More advice on blood tests

[Kiwidel]

Hello & happy New Year you helpful lot!

I've been diagnosed as having hypothyroidism and am after a bit more advice re blood test results.

I've posted 2 lots of results below, both times I've been told by the doctor that my results are weird. After the October tests my level thyroxine was increased to 100mg, after the Nov test I was told I was properly medicated but that my FBC results were still 'weird' - based on the exclamation marks on the results I'm assuming this something to do with low white blood cell count and the doctor mentioned something about a low immune system (but don't worry it's not leukaemia(!). Based on some of the reading I've done since and the fact I think I still have symptoms (broken sleep, weight gain, itchy skin, low body temp, fuzzy brain etc etc) I think I am under medicated.

I have now been referred to a haematologist in early Feb but would appreciate it if there's anyone out there who has had similar low white blood cell issues.

I'd also be interested in hearing views on if you've been referred to a haematologist, is it best to fast before the tests and generally how long before the tests should you stop taking vitamin & mineral supplements - I've seen everything from 1 month to 24 hours mentioned.

You'd think that this would be part of the guidance when the appointment letter comes out / on the hospital website but I haven't been able to find it anywhere!

Thanks in advance, here are the results:

October 14 test:

Serum free T4 12.5 pmol/L (9.0 - 19.0)

Serum TSH 7.42 mu/L

(Levothyroxine was increased to 100mg after this test)

Haemoglobin estimation 142 g/l (115 - 165)

Total white cell count 2.4 10*9/L (4.0 - 11.0)

Platelet count 214 10*9/L (135 - 400)

Red blood cell count 4.54 10*12/L (3.8 - 5.5)

Mean corpuscular volume 91 fL (80 - 98)

Haematocrit 0.413 1/1 (0.37 - 0.47)

Mean corpusc. Haemoglobin 31.3 pg (27 - 35)

Mean corpusc. Hb. Conc. 344 g/L (300 - 350)

Red blood cell distribut width 13.5 (0.00 - 14.0)

Neutrophil count 1.1 10*9/L (2.0 - 7.5)

Lymphocyte count 1.02 10*9/L (1.5 - 4.0)

Monocyte count 0.26 10*9/L (0.2 - 0.8)

Eosinophil count 0.03 10*9/L (0.04 - 0.4)

Basophil count 0.01 10*9/L (0.0 - 0.1)

Serum vitamin B12 648 pg/mL (187 - 883)

25-hydroxyvitamin D level 121.2 nmol/ L (>=50 nmol/L suggests vit d sufficiency)

November 14 test:

Serum free T4 12.6 pmol/L (9.0 - 19.0)

Serum TSH 3.14 mu/L

Serum folate 8.2 ng/mL (ans) - normal no action

Haemoglobin estimation 132 g/l (115 - 165)

Total white cell count 2 10*9/L (4.0 - 11.0)

Platelet count 270 10*9/L (135 - 400)

Red blood cell count 4.38 10*12/L (3.8 - 5.5)

Mean corpuscular volume 91.1 fL (80 - 98)

Haematocrit 0.399 1/1 (0.37 - 0.47)

Mean corpusc. Haemoglobin 30.1 pg (27 - 35)

Mean corpusc. Hb. Conc. 331 g/L (300 - 350)

Red blood cell distribut width 13.3 (0.00 - 14.0)

Neutrophil count 0.86 10*9/L (2.0 - 7.5)

Lymphocyte count 0.81 10*9/L (1.5 - 4.0)

Monocyte count 0.18 10*9/L (0.2 - 0.8)

Eosinophil count 0.1 10*9/L (0.04 - 0.4)

Basophil count 0.02 10*9/L (0.0 - 0.1)

[Hidden]

Every blood test that's been done shows that I have low white blood count. Only discovered this when I first became hypo and asked for a copy of my test results. Asked GP about this and, surprise surprise, he looked blankly at me and gave no explanation. I insisted I wanted this investigated so had an appointment with Haematology at the local hospital where they didn't think there was any cause for concern. What I didn't realise until I recently obtained my medical records was that the muppet GP gave them wrong info. You couldn't make it up!!

Sorry but I just don't trust any of them.

[Kiwidel in reply to Hidden]

Thanks for your answer. The doctor did say it might be just the way I am.

As a result of not having lived in the UK my whole life and having had no reason to have blood tests in the 16 years I've been here, there isn't much historical information to compare against. It would be good if these bodies came with a bit more of a user manual!

What did the haematologist do, just take bloods or was there more? I keep seeing things like tests on bone marrow for some of things I'm low in which sounds painful!

[Hidden in reply to Kiwidel]

Haematologist did nothing as the surgery had done the blood tests. Since obtaining a copy of my medical records I've found out that I'd actually been hypo for a few years and not been aware/told. Same GP failed to diagnose me with a TSH of 7.6 and all the typical hypo symptoms.

Nobody mentioned that having a low wbc would impact on any infections that I may have. It goes some way to explaining why my annual bout of sinusitis needed a hefty dose of antibiotics.

I really would recommend obtaining a copy of your medical records even if you feel there won't be much info in them. In my opinion the NHS can not be trusted with our health especially thyroid matters. Educate yourself as much as possible and don't rely on 'experts'.

It's a nightmare!

[faith63]

You are very hypothyroid and that will change the way your entire body functions. This might be the reason for all the low readings. If your doctor thinks your thyroid meds are ok and thyroid labs ok, then find a new doctor.

[Kiwidel in reply to faith63]

Thanks for your reply. To be fair I haven't gone back and challenged him on the level of medication - I wasn't sure if I was being impatient on how quickly the medication works (I was only diagnosed in Sept 14), and therefore thought it might be best to wait until the haematologist visit in Feb.

[faith63 in reply to Kiwidel]

The Hematologist will not recognize hypothyroidism as the cause of anything. Your doctor will tell him that you are indeed, properly medicated on thyroid meds. He has not even tested your free t3. You have had plenty of time for some improvements. What thyroid meds are you on and dose? Do you have Hashimotos causing your low Thyroid? It is autoimmune and you need to know.

[Kiwidel in reply to faith63]

Hi. I am on 100mg Levothyroxine.

I have asked my Doctor about doing a test for hashimotos and he said I wasn't symptomatic of hashimotos, so wasn't open to testing for it.

I was planning on asking the haematologist to include the antibodies tests as part of their assessment. I am also planning on taking copies of some of the papers that I've come across on this forum that indicate that I am under medicated based both on my THS results and the amount of medication I am on versus my weight - of course I could be being overly optimistic about how much they listen to me versus just following a standard protocol!

[faith63 in reply to Kiwidel]

I wonder what symptomatic of Hashimotos means? He doesn't know what he is doing!!! I do wish you the best of luck. I have had to self treat.

[Kiwidel in reply to faith63]

I think he was inferring I hadn't talked about any hyperthyroid symptoms and I don't look like I have a goitre.

I did have things like night sweats and at times was amazed with regards to my weight how sometimes I would just need to look at food to put on weight, and then at others eat quite badly with limited impact on weight.

I didn't mention any of this as at the time as I though it was just part of being a women in her early 40's and I had no idea what the symptoms of hyperthyroidism are.

Thanks for taking the time to respond -hope all is well with you now you've taken things into your own hands.