Blood test advice on results

[Doings]

Hello everyone I’d love some advice please.

I’m trying to wean off Pramipexole and have had blood test results back. I’ve been emailed a copy prior to doctors phonecall arranged for next week but if you can throw any light on result for

Serum Folate is 2.0 ug/L it is highlighted in red as Abnormal result and needs discussion

Ferritin is 316 and says it will be discussed at appointment.

TSH normal at1.31

B12 normal at 291

Glucose normal 4.2

Everything else on fbc is normal.

GP not knowledge but is helpful. I’m down to 3 and 1/2 Pramipexole per day for last 2 weeks, but will reduce again in a few days. I noticed calmer RLS on reduced dose so far.

If you could advise what RLS medication I should go onto and at what stage I’d be very grateful.

[Hidden]

The significance of the low folate is unclear.

Some sources say the normal range is 2 to 20 ug/L.

Some say that anything lower than 3 ug/L is low.

Whether this is significant or not depends on other factors.

1 is that this could be due to a lack of dietary intake in the last 3 days.

2 it usually goes along with a low B12.

3 Low B12/folate can cause megaloblastic anaemia. The FBC should have picked up if this is the case.

It may mean you need extra dietary folate or a supplement.

This is unrelated to iron deficiency anaemia. If your FBC is normal and ferritin 316, then you don't have this anaemia.

A ferritin of 316 seems unusual for somebody with RLS, however it is possible.

It may be a sign of inflammation.

Well done on reducing the pramipexole.

The standard recommended alternative to a dopamine agonist is an alpha 2 delta ligand, i.e. either pregabalin or gabapentin.

You can start taking one of these at any time. It is better to start at least 4 weeks before finally stopping. They can take that time to start working. You may have to adjust the dose until it's sufficient.

They don't work for everyone, but neither does ropinirole, I'm afraid it's a matter of trial and error.

Another alternative is an opioid.

[DicCarlson]

Lots of information regarding iron status - not just Ferritin level. You can read more here TIBC, % Saturation, etc...

bloodtestsresults.com/iron-...

And here...

davidg170.sg-host.com/frequ...

[SeekingAnswersForRLS]

Do not worry about ferum levels....The RLS patient's brain needs more, not less iron. 300 is ideal. It sounds like you're augmenting on pramipexole. What mg do you take? Do you subscribe to the RLS foundation? There is a lot of info on augmentation there....and ferritin levels.. Many well-meaning doctors who are ignorant to RLS prescribe too much pramipexole to their patients unknowingly. Do begin a folate supplement. Blessings to you.

[Doings in reply to SeekingAnswersForRLS]

Thank you for your response. I was on 0.088 x 4 tablets per day now I’m on 3 1/2 and will go to 3 1/4 shortly. The magnesium seems to help and will get a Folate supplement as well.