Gp sticking to blood test ranges

[CarpaBob]

So had an appointment with my gp to assess my blood test results of

Tsh 4.7 (0.35-5.5)

T4 is 16 (9.0-23)

Free t3 4.6 (3.5-6.5)

B12 301 (190.0-910.0)

Foliate 5.9 (3.3-99999.0)

Ferritin 24.4. (13.0-300.00)

She says everything is fine and in range, I asked to have b12, ferritin supplements but she refused stating they are well within range! She agreed to increase my thyroxine dose to 75mg a day after I argued that the tsh was still in the upper range but did say she would not allow my tsh to drop below 1. My vit d came back at 12 and she has given me a prescription for that. But I am at a loss as what to do regarding the b12 and ferritin, I am in a very difficult financial situation and can't afford supplements. I am thinking of changing doctors but am worried it will be on my records that she refused and they won't help either, does anyone have any experience of changing doctors surgeries. I also have tinnitus and a complete intolerance to most household sounds down to lights being turned on and cutlery on plates, I have done some research which suggests b12 could be the cause of this but again the gp wasn't interested. The conversation ended with her basically saying she had agreed to the thyroxine increase and that I should shut up or else. She did however stated that if I didn't feel any better after the 12 week vit d course she would refer to an endo. I even pointed out that I was frustrated that they want to give me amitryptaline, duloxetine and propranolol to mask my symptoms which surely cost the NHS more. I am starting to feel like there is no point in life anymore.

[Clutter]

CarpaBob,

Increasing dose should bring your TSH down and raise your FT4.

GPs don't usually prescribe supplements when vitamins are within range. If you want to optimise levels you can self supplement.

B12 and iron supplements shouldn't work out at more than £3 a month and you can buy a supermarket B Complex for around £1 which will boost folate.

amazon.co.uk/s/ref=nb_sb_no...

amazon.co.uk/s/ref=nb_sb_ss...

[CarpaBob in reply to Clutter]

Do you know if the cheaper iron tablets give the same amount of iron as the 210mg ferrous fumerate. I suspect I would need sublingual for b12 though as my diet is high in b12 anyway, would 1000mg sublingual per day be enough to raise my level.

[Clutter in reply to CarpaBob]

CarpaBob,

It will depend how much elemental iron is in the cheaper iron tablets. I think there is around 65mg elemental iron in 210mg Ferrous Fumarate.

I doubled my B12 to >700 8 weeks after supplementing 1,000mcg daily. I use the Jarrows Formula sublinguals.

[Pastille in reply to CarpaBob]

There are some ferrous fumarate on Amazon, 84 x 210mg tabs for £4.25 free UK delivery

[CarpaBob in reply to Pastille]

Many thanks for the advice, Can any of you advise on how much iron to take and how long for? I am aware I need to be careful of iron overdose and am going to assume the gp won't be interested in testing me for self supplementing.

[bluebug in reply to CarpaBob]

If you go to patient.info they advise two tablets a day.

However I was advised one as my haemoglobin was in range and I had no other signs of red cells problems.

This is because some people are susceptible to iron overload. (I'm not)

How long for? 6 months. Then you need to retest.

The ferrous fumarate tablets costs the same amount in Boots and Asda pharmacies. So you don't need to buy it online. However you may need to explain to the pharmacist that you have been advised to buy it as your ferritin level is low.

Most CCGs don't allow GPs to prescribe vitamins and mineral supplements if blood tests show values in range. This why if you can get a full blood count with a ferritin, folate and vitamin B test you are more likely to be prescribed them.

Unfortunately most CCGs don't like paying for that so the lab may question the GP/nurse practitioner why you are having a full blood count and nutrition tests, then refuse to do some of them.

Sometimes the pharmacist will question the prescription the GP writes and may tell you they have to keep the prescription while they refer back to the CCG.

While some of the processes are to save money others like with the pharmacists are also safety checks.

[Marz]

Tinnitus could be classed as a neurological symptom of your LOW B12 ( Only 20% of your B12 result is available to be utilised at a cellular level where it is needed )

Go the Pernicious Anaemia Society website and read as much as you can. When a 1000 people with PA were asked about their most prominent symptom - almost a 100% said Tinnitus. So I do not agree with your Doc that it is not the LOW B12. Anything under 500 can cause neurological symptoms.

b12deficiency.info/signs-an...

healthunlocked.com/pasoc/po...

In the first link there is so much to learn about B12 - scroll down for the signs and symptoms. There is also a Draft letter for your GP if you are having problems getting through. Also other tests they should do.

The second link takes you to the PAS forum here on HU - one I have chosen as it is packed with helpful links.

Do not ignore LOW B12 ....

[faith63 in reply to Marz]

i was told by someone on this forum that blood is not a good measure of magnesium and that my level of 1200, means i am not absorbing the b12..its pooling? Seems you just can't win!

[Marz in reply to faith63]

I think the magnesium test is of little value as it resides in the cells - not the blood. Think it was jim that mentioned it.

[faith63 in reply to Marz]

this is the same for thyroid, yet people keep relying on test s for dosing..its dead wrong.

so how is mag tested then?

[Marz in reply to faith63]

mymagnesiumdeficiency.info/...

[Angel_of_the_North]

Any chance of a new GP with more of a clue, who actually wants you to get better? High TSH (for someone on meds). Low B12, low folate, low ferritin - although they are all cheap to supplement and you can get the same ferrous fumarate that the GP prescribes at a pharmacy (eg Tescos). Of course, if you get free prescriptions it's an added cost. I never understand why they are happy to prescribe loads of unnecessary meds but not vitamins and minerals. You could eat liver (unless you are a veggie); it's quite cheap and filling.

[CarpaBob]

Many thanks for your replies, I was intending to change gp surgery as I had a lot of trouble getting the blood results as at one point they wouldn't give me the actual numbers. I have found a surgery with online access to test results so will be going there. In the mean time I will check out the Pernicious Anemia society. Have found a sublingual b complex at holland and Barrett that's on offer at 2 for £ 10 (in case anyone else needs to buy some).