Thyroid UK

GP appointment , what do I say, can anyone help me please

hi I have posted before and I apologize for going over the same things but can anyone advise me on what to say to the gp. I have made an appointment to see someone different tomorrow. My test results are as follows

Vit b12 210 ng/L (211-911) below range but say no action needed??

Serum folate 10.1 by/no (3.4-15.8)

Free t4 12.8 plop/L (10-18.7)

TAG 3.53miu/L (0.38-5.5

Anti nuclear factor level + nuclear pattern - nucleolar Ana present

Ferritin 43 ng/nL (22.0-322.0)

FBC platelet count 184 10*9/L (150-400)

Red blood count 4.42 10*12/L (3.85-4.9)

Haemoglobin concentration 137 g/L (119-149)

Haematocrit .410 (0.35-0.46)

White blood count 8.10 10*9/L (3.7-10)

Neutrophils 5.6 10*9/L (1.7-6.6)

Lymphocytes 1.8 10*9/L (1.0-3.0)

Sorry about the extent of this information but I have no idea what all this means if anything. Do these results warrant any treatment/diagnosis if so what should I be saying to the gp. On top of all this I still have all the symptoms and despite a change in diet and exercise regime I still cannot lose any of the 4 stone I've gained

14 Replies

Hello tracyp, I believe that the presence of nucleolar Ana may be an indicator for both systemic autoimmune rheumatic diseases and organ-specific autoimmune diseases, and also for other nonautoimmune diseases such as viral infections (have you been poorly lately, with an infection?). It is a first line test only, and further tests would be required to track down the cause for it showing up if the level warranted it, especially as I believe it is also present in healthy individuals, so can be a bit of a red herring!

Others will comment on your other results but your Vit B12 is below range, so how it can be normal - Drs can't have it both ways - we are told we are normal because our results are in range, so they can't say they're normal if they are below range! It needs to be much higher - the japanese range starts at 500!

Your ferritin is low too and needs to be in the range 70-90.


Your Doc should be shot ! With a B12 that low you could have all sorts of problems. Only about 20% of that result is available in the cells where it is needed. Do you have gut problems ? - this could affect the absorption of B12. Anything below 500 can be the cause of neurological conditions... Type B12 into the Search Box on the green bar above and you will be able to read loads....meanwhile....

This will explain other tests too that may be needed in the presence of low B12. Once you start supplementing with B12 further testing is meaningless as the results are skewed. Ferritin - Stored Iron - is also so low. So with nothing in the store cupboard your Iron levels will be affected. Sorry can't help much with all the other results....

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Hi thanks for the responses. Marz I do have gut problems I.e. chronic constipation could this be a cause or a symptom of my other problems. I'm quite scared about how to broach this with my gp with ferritin and b12,as they are what should I be asking them to do what could this be??


Hi tracy, if your GP refuses to give you the supplements I am sure a mmber would be able to recommend good vitB12 and iron you can buy youtself so dont get too stressed about your appt x


you can supplement ferritin and b12 yourself. there are good supplements available from Amazon and from this place:

if you already suffer with constipation be careful which ferritin supplement you choose, as some can create that problem by themselves. there are gentle ones. I think the liquids are supposed to be better for that.


Hi well been back to gp and they are not doing anything I raised the question about my b12and they said it's only one point under range so doesn't need treatment I questioned this and also my ferrittin quoting that it should be above 70 still not prepared to do anything might as well not bother still exhausted and can't lose weight, hair brittle and falling out, joints and muscles ache dizzy spells and when I stand I get a tight feeling in my chest neck andears DDon't know which way to turn now all they want to do is tell me I'm depressed but NO I am not I'm just tired all the time HELP


Get yourself on iron & b12 supplements straightaway. If the gp won't help, you just have to get on with it I'm afraid :-(


Tracy, If you buy your supplements from Amazon through ThyroidUK they get a small commission.

My B12 is low but not quite under range, my ferritin is low and folate under range. The Lab's verdict... 'no action needed.' So like many people on here who had to get on with it, I rolled my sleeves too- my body, my responsibility. My stash consists of:

Viepatch Vitamin B12 Plus 10 High Strength Patches 5000mcg (every 3rd day)

Jarrow Formulas Methyl Folate 400mcg

Vit C 1,000mcg (2 x daily)

Ferrous Sulphate 200mcg (3 x daily)


Tracy, your GP's out of order. Don't use the B12 supplements until you've shown him the recent B12 guidelines He should be checking for pernicious anaemia and arranging loading doses of B12 until there is no further improvement in your symptoms. If he won't help you it will be worth seeing another GP at your practice or changing GP surgery.


Spoke to chemist and ordered some b12 not sure about the iron though as I suffer with constipation but also ive read that iron tablets Don't affect your feritin levels


Ferritin is stored iron, so you need to take iron. Vitamin c with it will help prevent constipation.


Ferritin is a way in which our bodies store iron safely tucked away but available if needed.

Adequate iron levels will almost always allow ferritin levels to rise.

Iron supplements can help to achieve adequate iron levels. However, it may be necessary to put a bit of effort in to absorb them well. For example, taking with ascorbic acid (vitamin C) and near or with food.

People vary in how well they absorb iron and how they react to the various forms. If the mineral iron supplements (ferrous sulphate, ferrous fumarate, etc.) do not work well for you, you could consider the so-called haem (or heme) iron which is derived from things like liver.

I am wondering what B12 you have ordered? I'd hope that they are at east 1000 microgram Methylcobalamin tablets? And I also hope they are not over-charging for them. They are readily available from many on-line suppliers such as Amazon.



The haemotologist at my local hospital prescribed the iron because of low ferritin. I have classic IBS-C so I must admit was apprehensive about taking the iron tablets, thankfully they haven't made it any worse (although I doubt it could get any worse!) :-D


Thank you all for your advice it really is appreciated I think if I'd not joined this site I would have gone mad. Tried 3 GPS at my surgery and all sticking tgethor think they are primed to hold back on treatment. Raised the debate about results being in the top 80% of the range but just ignored me


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