Understanding blood test results

[heatherj23]

Hi all. After 15 years on levo and constantly suffering from fatigue etc I have pretty much demanded an endo referral. My GP ran some blood tests last week and has sent off the referral. The surgery receptionist has printed off the results for me today. Slightly mystified that there are no thyroid results. Not sure if they forgot about those but I will query it but what I have I will type below and would be grateful for any interpretation of these.

Serum Urea Level (XM0lt)7.1 mmol/L [2.5 – 7.8]

Serum Sodium Level (XE2q0)134 mmol/L [133.0 – 146.0]

Serum Potassium level (XE2pz)4.2 mmol/L [3.5 – 5.3]

Serum Chloride Level (XE2q1)99 mmol/L [95.0 – 108.0]

Serum Creatine Level (XE2q5)66 umol/L [40.0 – 90.0]

GFR calculated abbreviated MDRD (XaK8y)86 mL/min/1.73m^2 [>90.0] (Below low ref limit)

Serum cholesterol level (XE2eD)5.85 mmol/L [< 5.0] (Above high ref limit)

Calculated LDL cholesterol level (Xalp4)3.67 mmol/L [< 3.0] (Above high ref limit)

Serum triglyceride levels (XE2q9)1.47 mmol/L [0.6 – 1.7]

Serum HDL cholesterol level (44P5)1.51 mmol/L [> 1.3]

Total cholesterol HDL ratio (44PF)3.87 [< 3.0] (Above high ref limit)

Non high density lipoprotein cholesterol level (XaN3z)4.3 mmol/L [< 4.0] (Above high ref limit)

Serum calcium level (XE2q3)2.29 mmol/L [2.2 – 2.6]

Serum inorganic phosphate level (XE2q4)0.97 mmol/L [0.8 – 1.5]

Serum alkaline phosphatase level (XE2px)101 u/L [30.0 – 130.0]

Serum total protein level (SE2e9)71 g/L n[60.0 – 80.0]

Serum albumin level (XE2eA)36 g/L [35.0 – 50.0]

Serum globulin level (XE2eB)35 g/L [20.0 – 40.0]

Serum adjusted calcium concentration (Xabpk)2.34 mmol/L [2.2 – 2.6]

Serum total bilirubin tests (X77WP)11 umol/L [< 21.0]

Serum alanine aminotransferase level (XsLJx)28 u/L [< 31.0]

Serum cortisol level (XE2xW)275 nmol/L (Suggestive of intact H-P-Adrenal axis and adequate adrenal reserve)

Serum C reactive protein level (XaINL)3.1 mg/L [0.0 – 5.0]

Plasma fasting glucose level (44g1)5.1 mmol/L [3.5 – 5.6]

[heatherj23]

Ah I just logged into my records online and found this. Guess she didn't print all of it out.

Serum free triiodothyronine level 5.9 pmol/L [3.5 - 5.8]

Above high reference limit

Serum TSH level 0.97 mu/L [0.3 - 5.0]

[heatherj23 in reply to heatherj23]

Actually it seems there was quite a bit she forgot to print out

Full blood count Automated FBC - Normal.

Total white blood count 5.6 10*9/L [4.0 - 11.0]

Haemoglobin concentration 139 g/L [120.0 - 175.0]

Haematocrit 0.419 [0.36 - 0.48]

Mean cell volume 85 fL [78.0 - 100.0]

Mean cell haemoglobin concentration 332 g/L [320.0 - 370.0]

Platelet count - observation 231 10*9/L [140.0 - 400.0]

Neutrophil count 2.8 10*9/L [2.0 - 7.5]

Eosinophil count - observation 0.1 10*9/L [0.0 - 0.5]

Basophil count 0.0 10*9/L [0.0 - 0.2]

Lymphocyte count 2.1 10*9/L [1.0 - 3.5]

Monocyte count - observation 0.5 10*9/L [0.2 - 1.0]

Red blood cell count 4.94 10*12/L [3.8 - 5.8]

Mean cell haemoglobin level 28.1 pg [28.0 - 34.0]

B12/folate level

Serum vitamin B12 level 396 ng/L [180.0 - 900.0]

Serum folate level 5.1 ug/L [4.0 - 20.0]

Serum ferritin level 33 ug/L [15.0 - 200.0]

<15 IDA confirmed, 15-40 IDA possible, 41-100 IDA less likely.

>100 IDA excluded, >300 possible Iron overload.

Haemoglobin A1c level - IFCC standardised 39 mmol/mol [20.0 - 42.0]

HBA1c>42 mmol/mol(6.0%) Suggest rule out impaired Glycaemia

(monitor/OGTT)

HbA1c>48 mmol/mol(6.5%) If not known DM. support ^ risk for DM

Suggest confirmatory tests as clinically appropriate.

HbA1c>58 mmol/mol(7.5%) Review Glycaemic control.

[Angel_of_the_North in reply to heatherj23]

B12 level too low - needs to be over 500 to avoid neurological damage (pref 1000)

folate too low - middle of range

ferritin too low - needs to be at least 70.

CRP and blood sugar are beginning to rise (although still in range) - do you have antibodies or any other autoimmune disease - suggesting what some doctors are calling metabolic syndrome. Might be time for paleo type diet.

T3 is only just over range - wouldn't worry about that, but it means you are converting your levo well in spite of low B12 etc. Or that you are having a hashi flare and your thyroid is just dumping hormone.

Can't see your free T4.

When you have adequate B12 etc, you might need to reduce your levo, if you don't have hashis.

[heatherj23]

Thankyou. Well lets hope I get further with my endo referral than I have got with the GPs that I have been telling how tired I am for the last 15 years.

There have been periods when I have stopped taking my levo and I can honestly say I don't feel any different. It shows in blood test results obviously. But not in the way I feel.

[Angel_of_the_North]

Nothing much useful there for a thyroid point of view. Slightly high cholesterol is a hypo symptom. The GFR calculated abbreviated MDRD is to do with kidneys.

[Angel_of_the_North]

But she has high free T3 and isn't taking T3 so must be producing it from somewhere. There is no Free T4 result so can't see where that is in range.

[greygoose]

There isn't even an rT3 test, so how can you say that? Her FT3 is high.

[greygoose]

The most important questions is : how do you feel? Do you still feel hypo? I guess so, as you are requesting a referral. I don't know what he can do, because your FT3 is slightly over-range. So, either you aren't absorbing it, or your low B12 is causing your symptoms.