Blood test results help please :-)

[Tweetypie28]

Finally got my results today:

Full Blood Count

WBC 4.5 (3.7 - 11.00)

RBC 4.18 ( 3.8 - 5.8)

Haemoglobin 139 (120 - 150)

HCT 0.42 (0.36 - 0.46)

MCV 101 (81 - 98) ** last test: 92

MCH 33.4 (26 - 31) ** last test: 30

MCHC 331 (315 - 345)

Platelets 247 (150 - 450)

RDW 10.3 (11 - 14) ** last test: 12.5

Neutrophils 2.31 ( 2 - 7.5)

Lymphoctes 1.76 (1 - 4.5)

Monocytes 0.27 (0.2 - 1)

Eosinophils 0.14 (0.02 - 0.5)

Basophils 0.02 (0.02 - 0.1)

CRP 3 (1 - 5)

sodium 139 (133 - 146)

potassium 4.5 (3.5 - 5.3)

Urea 4.8 (2.8 - 7.8)

Creatinine 70 (45 - 84)

MDRD eGFR > 60 no range but range on last results (same hospital) suggest i need to be >60

Total bilirubin 7 (0-21)

Alkaline Phosphate 83 (30 - 130)

ALT 14 (0-33)

GGT 12 (0-40)

AST 13 (0-32)

Total Protein 73 (60 - 80)

Albumin 44 (35 - 50)

Globulin 29 (20 - 35)

AST 13 (0 -32)

LDH 152 (135 - 214)

Calcium

Serum Calcium 2.43 no range given (2.2-2.6 given in last results)

Albumin 44 (35 - 50)

Adjusted calcium 2.43 (2.2 - 2.6)

Uric Acid 320 ( 140 - 360)

Blood Glucose 5 >5.6 - normal

Cholestoral 5.57 (less than 5.2)

TRIGLYCERIDES 0.95 (less than 2.26)

HDL cholestorol 1.88 (1.68)

low density lipoprotein 3.3 (<4.4)

Vitamin B12 568 (191 - 663)

Folate (serum) 6.2 (4.6 - 18.7)

Iron and UIBC

UIBC 39 (no range 20 - 62 in last results)

Iron 17.0 (6.6 - 30.4)

Total Iron binding capacity 56 (no range given 45 - 70 in last results)

Transferrin saturation 30 (no range given 20 - 50 in last results)

Ferritin 45.9 (13 - 400) 11.8 in last test results

TSH 0.522 (0.270 - 4.2) 0.785 in last test results

Free T4 18.25 (12 - 22) 14.3 in last results

Vitamin D 44.9 I am in the borderline to insufficient range - was 31 in last results

I had tests done to check iron fit D & calcium as on Vit D & iron tablets. My iron and fit D has improved slightly as you can see but current symptoms are:

taking deep breaths

tired

hair falling out

very bloated

tearful again

The first section full blood count causes concern - when I research it is pointing towards anaemia but then why is my iron improving. Bit confused!

Any help much appreciated

Many thanks xx

[Moggie]

Although your ferritin level has increased lots - and well done you for sticking with it - it needs to be almost double what it is now, so you still have a way to go. Don't forget it needs to reach 80 for your hair to stop falling out so please be patient. Even though your ferritin levels are improving it will take it to be higher for your other blood results to improve - my RBC is still out of kilter - but they are moving in the right direction.

Your vitd is still low, as you know, so still a way to go with that one too.

Your FT4 has improved a lot, which tells you your increased vitd and ferritin levels are working.

I know its hard but you are just going to have to give it more time. If you cast your mind back to your first question on here you must realise how much you have improved and you will continue to improve the more your vitamin levels increase. It is a long process, especially iron, but you have done really well so far so keep doing what you are doing and you will get there in the end.

Moggie x

[Tweetypie28]

Thanks Moggie

You are quite right, I have come such a long way since first post and I must be patient but I don't really understand why I have taken a nose dive in the last few weeks when really, on paper, I should be better.

My endo has indicated an addition of T3 may be necessary, have sent her results and await her response. Have you tried/take T3?

[Moggie in reply to Tweetypie28]

Yep and it wasn't good for me but please remember that you need very good ferritin levels (over 70) for T3 to work.

I was on a T3/T4 combo for over a year and ended up with heart issues because I didn't actually need T3 at all as it was my low vitamins that was causing the remaining symptoms. If you endo is going to give you T3 then I would insist on a FT3 test first to see if you do actually need it because if this is still low then it would possibly indicate that you have a conversion issues, but if it is well up in the range then taking T3 could leave you in the same boat as me and having heart issues really is not fun.

Moggie x

[Tweetypie28 in reply to Moggie]

Doesn't sound it either Moggie, certainly don't want that. Endo wanted ferritin levels checked before issuing t3 so maybe she won't go down that route yet. Was surprised that she didn't suggest a T3 test within these last tests, don't understand how you can just issue T 3 without knowing what your levels are. She also talked about armour, maybe that would be better although I'm guessing you still think I need to just be patient and get my vit d and ferritin levels up further? Have you tried armour?

