High Inflammation markers

[Elsa1509]

I am just writing about my 20 year old daughter who has had recent blood tests done after many years of low immunity and fatigue and migraines. She has recently returned from holiday where she got very ill and was hospitalised with chest infection, UTI, cellulitis in the foot, tachycardia and very high fever. She flew out with a bad cough and cold. The doctors rang me to ask me if she had thyroid problems as she had an enlarged thyroid. I, as her mother, have very high thyroid antibodies in the thousands, but 'normal' thyroid hormones. Anyway, the GP here has been very worried about her and here are her results:-

Erythrocyte Sedimentation rate 19mm/h (range: 1.00 - 19 mm/h)

Plasma C Reactive Protein 7mg/L (range: 0.00 to 7 mg/L)

Ferritin 15 ug/L (range 11.00 to 307.00 ug/L)

Platelets 451 (range 150 to 400)

Plasma ALT 36 ug/L (range 7.00 to 35 ug/L

Anti-tissue transglutanase (coeliac) 0.2 (range 0.00 to 4.00 u/ml)

TSH 1.26 (range 0.34 to 5.60 mu/L)

FT4 10.3 (range 7.50 to 21.0 pmol/L)

HbA1C level 34mmol (Desirable less than 58 mmol)

The GP has said all these results are fine (!!) and her extreme fatigue is not anaemia (!). He says her IBS symptoms are stress related and he is not going to test her for thyroid antibodies despite the doctors in South East Asia (who cared for her amazingly for 4 days in hospital) telling me she has thyroid problems. I am still waiting for their medical report to come through. My daughter bruises very easily and doesn't heal well. Her very clever dentist has suggested to me she is tested for Lupus as she suffers from inflammed, bleeding gums despite careful dental care. She also has mild asthma and regular tachycardia and panic attacks. Her GP is very caring and 'looks after' her well, but thinks these results are all ok. My daughter had an extremely stressful event happen to her last year so I guess some of her symptoms could be stress related as she is still getting over what happened to her.

Can anyone help or comment on these results and maybe provide a little bit of advice. Thanks so much in advance! This is such a great forum and has helped me so much in the past.

[bluebug]

I would first see if you can get her tested for Lupus.

Is it possible to request that the dentist writes to the GP to voice his findings and concern? The GP is more likely to take on board requests from another health professional who has specialist knowledge about an area he hasn't than your requests especially if they are in written form, as then they will form part of her medical records and will also be in her dental records.

Yes her ferritin level is low but you seem to have missed out lots of her blood test results e.g. haemoglobin, rest of iron panel, white cells, red cells. Did the GP not conduct proper tests?

[Elsa1509 in reply to bluebug]

Hi Bluebug. Thanks so much for your answer. I didn't want to put too many test results in as the others seemed relatively normal and I didn't want to inundate people!. However, here they are:-

Haemoglobin estimation: 130 g/L (120 to 150)

Total White cell count: 9.6 (4 to 11)

Neutrophil: 6.8 (2.0 to 7.5)

Lymphocyte: 2 (1.50 to 4.00)

Monocyte: 0.6 (0.20 to 1.00)

Eosinophil: 0.1 (0.00 to 0.50)

Basophil: 0.1 (0.00 to 0.10)

Red Blood Cell Count: 4.35 (3.80 to 4.80)

Haematocrit: 0.399 (0.36 to 0.46)

Mean Corpuscular Volume: 91.7 (80 to 100)

Mean Corpuscular Haemoglobin: 29.9 (27.0 to 32.0)

Mean Corpuscular Hb.conc: 326 (320 to 360)

Sodium: 137 mmol/L (133 to 146)

Potassium: 4mmol/L (3.5 to 5.0)

Creatinine: 62 umol/L (53.0 to 97.0)

Plasma Total Protein: 80 g/L (60 to 80)

Plasma Total Bilirubin: 5 umol/L (0.00 to 20)

Plasma Albumin: 36 g/L (35.0 to 50.0)

Calcium: 2.42 (2.2 to 2.60)

I think the only thing I can see is slightly high "Protein' levels and low "Albumin" levels. We are going to push for further auto-immune testing (Lupus and Hashimotos). B12 wasn't tested. My daughter has had a lot of sunshine this Summer and is quite tanned, so we think it unlikely she will have low Vit D.

Thanks very much for your reply.

[Katariina]

Hi Elsa1509,

Your daughter's symptoms very similar to my own experience at her age, a long time ago now. Had fatigue, migraines, low iron, easy bruising, raised platelets and IBS. Had blood tests to monitor the raised platelets every six months as the doctors didn't know why they should be raised. TSH tested at that time and didn't raise any alarms.

It was when my mother got diagnosed with Coeliac disease some years later that I was tested for it as well by blood test and biopsy, which were both positive. Going gluten free brought the platelets down to normal levels very quickly and helped with some of the other symptoms as well.

If your daughter has not been tested for Coeliac disease then it might be worth checking due to low ferritin and IBS symptoms.

My fatigue symptoms, amongst many new ones appearing, went on for years with GP taking no notice of TSH being up and down within normal range. I finally had a private thyroid panel done and found out that I had Hashimoto's alongside Coeliacs. Once on medication now feel better than I did in my twenties.

So keep looking for answers and be assertive with GP. Good luck!

