Can anyone look at these blood tests please and help me undrstand before Endo apt

[Corinne]

Hi

I am due to see new Endo on Thursday, I have Hashi's and on 75mg Levo, have felt unwell for years and recently feeling bad , worst are: insomnia, brain fog, memory probs, head aches, cant get words out, muscle weakness and aches consitpation .bloated. Have had blood test a few weeks ago following a really dizzy sick felling whilst I was out shopping and felt almost drunk! never felt before and below were results taken 1 week after:

Had blood tests done few weeks ago:

B12 733 ( 180-800)

ferritin 227 (25-300)

glucose 4.5 (3-7.80)

Folate 17.4 (3-20)

Creatinine 81 ( 44-80)

Calcium 2.62 (2.20-2.60)

corrected Calcium 2.52 (2.20 2.60)

Bone profile out of all higher test:

albumin 50 (35-50)

MCV mean corpusclar volume 101 ( 76-96)

MCH mean corpusc. haemoglobin 34.8 ( 27-32)

red blood cell distribution 14.9 % (10-15 %)

on 75g Levo

Free T4 16.5 (12-22)

TSH 0.15 (0.40-4)

Can anyone help me with results as GP says no action.

Thanks

Corinne

[Hidden]

Do you take any supplements?

[Hidden in reply to Hidden]

My initial thoughts are your ferritin is very high. This can be a sign of iron overload, or an acute inflammatory reaction. I would ask your Endo to run further iron tests (serum iron, TIBC etc.) to get a fuller picture. If these are high as well this could indicate iron overload, if these are low then the inflammatory response is most likely:

labtestsonline.org.uk/under...

Whilst your B12 and folate look to be at good levels, there is a contradiction in your full blood count results. High MCV, high MCH, and high end of the range red blood cell distribution, all point to macrocytic anaemia (as can be caused by B12 and folate deficiency):

labtestsonline.org.uk/under...

This could indicate a problem with transporting B12 to where it needs to go - it might be swirling around in your blood, but can it get to tissue level? Useful tests would be active B12, MMA and homocysteine, if you can twist the Endo's arm to do them:

biolab.co.uk/docs/vitaminB1...

biolab.co.uk/docs/homocyst.pdf

Your calcium is top end of the range, I don't know much about this but possibly worth the Endo running some tests to check your parathyroids.

Creatinine is a measure of kidney function, obviously you're right at the top of that range too so worth asking the Endo to explain.

I really don't understand why your GP doesn't see these flags in the context of your symptoms, particularly as he is ignoring some out of range items. They really don't have the skills to look beyond the basics I'm afraid. Your best bet is to insist on some answers from the Endo I think.

H x

[helvella]

There is a mis-match in my view between the apparently adequate B12 and folate and yet an out-of-range high MCV. And a top-of-range red blood cell distribution width? (That tends to be high if you have one factor such as iron deficiency trying make your red blood cells smaller and another factor (often low B12) trying to make them bigger. You end up with some small and some big and too few at the optimum middling size.)

You appear to have plenty of iron. (If my very limited knowledge and understanding works, MCH is a touch high simply because MCV is high.) Indeed I would perhaps be surprised at your ferritin being that high and would at least consider if there were a cause (though it is clearly still well in range).

Are you taking any B12 supplementation? I would wish you to have an Active B12 test.

Do post anything else you have which might help us to understand better.

Rod

[PinkNinja in reply to helvella]

Perhaps she has recently started B12 and it hasn't had chance to improve the MCV. Perhaps this could explain the cell width distribution to an extent. Perhaps she took her B12 within a couple of days of the test...

Although ferritin was performed, no other iron test was so it is difficult to know if her iron and is indeed at a good level. There is a possibility that the high ferritin is caused by inflammation and she in fact has lower serum iron, which would make your reasoning about the small cell size quite likely.

We need more clues for our detective work but I like your reasoning so far

[helvella in reply to PinkNinja]

I assumed Corinne didn't post some other results?

I agree about starting B12 being a good candidate - maybe even a relatively low dose if Corrinne is absorbing reasonably well.

Glad you worked out my ferritin reasoning.

Rod

[Corinne in reply to PinkNinja]

Hi Carolyn

The ferritin is serum ferritin level, am taking high potencey vit B ,but not regularly as keep forgetting to take them and not sure if I took them when I had blood test!

Sorry about having to do detective work due to to lack of info!!

[PinkNinja in reply to Corinne]

Actually I was rather enjoying it A detective was actually one of the things I wanted to be when I was growing up, as well as a doctor and a mad scientist. I ultimately chose 'mad scientist'

Even if you didn't take your vitamin B that day, taking it in the few days before can affect your blood test result.

Do you have a serum iron reading? This would be useful as it would indicate whether your ferritin is this high because you have good iron stores or because you have inflammation

Carolyn x

[Corinne in reply to PinkNinja]

Hi CarolynB,

cool ud make a good detective!

my serun ferritin reading was 227ug ( 25-300)

serum Folate 17.4 ug ( 3-20)

Corinne x

[Corinne]

Hi Hampster1,

Yes I take 2g Vit C. high potency Vit B , selenium and zinc.

and my blood tests came back showing all within range.

Corinne x

[Hidden in reply to Corinne]

What do you mean by high potency vit B? Do you mean a methyl B12 sublingual or spray? Would be useful to know what type and strength of supplement. H x

[Corinne]

Hi hampster1,

what I meant was it is a higher than norm Vit B supp, its:

Viridian High five B-complex with magnesium ascorbate: ascorbic acid 200 mg

magnesium 12mg

pantothenic acid (b5) 200mg

Niacin (vit b3) 50mg

vit b6 20mg

Thiamin b1 20mg

Riboflavin b2 20mg

choline bitrartrate 20mg

inositol 20mg

PABA para aminobenzonic acid 20mg

Biotin 200ug

Folic acid 200ug

Vit B12 colbalamin 20ug

vegetarian cellulose capsule 120mg

was told by store person high strength Vit b product so thought was good idea to have to support Thyroid

Corinne.

[Hidden in reply to Corinne]

Yes it is a good idea to take a B-complex, but if you have problems absorbing or transporting B12 or folate the amounts in that one are small and wouldn't correct a deficiency.

Also not enough in there to affect your blood test results I would have thought, so on the face of it you have good serum B12 and folate but signs in your FBC that you are actually deficient (high MCV).

See if you can convince the endo to run some of the tests we've discussed above, you can but ask, but I'm assuming he won't be that forward thinking.

Here is a symptom list for B12 deficiency so you can compare to your own situation:

pernicious-anaemia-society....

H x

[Corinne in reply to Hidden]

Hi hampster1,

Have looked on blood test result links you posted a few posts before and it also says that high MCH results could be a indication of Thyroid malfuction also, so is possibls it could be that. rather than deficiency in Folate Vit b12 Vit b6.

How would I know? I guess by asking for tests for deficency's.

Corinne

[Corinne in reply to Hidden]

Hi hampster1,

Thanks for reply I will ask for tests to be done, am taking someone with me so strength in numbers! thanks for link to list have a lot of symptoms shown.

Corinne