[Moggie in reply to Tweetypie28]

I'm a veggie so it would go against everything I believe in to then ingest dried pigs thyroid, but that is my beliefs and I don't hold it against anyone who is ill to do what is necessary for them, I'm just glad that I have never had to seriously consider it.

Your endo sounds good as at least she is aware of the ferritin/T3 link and knows that giving T3 to someone with low ferritin will only cause problems.

If she does try to give you T3 then ask her how she can give you a script for something without it being tested first and see what she says. If she still refuses ask her how much a private test would be as I feel it is important to get one done before starting T3.

Moggie x

[Hidden]

Are you supplementing B12? Although your B12 and folate results are in the normal range, your high MCV and high MCH point to B12 and/or folate deficiency. If you're taking an oral B12 supplement it could be raising your blood levels but not actually getting through to tissue level where it's needed.

[Tweetypie28 in reply to Hidden]

Hi

Thanks for this - I am currently researching the high MCV & MCH and am being pointed towards Pernicious Anaemia which I know nothing about! I am understanding that deficient B12 causes this. Am I correct do you know? This is what then confuses me as how can I be deficient in B12 if my yes results say I am not?

My symptoms have increased this last month despite my iron levels and Vit D levels slowly rising. I am struggling to walk on my feet when getting from a seated position, Im gasping for breathe all the time, my heart rate can be a bit erratic and Im soooo tired again.

I was talking to my mum about it today and she then told me that my nan had pernicious anaemia most of her life and was constantly at the hospital getting injections although she is not sure what was injections she was having. I understand PA can be hereditary??

Im not taking a B12 supplement by the way x

[HarryE in reply to Tweetypie28]

High MCV is associated with B12 deficiency, yes. As i understand it, the B12 test the NHS use is pretty hopeless, there is a different type - possibly called 'active B12' - someone else with know

[Hidden in reply to Tweetypie28]

Sounds like it could be PA or B12 deficiency to me. Just to clarify, B12 deficiency is in effect the symptom, and can be caused by many things, see here:

b12deficiency.info/what-are...

B12 deficiency caused by an autoimmune attack is PA. If you have PA you might have intrinsic factor antibodies (diagnostic of PA but only 50% of sufferers test positive), and you might have parietal cell antibodies (80 or 90% test positive). Intrinsic factor picks up food bound B12, so if it's under attack from antibodies you won't absorb B12. Parietal cells produce gastric acid and intrinsic factor in the stomach, so antibodies against them will eventually lead to PA because you won't be able to produce intrinsic factor. Also your stomach will have a low acid environment which in itself makes it harder to absorb vits and minerals. But you can test negative for both and still have PA, or your B12 deficiency could be caused by something else (as listed in the above link).

The serum B12 test is unreliable, so much so that there is a warning about it here:

ukneqas-haematinics.org.uk/...

"False normal B12 results and the risk of neurological damage (Please click for details)

“In the event of any discordance between clinical findings of B12 deficiency and a normal B12 laboratory result, then treatment should not be delayed. Clinical findings might include possible pernicious anaemia or neuropathy including subacute combined degeneration of the cord. We recommend storing serum for further analysis including MMA, or holotranscobalamin and intrinsic factor antibody analysis, and treating the patient immediately with parenteral B12 treatment.”"

I always feel very frustrated when people post serum B12 results asking for advice, because in some ways it's irrelevant because of the tests unreliability. It is only actually useful when it comes back low, because then at least you can get some treatment. You can be suffering quite serious neurological damage with a "normal" serum B12 level. The only way to know is to have some further tests done or get a trial of injections. I think most docs would refuse the trial at your B12 levels, because that number is all they see.

But I think you have plenty of risk factors, an existing autoimmune condition, a family history of PA, and most importantly you are symptomatic. Show your GP the UK NEQAS warning and ask for the antibody tests. There is some really quite astonishing research behind that warning, the failure rate of the test is up to 35%:

nejm.org/doi/full/10.1056/N...

And look at the supplemental table here, some of them had false readings over 1000:

nejm.org/doi/suppl/10.1056/...

Explore this website:

b12deficiency.info/

It is easy to read and has everything you need to know, as well as a useful What To Do Next? page. In the Very Useful Links section you will find links to the PAS, B12d.org and a friendly Facebook group. There is also a page about other tests you can have, namely Active B12, MMA and Homocysteine.

H x

[Tweetypie28 in reply to Hidden]

Hampster - did anyone ever tell you you're fabulous?!! Im at work at the mo although now having to go home as so tired, can't make it to the end of the day! Ive briefly looked at some of these sites an things are starting to fall into place. Thank you xx

[Ctb567]

Hi, first of all there are different kinds of anemia, not just the iron deficiency anemia which is the most well known. Your MCV and MCH being slightly high indicates that you have macrocytic anemia which is a type of anemia cause by either a b12 or folate deficiency. As your b12 is completely normal this has probably been caused by your low folate level, even though its technically in the normal range its still a bit too low. Being tired and feel down are definitely symptoms of a folate deficiency so I would ask the dr's what they thought of your levels and see if you can get them to treat you for that, if not try to get some good over the counter folate vitamins.

Hope this helps