Katariina

[Elsa1509 in reply to Katariina]

Hi Katariina

Thanks very much for your reply and I'm sorry you had to go through similar symptoms. My daughter was tested for coeliac with the Anti-tissue Transglutnase Level and her results were 0.2 (normal range being 0.00 to 4.00). Due to my Hashimotos and severe iron deficiency in the past (my Ferritin dropped to 3), I had a gastroscopy and blood tests for coeliac and they were negative, but an alternative doctor said I was gluten intolerant over 20 years ago using a vega machine. Whenever I eat gluten I really suffer! My daughter has tried coming off gluten but being a young student, she finds it hard and regresses back to eating it! We do need to eliminate it completely from her diet as I truly believe a person can be very gluten intolerant but not show up as coeliac. I get skin rashes and IBS symptoms whenever I eat gluten and generally feel unwell and extra tired.

I'm glad you got your symptoms at least somewhat resolved and you got a proper diagnosis in the end. It's a shame most GPs are oblivious to much of this or just don't seem to want to acknowledge this. How can they say a young 20 year old girl, suffering from complete exhaustion with a Ferritin of 15, is not at all anaemic. Fortunately, I have endless supplies of Ferrous Fumerate and after 2 weeks on this, my daughter is beginning to feel a bit more human!

Thanks once again for your reply!

[bluebug in reply to Elsa1509]

Hi,

Your daughter doesn't have iron deficiency anaemia. She has non-anaemic iron deficiency due to her low ferritin stores and normal haemoglobin levels.

patient.info/doctor/non-ana...

However your GP would disagree due to only looking at the range. This is unfortunately the minimum the NHS expects doctors to do.

Raised platelets are seen in iron deficiency anaemia and in inflammation. So if she is gluten intolerant this is possibly the cause. Inflammation also causes raised liver enzymes and increase in the percentage of some of the white blood cells.

If she is gluten intolerant she will probably have low vitamin B12 and folate levels.

I still think it is worth your dentist writing to the GP to note his observations and thoughts. Some GPs do nothing until another medical professional comments as then they realise if they do nothing and the patient complains/something happens they will get in trouble.

BTW The reason I wanted the full blood count was to see whether she was near to having iron deficiency anaemia as well, however at the moment she isn't.

[Elsa1509 in reply to bluebug]

Thank you very much bluebug. I am sure our dentist will write to the GP expressing his concerns which should motivate the GP to test for at least some autoimmune diseases. We are definitely going to go for the gluten free and our GP has agreed to re-test the inflammation markers in a couple of weeks. Thanks for all your advice and knowledge!

[bluebug in reply to Elsa1509]

I just realised I said something not strictly true. Your daughter could end up anaemic with a low ferritin level, or just end up collapsing as it falls. However as she is being made to supplement iron by you it is NOT likely.

Anyway good luck.

[Elsa1509 in reply to bluebug]

Many thanks bluebug. We will keep up the iron for now and it is significant the difference in colour in her lower eye lids which were almost white before and now a much healthier pink so she is clearly absorbing it! Fortunately, I know just how to take the iron (with Vit C and not around tea and other certain foods). The sort of thing the GP never tells you....... !

Thank you once again!

[Elsa1509]

Many thanks reallyfedup123 and I agree that we should take this next step that you suggested. I am going to order the Blue Horizon test for my daughter (we are hoping this finger prick test will be ok as she is prone to fainting at the sight of blood!), but I have found Blue Horizon to be brilliant and I have done a number of finger prick tests through them. If my daughter's FT3 is low (mine has ranged from below normal to just above normal in the past 2 years!!) then we will insist on an NHS referral to an endo. She really does suffer from fatigue and is prone to weight gain although ok at the moment. The Ferrous Fumerate has enabled her to function just a little bit more normally of late, but she still needs frequent rests and sleeps. A young girl shouldn't be like that all the time! We have also discovered in two recent blood tests that she has very low oestrogen and she has some menopausal symptoms so again, this could be a pituitary problem. Thanks for all your advice and help, it really is appreciated.

[Elsa1509]

Good idea. I might see if she's happy to shut her eyes as well while I do all the work Thanks for all your help!

[SlowDragon Administrator]

Make sure to order Vit D test when you get the Blue Horizon blood test - their thyroid plus eleven test includes Vit D.

The other thing that might help her, is to start supplementing selenium.

hypothyroidmom.com/92-of-ha...

drgominak.com/vitamin-d-hor...

vitamindcouncil.org/tag/aut...

chriskresser.com/the-gluten...

[Elsa1509 in reply to SlowDragon]

Thanks so much SlowDragon. My daughter couldn't go through with the finger prick test when she saw me doing it and was close to fainting. We have asked the GP a few times to test her thyroid antibodies but they don't see it necessary. She has had a lot of sunshine this Summer so should have got her Vit D up. She cannot tolerate gluten anymore and barely touches it as her stomach problems were so bad. She has started Spironolactone for acne and is so fatigued she can barely function but it has cleared up her acne which she is thrilled about. Her gums continue to readily bleed and her tachycardia is very bad on and off. We think she is less anaemic and she is due for a full blood test soon due to the risks of Spironolactone. I really like Chris's Kesser's articles. They are so informative. Thanks so much for the helpful links and your reply.