Latest blood tests results - opinions please

I phoned up my surgery today to ask about my results and the receptionist had a look and said that it was all normal. I then asked for a print out so I went up there to pick up them up.

Here are the results:

Vitamin B12 362 ng/L (211-911)

Folate 6.19 ug/L (greater than 5.38)

Ferritin 12 ug/L (10 - 291)

Anti TTG(igA) 0.2 u/mL(0.0-6.0) this result makes coeliac unlikely but doesn't exclude it

IgA Coeliac 1.6g/L(0.8-3.7)

Thyroid peroxidase antibody 92 iu/mL (0.0-100.0)

Serum albumin level 41 g/L (30-51)

Serum calcium level 2.28 mmol/L

Corrected serum calcium level 2.22mmol (2.1-2.5)

serum inorganic phosphate level 1.37 mmol/L (0.8-1.4)

serum alkaline phosphatase 70u/L (30-135)

serum C reactive protein level 2 mg/L (0.0-6.0)

serum prolactin level 146mu/L (59-619)

25Oh vitamin D

serum 25-Hydroxy vitamin D3 level 24.3 nmol/L

serum vitamin d2 level 5.0 nmol/L

It says also that D2+ D3 under 25 total means you are deficient, 25 to 50 sub-optimal treatment may be required, above 125 is overtreated and above 500 is toxicity

I'm no expert but ferritin seems really down to the bottom and vitamin d is also quite low. No idea what the tpo antibodies results mean. Any help would be greatly appreciated.

16 Replies

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  • TPO info here healthunlocked.com/thyroidu...

    Ferritin is low- are you on Levo? Then it would matter more as needed for conversion to T3.

    [As no thyroid panel , I think not]

  • Hi tegz

    nope not on Levo, still trying to figure out what is wrong with me.

    Had tsh and ft4 tested at the end of August but my results were normal. tsh was 1.4 and ft4 was 16.4. My doctor wouldn't repeat but maanged to convince her to do all the above tests.

  • No serum Iron? That could be low -and cause fatigue.[Anemia]

    You VitD is low for summer- probably need topping up in winter!

    If you're thinking 'thyroid' still, a private T3 test could be useful.

    NHS won't do it on your figures.

  • Can't see serum iron on the list so don't think it was tested.

    Feeling very fatigued,losing lots of hair and have joint pain.Also feel cold all the time, get pins and needles in feet and hands, depression that comes and goes. Kept thinking that it was a thyroid issue. Someone had told me that perhaps it was Hashimoto that is why I pushed for tpo antibodies but as the results are in the top of end of the range I wasn't sure if it meant anything.

    Might look into testing t3 as you suggested.Thanks tegz

  • Be aware, your TPO is high and that's the wrong end to be- so you're right to pursue this.

    With the symptoms you're getting you need to be treatedl. Get the iron checked., though.

    Even 'simple' HypoT seems to throw the NHS in a spin, far too often.

    Your folate is low -so B12 may not be effective and that level is not that high, either.

    Iron, B12 and D are all needed to get UAT treated well- so you are on track already :)

  • In my personal opinion your ferritin level is so low that you are virtually anaemic. This alone can make you feel c**p. Been there, done that, as they say. Get some spatone from your chemist, or iron tablets or a good multivitamin with iron.

    Your B12 level is low and that can also make you feel rubbish. I use a Vit B12 oral spray which I buy from Amazon. Your Vit D level is low and I also use an oral spray from Amazon for that.

    Assuming the usual ranges, your FT4 is too low. You need to have your FT3 measured. The labs usually refuse to do this. My doctor had to put in a special request to get mine done. Politely but firmly insist that you want it measured. That is the hormone that the body uses. FT4 is not used, but converted to T3. If your T4 is low, it is likely that your fT3 level will be too low. Your TSH is produced by your pituitary and there are many reasons why the pituitary cannot always make the required level to keep your thyroid working effectively.

    If your doctor refuses to help you, consider trying Nutri Thyroid nutricentre.com/p-21606-nut... (I take 2 a day).

  • Tegz and Rosetrees

    Thank you both for your input and advice. My doctor is being very difficult about all of this. I haven't seen her about these latest results as she just seems to think that I'm depressed and all these symptoms are in my head.

