High haemaglobin, haematocrit

[Eyebright]

Hi All, could anyone comment on my bloods? Have been referred to a haematologist due to high readings as follows:

Haemaglobin 158. Ref range 115-158

Haematocrit 49. Ref range: 0.37-0.47

MCV previously high but last test within range. I have charted my results going back to 2011 and results have been consistently high. So why a referral now? Not that I'm complaining. It's such a rare event! Don't smoke and had a liver scan which came back fine. Would really appreciate your comments.

[Eyebright]

Sorry ref range for haemaglobin is 115-155

[gabkad]

These tests are based on measurements per volume of the blood. If you were fasted before the blood was taken and you did not drink any fluids either for 12 to 14 hours, it's possibly an artifact of having low blood volume at the time of the phlebotomy. You can drink water in the morning before going to the lab to have blood taken. Just no food or drinks such as coffee or tea etc.

I asked a nephrologist about this because when I was fully hydrated, my hgb was 148 but when I was 'fasted' and had no water to drink, my hgb was 160. The endo asked me about this if anyone ever mentioned the high hgb before. That's why I asked the nephrologist about it.

Hypothyroidism also results in low blood volume (I don't know if that concentrates the cells as well). I had a test done for this back in 2000 and it came up as 88% of what normal blood volume is supposed to be. Painful test and won't ever repeat it.

[jezebel69 in reply to gabkad]

This could well explain a very high reading I had last year. It was flagged up as a possible liver problem but when retested everything was fine. I was told there could have been an infection present too - not unusual with Hashis

[Clutter]

Eyebright, possibly want to rule out or confirm polycythaemia

labtestsonline.org.uk/under...

[Eyebright in reply to Clutter]

Hi Clutter, thanks for response. Can I get your comments on further bloods today please. Am Vit D deficient - 39 nmol/ L (ref range 50 - 150). TSH - 0.05 (0.3 - 5.5) and Free T4 19.3 (9 - 25). GP wants to talk to me about TSH and think she might say drop Levo. Is it too low? Bloods better but packed cell volume still raised - 0.48 (0.37-0.47). Difficult to know how effective Levo is at mo cos I feel dreadful. Presumably due to low Vit D. But don't want to be railroaded to decrease Levo and then feel worse. Be grateful for comment.

[Clutter in reply to Eyebright]

Eyebright, TSH is low but not suppressed and FT4 is good, but nowhere near the top of range so you aren't overmedicated. Reducing your Levothyroxine dose to raise TSH is likely to lead to yo-yo dosing as next bloods TSH may be high and Levothyroxine raised... That isn't likely to make you feel well or stable. Any chance of persuading your GP to test FT3? Low T3 may be why you feel unwell. Low TSH and good FT4 aren't guarantees of good conversion to T3. You can order private tests from Blue Horizon and Genova if your GP won't test FT3 thyroiduk.org.uk/tuk/testin...

Low vitD can cause musculoskeletal pain, fatigue and low mood. Good levels aid T4 to T3 conversion. I think you need to supplement 5,000iu daily for 6-8 weeks to boost levels and can cut back to 2-3,000iu daily end of April if you are able to get sun on your face and arms a few hours per week.

[Eyebright in reply to Clutter]

Hi Clutter and thanks again. T3 was amazingly enough tested. 5.7 pmol/l (3.5 -6.5)they have always refused to do it in the past and I did't ask this time but they did it. I had also already booked test with Blue Horizon, done today, so be useful to see what results come back from that for TSH and FT4. Is T3 level above ok? Thanks again for your help.

[Clutter in reply to Eyebright]

Eyebright, your FT3 is very good, almost in the top 75% of range. If you were overmedicated it would be over range. Not sure how long you have been on a dose to produce that result but it can take a few weeks for symptoms to catch up with good biochemistry.

[Eyebright in reply to Clutter]

Too long Clutter! 8 years now. Thank you for bringing me some good news. The slightly alarming blood test results in haemaglobin etc are turning out to be more useful that I would have thought.

[Eyebright in reply to Eyebright]

Hi Clutter, thought I would update (based on a recent post grumbling that people didn't). Latest bloods (private test) show same levels of TSH And FT4 as earlier. But....bloods show raised white and red cell count and raised lymphocytes with atypical forms. The RBc and WBC are marginal they said but the atypical forms needs follow up with the haemo. No recent infection (I am aware of). GP comments on tests - TSH low and to be monitored in case of hyperthyroidism! I have slightly raised serum inorganic phosphate and mention was made that hyperparathyroidism can be seen not only with high Vit D levels, hut also low Vit D, (if parathyroid levels are low) and low level of calcium. Serum calcium level is 2.17 (2.15 - 2.60). I do have slight tenderness in the thyroid region of my neck but don't really like feeling....gives me the heeby-jeebies! (Spelling??). So Gp phone consultation next and then haemo. Who was the joker that said life begins at 50? I'm off back to bed!

[Eyebright]

Thanks very much. That's very helpful.