for B12 deficiency.

1) for those without neuro symptoms

2) for those WITH neuro symptoms

bnf.nice.org.uk/drugs/hydro...

Pernicious Anaemia Society website

pernicious-anaemia-society....

B12 Deficiency Info website

b12deficiency.info/

[Milsean in reply to Sleepybunny]

Hi Sleepybunny, thank you so much for the links. I will read up on them. xx

[Sleepybunny in reply to Milsean]

" I am so tired lately"

I just wondered if some of your tiredness might be caused by not getting enough B12.

Have you got results for folate and Vitamin D?

It's quite common on this forum for people to have folate, iron and Vit D deficiencies as well as B12 deficiency.

Serum ferritin level 127.0 ng/mL [13.0 - 150.0];

Your ferritin level is within normal range, were you taking an iron supplement?

I'm asking because I think some forum members would struggle to maintain an iron level as far up the range as yours.

Have you had any other iron tests?

Iron Studies

labtestsonline.org.uk/tests...

Links to forum threads where I left detailed replies with lots of B12 deficiency info eg causes and symptoms, more UK B12 documents, B12 books, B12 websites/films and B12 articles and a few hints on dealing with unhelpful GPs.

Some links may have details that could be upsetting.

Some of the info will be specific to UK.

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...

healthunlocked.com/pasoc/po...