    Judging but what you are both saying these results are far from normal then. I do feel like utter crap and like I can't function properly as a wife and mother.

    Rosetrees - you mention that my FT4 is low. I thought it looked pretty normal :/ I am now wondering if it is FT4 then :s The paperwork says serum free T4 level so I am assuming that is FT4? Ranges 10 -19.8.

    Tegz - I don't think I am entirely getting to grips with the tpo antibodies thing. Does someone WITHOUT thyroid problems have tpo antibodies or do you just make them if there is an issue there? I also did think I was at the top end of the range so I wasn't sure if between 0-100 is normal and above that is bad.

  • My TPO reading was low <10, along with Thyroglobulin AB's -so I haven't delved too deep there.

    I know Hashis is caused by auto-immune attacks on the thyroid and this can take time to go hypo.

    Figures in the thousands have been quoted here and that is way too high -and too late for comfort.

    I think everyone can have ABs 'as normal' -but yours at the top end, with thyroid query, needs watching.

    Autoimmune stuff doesn't scan easy -and Drs like to 'wait and see'!

  • Ugh wait and see doesn't sound like fun when you feel rubbish. Thanks for explaining the tpo reading. Do you know if the amount can go down or is it that once it reaches that number the only way is stay as it is or go up?

    My neck area has been feeling weird in the past few weeks but I can't work out if it's where the thyroid is and also if I'm just imagining it as I have been reading so much about it all. I especially notice it when I read out loud for a long period of time. It doesn't hurt but it feels a bit weird like there is something there. It's only on one side though.

  • Ugh, Yep- I know, I thought that when I typed it- but we know GPs too!

    I think you'll get wised up from tips here and push harder next visit and that should help.

    The TPO check can be redone easily enough & it is a specific marker.

    Maybe- ask for an ultrasound scan?

  • You're pretty much in the situation I was in 4 years ago. Your symptoms looks pretty much identical to mine. I have had little or no help from the NHS with this, but I have raised my B12 and folate, D and ferritin to optimal levels and the difference it makes is unbelievable. When they were all low and the NHS was being unhelpful, I was diagnosed with CFS and just left to get on with it.

    A sub-lingual B12 lozenge, a vitamin D gelcap and tablets for the others, should do the trick. Spatone will not be strong enough to raise that ferritin level, you will need ferrous fumarate or something similar.

    Good luck!

  • Hi Chihiro,

    You've had some great advice. Your results lean towards something causing malabsorption - ferritin, vit D and folate right at the bottom of the range, B12 not much better, definitely in the grey area. Yes you can self treat all these things, but first I really would see the doctor about the results. You say you've only spoken to the receptionist, who said they were all normal? I don't know about you, but I'm not prepared to take medical advice from a receptionist (no disrespect intended).

    Can you make an appointment with the GP, maybe a different one at the practice? I think you need to discuss, in particular, your very low ferritin and vit D, and see if you can get treatment from your doctor for these. As others have said, they should be checking the other iron markers with that result, see here:

    labtestsonline.org.uk/under...

    In terms of vitamin D, you're so close to the deficient bucket, and if I remember from your previous post vit D deficiency is what came to mind with your symptoms before you had the test. I really think you should stress with your doctor that you think this result is abnormal given the fact that the test was taken at the end of a long hot summer. Frankly, your result is still in the bucket that says "sub optimal treatment may be required", and since you are symptomatic of vit D deficiency I would really expect the doctor to treat you. I have seen vit D ranges in which your result would be considered deficient.

    Bring this along to your doctor, according to this <30nmol/L is deficient:

    nos.org.uk/document.doc?id=...

    And have a look at this, it's NHS guidance for one particular area in London, and has a really good treatment flowchart:

    bhrhospitals.nhs.uk/Downloa...

    You would be in the 25-50 bracket +symptoms, and treatment is suggested. Even with no symptoms it suggests a maintenance dose.

    There is clearly something physical going on here, whether it be the start of a thyroid condition, or malabsorption for some other reason (?) but ultimately you need to discuss all this with a medical professional first. Bring a bullet list with all your symptoms with you and ask for it to be added to your medical records. In this way it makes it harder for them to just write down "depressed" without making note of anything else.

