FBC Test results help please

[tzracer]

Hi, I mainly hang around the thyroid forum and a bit on here as I've injected B12 in the past.

I have a friend who has had his thyroid removed last year and is struggling with liver and kidney function and GP isnt helping much. I'm trying to get him to ask GP for B12, Ferritin, Folate and vit D to be tested as he doesnt seem to have any results for these.

Here is his full blood count results, I would be gratefull to hear some opinion on them as you are much more knowlegable in this area. Obviousley quite a number are out of range.

Total white cell count

8.6 10*9/L (3.7 - 9.5)

Red blood cell (RBC) count

3.91 10*12/L (4.50 - 6.00)

Haemoglobin estimation

103 g/L (133 - 167)

Haematocrit

0.306 (0.400 - 0.520)

Mean corpuscular volume (MCV)

78.3 fL (78.0 - 102.0)

Mean corpusc. haemoglobin(MCH)

26.3 pg (25.6 - 34.8)

Mean corpusc. Hb. conc. (MCHC)

337 g/L (310 - 360)

Red blood cell distribution width

13.9% (11.6 - 14.6)

Platelet count

261 10*9/L (150 - 450)

Neutrophil count

6.6 10*9/L (1.8 - 7.5)

Lymphocyte count

1.1 10*9/L (1.0 - 4.0)

Monocyte count

0.6 10*9/L (0.0 - 1.0)

Eosinophil count

0.3 10*9/L (0.0 - 0.4)

Basophil count

0.1 10*9/L (0.0 - 0.2)

Many thanks in advance

[shaws]

I have several autoimmune conditions - one of them is Pernicious Anaemia and I've had it for a number of years.

I have now been given a B12 injection monthly for this condition instead of the quarterly one I used to get.

I am sorry I cannot be more helpful.

I feel well and am energetic.

My Mother's B12 injections were stopped as GP stated she needed no more B12 injections.

This decision - I believe -may have caused my Mother to develop stomach cancer which I think may be due to having B12 removed.

[tzracer in reply to shaws]

Thanks for replying, good news regarding your B12 injections but saddening to hear about your mum's treatment.

[Narwhal10]

Sorry tzracer,

An FBC in isolation tells very limited information. Without your friend’s symptoms.

Why he had thyroid removed.

Medication because of thyroidectomy.

His U & E’s, LFT’s, Ferritin (an Iron panel would be better), Vitamin D, folate, Vitamin B12.

His age, Family History, Medical History, his level of activity all tell something. So, his Clinical Picture.

🤷‍♀️

[tzracer in reply to Narwhal10]

Thanks for the reply, I can fill in some of the blanks and was hoping something stood out in those results.He is 65, currently very fatigued and quiet breathless moving around. He was hyperthyroid and (my opinion) over treated with carbimazol to the point he got 2 large nodules and became hypothyroid. They started him on levothyroxine, 150mcg now on 200mcg. Removed the nodules and his thyroid. He has a lot going on, a number of major surgeries, diabetic, 1 kidney his gfr is 20. Plus quite a medication list.

TSH was 2 and think t4 was 15. He is 116kg so in theory getting a good dose of T4. I'm trying to help him to mitigate absorbsion issues.

His surgeon has brought up the question of anemia in a letter to his GP early Jan. But GP has done nothing and my friend isn't very pushy to get things followed up.

I'll try and get more info and report back.

[Narwhal10 in reply to tzracer]

Your friend’s surgeon is far more qualified than me. Plus, a GP takes advice from them. Your friend can ring their GP, the surgeon’s secretary.

I am really sorry, I am just a random person on the internet. The breathlessness is a cause for concern and the fatigue. Hope you get the ball rolling in the right direction and soon.

[tzracer in reply to Narwhal10]

Ok, thanks again for the reply. I appreciate your time and maybe things are different in the PAS group than the thyroid group where people seem far more informed than GPs and endochronoligists. It's the GP and himself that have got him in this mess.

[Narwhal10 in reply to tzracer]

Hi tzracer,

I am sorry, several of us are medically qualified on these sites. I am a midwife with further qualifications and from a medical family. I advise safely.

Your friend has a complex medical history. In his case, I would want him sat in front of me. So, I can also physically examine him, head to toe. Read all his notes, what the surgeon had to say. Ask your friend a long list of questions. Order more tests. It is complex. Like FlipperTD says,

My first guess is that his iron status is borderline, if not deficient. I can just glance at a person and know that. I would confirm it via full iron panel.

Best wishes

[FlipperTD]

Scientist, not medic.

Working with what we've got here, he's anaemic. [Hb reduced.] His red cells are on the small small side, even if they appear to be in the reference range quoted [MCV]. This appears to be relatively stable [RDW within the quoted range].

My first guess is that his iron status is borderline, if not deficient. That can mask megaloblastic change that we find in B12 and/or folate deficiency, so it would be worth checking those.

You tell us that he's struggling with liver & kidney function; Urea and Electrolytes would be worth measuring for starters, because deranged U&Es can be associated with anaemia.

These results need analysis with the patient, by a GP who is up to speed with what's going on, as there may be other relevant information in the patient's notes.

Hope this helps!

[tzracer in reply to FlipperTD]

Thanks for the reply, I'm pushing him to get back on to to the GP, he has an appointment with nephrology on Thursday.

[FlipperTD in reply to tzracer]

That sounds like a good idea. 👍

[B12life]

also ch ck zinc and copper. Vit d

[tzracer in reply to B12life]

Thanks, I'll get him to try and add them to the list