Need advise on blood test results. Please, help!

[victoria1234]

Here are results for my 15 yrs old daughter blood tests. We have discovered recently she was born with only one thyroid lobe. Also, ultrasound revealed she has a lymph nodes. it looks like she has all signs of hypo: anemia, loosing breath, non-usial weight gain, having something like "shacking" attacks sometime, mood swings.

So results are:

Hematology panel:

WBC - 5.6 (3.9-10.2) 10*9/L

RBC- 4.87 (4.05-4.98) 10*12/L

Hemoglobin 121 (117-149) g/L

Hematocrit 0.39 (0.35-0.44) L/L

MCV 79 (77-92) fL

MCH- Low - 24.8 (25.8-31.7), pg

MCHC- Low- 313 (330-365) g/L

Platelet count- 255 (180-440) 10*9/L

Differential:

Neurophils 2.9 (1.6-7.9) 10*9 /L

Lymphocytes - 2.1 (0.9-3.5), 10*9 /L

Monocytes - 0.5 ( <0.6), 10*9 /L

Eosinophils 0.1 (<0.9) 10*9/L

Basophils 0.0 (<0.3) 10*9/L

Grans Immature 0.0 (<0.2) 10*9/L

Biochemical investigation of anemias;

Ferritin- Low - 11 (>11) ug/L

General Chemistry:

Calcium - 2.37 (2.10-2.60) mmol/L

RBS 4.8 (3.6-8.3) mmol/L

Thyroid function:

TSH - 1.76 (0.3-5.5) mU/L;

Free T4- 17 (11-22) pmol/L;

Free T3- 5.2 (33.7-7.7) pmol/L;

Adrenal function:

Rand. Cortisol 161 nmol/L (Rand cort coll at 1050h)

( Pathologist comment: value is low and if patient is not on corticosteroids, further assessment is required. If part of suppression test, reduced suppression is noted)

Our family doctor told me that everything is fine, explaining results, just a little bit of iron on the low end limit. He told, it is not a concern.

We need assistance with results. I worry about several values: MCH, MCHC, Ferritin and Cortisol, especially last one.

Please, advise, how to understand it and what will be the next step? Also, how often lymph nodes can be checked. Doctor told it is not a problem, it is just one lobe overloaded with the work of two. What lymph nodes mean?

Thank you SO MUCH.

Regards,

Victoria

[Hidden]

I can't comment on the cortisol thing but your daughter's ferritin is incredibly low. Her Mean Corpuscular Volume result (MCV) was the thing I first spotted - her blood cells are very much on the small side, probably because there's not enough oxygen being carried on them.

So the reason she's feeling so awful is anaemia. GPs often seem only to look at haemoglobin levels but they don't tell the whole story. She needs iron supplements, possibly even an iron infusion, to get those levels back up. Until they are, she's going to have no energy, feel listless and tired. Enough to make anyone feel very low.

Plus the result that's missing there is Vit B12. Would be well worth knowing whether she's deficient, as different types of anaemia often go hand in hand.

Interestingly, her thyroid function, on paper at least, doesn't look too bad - pretty normal, actually. My money's on anaemia being the biggest problem at the moment. Ferritin should be 70 or more, so 11 is very low indeed.