    If you still get nowhere with your GP, then that is the time to consider other options, like seeing someone privately or self treating the deficiencies. For now I would get back in there to discuss these latest results face to face. Is there someone you can bring with you for support?

    In terms of vitamin B12 and folate, you'll probably need to self supplement as your result would be considered normal, unless you want to go down the road of private testing for Active B12, MMA and homocysteine. Make sure its sublingual MethylB12, at least 1000mcg. You can get Jarrow's MethylB12 sublinguals in 1000mcg or 5000mcg, put under the tongue for as long as possible, at least 45 mins if you can. Or Betteryou Boost Methyl B12 spray under the tongue. For folate use something like Solgar folate (as Metafolin).

    H x

  • UPDATE -

    Have seen the doctor and she initially said results were normal but then had another look and admitted ferritin was a bit low and so was vitamin D. She told me to go buy supplements for them.

    She said B12 was good enough but I could supplement if I needed to. I asked if the physical symptoms I have been having could then be caused by these low levels and she agreed. She then asked me if I wanted b12 injections. I said yes so I start those next week. Are there side effects?

    My husband has also gone out to buy vitamin D tablets and floradix to help with the iron but I noticed that it also has vitamin b12 in it. Would having too much vitamin b12 be bad for me????

    I also asked her about my depression that comes and goes and she just pretty much told me that when depressed you can have good days. I immediately told her that I have been depressed before and yes I had good days but the depression would always be there. This feels different. It comes and it goes like a switch. To shut me up she said that maybe I have cyclothymia. I came home and looked it up and I don't think I do because there is no mania.

    Oh and finally I asked her about the borderline tpo ab results and she said they are normal because in range but I think has agreed to recheck them in 3 months time when we will also check the ferritin, vitamin D and b12 again. Couldn't get her to agree to test anything else at this stage.

  • I think this is a really good result Chihiro, she's paying attention and willing to monitor you as well (even though you have to buy your own supplements)! B12 is water soluble so any excess is excreted in urine, so I wouldn't worry about it being in the floradix (such a small amount in there anyway). Make sure the vit D tablets are D3. Fantastic news that she's agreed to the B12 injections, you'll also need some folic acid or metafolin (the more active form). There's a little bit in the floradix, but not enough.

    Here is a link about what to expect from injections:

    b12d.org/b12-injections-wha...

    And here's one about B12 and folate:

    b12d.org/b12-and-folate

    The first time I had the loading dose 7 years ago I had no side effects at all, just felt really great almost straight away. The second time I had them after 7 years of no treatment my deficiency was more advanced, so I did have some start-up symptoms (headaches, nerve pain). But when this passed I felt great. Everyone's different. I would perhaps say don't expect to feel great straight away, and it's worth keeping a symptom diary to monitor how things are progressing. I suspect you might not feel a whole lot of improvement until you get that iron and vit D up a bit higher.

    Keep in touch and let me know how it's all going, H x

  • Hi Hampster

    Thanks for the tips and links....very informative and between them and your experiences I don't feel so worried about them now. Do you know what my doctor said today? I was telling her that a friend of mine has been having b12 injections because she was severly deficient and that she had told me that literally from one day to the next she felt like her old self was coming back, she had energy again and didn't feel like sleeping all day long. The doctor told me that the injections are like a placebo...nothing actually happens that quickly but the fact that you had the injections tricks your brain into believing you are better.

    This with the "depression stands alone" comment from last week is really making me think that I need to change doctor. Still...you are right she has acknowledged that there is a problem here so I can't complain too much.

    I do wonder though if my problem is simply just that all these levels are low I should start feeling better but if on top of this there is also a thyroid issue does it mean that I still won't feel well despite the injections and supplements??

  • Placebo effect, that old chesnut. Sometimes, I think we're living in a parallel universe from our doctors. If I was going to get relief from a Placebo effect, I'd sure as hell make sure my brain didn't give me any start-up symptoms first, just the fun stuff!!!

    Regarding the thyroid, just make sure she re-tests that as well at the 3 month mark, and then you'll know which way you're going with it. I'd stick with this doctor, as it sounds like she's going to take her cues from you, even if she thinks it's all bogus.

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