Blood results analysis help needed

[Mighty_mum]

Hi!

I'm seeing my GP tomorrow and could really do with some input into my blood test results, particularly on thyroid and iron levels.

I had a thyroidectamy 14 years ago due to a goitre, so take Thyroxine 50 mgs. I also have PBC and take medication for that. Anaemic but not taking iron because I was getting stomach cramps.

I get pretty tired and have unfortunately had to give up my job.

Serum B12- 518ng/l (147-840)

Serum ferritin - 8 ug/l (11-307) Low

Serum folate- 13 ug/l (3.1-19.9)

Serum free T4 15-1 (8-16)

Serum TSH - 0.03 (0.38-5.33) BELoW

I had a full blood count, I havnt copied down, do you need?

D3- 78 - above 50 is deemed ok

Do you need anything else? I asked them to do T3 as there's a lot of discussion about it on this forum, I'm still getting to grips with it, but I don't have a result for it.

I also had glucose, serum c reactive protein, cholesterol, and liver tested, but not copied down unless it means something to someone!

Look forward to your input, I really need to go to the doctor with some knowledge, don't want to get fobbed off again, the exhaustion is too much

👍

[galathea]

You need to up the ferritin. Have you tried a couple of sachets of Spatone every day? It takes time, but it does work and shouldnt mess up your gut. Apple flavour is palateable.

Available, chemists, supermarkets and amazon.

Advert over!!!

G xx

[Mighty_mum in reply to galathea]

Yes! Proving tricky, been anaemic for over 12 months and taking iron pills on and off during that time.

Iron injections? Perhaps long term on Spatone, thank you for your advice Galathea xx

Does anaemia go hand in hand with underactive thyroid probs or PBC liver disease?

And why cant i retain the iron? i try to have a really good diet...

[bluebug in reply to Mighty_mum]

If you are frequently anaemic like I am then Spatone does not contain enough iron to ensure both your ferritin level - iron stores- and haemoglobin level - protein that contains iron that carries oxygen around - are high enough.

You need to take something like ferrous fumerate, ferrous sulphate, ferrous gluconate or ferrous bisglycinate continuously for 6 months to a year to get your levels up. Then when your levels are optimal you can take a maintenance dose to try and keep it there. You will have to be tested every 6 months or so though your GP may refuse to do so.

This because Spatone contains 5mg of elemental iron while ferrous fumerate and ferrous sulphate contain something like 65mg of iron each. Ferrous gluconate contains about 37mg of iron and ferrous bisglycinate contains about 20mg. Ferrous gluconate and ferrous bislygcinate (Solgar gentle iron) are more bioavailable e.g. you absorb more from a smaller dose than other iron salts, and give less side effects than ferrous fumerate and ferrous sulphate so they shouldn't give you stomach cramps, diarrhoea and/or constipation. (You will need to take 4 tablets of them per a day rather than 2-3 and they are much more expensive.)

Unfortunately some women due to illness especially if they still menstruate have problems maintaining their iron levels. If you cannot take ferrous gluconate or ferrous ferrous bislygcinate you should have an iron infusion. However as some GPs are idiots they won't refer you for one, and you have to wait until you collapse and are admitted to A&E as an emergency before you get one. If your GP is amenable you should ask him/her every time you see him/her why you cannot get your iron level up and ask for a referral to haematology. Make sure you tell your GP that you eat red meat etc daily when asking for it. Be aware haematology can refuse to see you and advice your GP to try something else.

BTW you vitamin D level should be at 100 not just over 50 due to having a thyroid condition. So ensure you are supplementing to get it over 100 but ensure it stays under 150. Like with T3 receptors there are vitamin D receptors all over the body. If your vitamin D levels and your T3 levels are not optimal some research states that you can have difficulty maintaining B vitamin and iron levels.

[Mighty_mum in reply to bluebug]

Can I get Ferrous gluconate or ferrous bislygcnate from the doc on prescription? or should i ask for an infusion?

I was thinking of supplimenting Vit D over winter as I get the winter blues...any recomendations for this?

Also, you mention T3 levels, I didnt have these tested even though i asked, should I push for this and why?

Really appreciate your time and knowledge Bluebug xx

[Mighty_mum in reply to bluebug]

Also, are you able to interpret the thyroid results? Am i over replaced? but I feel absolutely exhausted. would I benefit from some T3 as well as T4, how would I know?

Ta! xx

[bluebug]

What is your haemoglobin level? This is important if your ferritin is low. It may be under haemoglobin estimate on your full blood count.

Also are any of the other results in your full blood count out of range? If so please post them and the ranges.

[Mighty_mum in reply to bluebug]

Thank you Bluebug...

Haemoglobin concentration 122 (120-160) a bit low? i dont know how to interpret

Otherblood count levels seem fairly within range

Its the serum ferritin 8 (11-307) thats a problem

and T4 15.1 (8-16)

and TSH 0.03 (0.38-5.33)

[bluebug in reply to Mighty_mum]

Your haemoglobin is "fine" but preferably should be around 130-140. However as your ferritin level is so low it won't get there as you simply have no iron stores.

In regards to my other long post about iron supplements you either need to take a total :

1. 2 ferrous sulphate or ferrous fumerate per day , OR ,

2. 4 ferrous gluconate or ferrous bisglycinate

The latter, ferrous gluconate or ferrous bisglycinate, is less likely to give you stomach cramps but I would start on one per day for 3 days then if that's fine increase to two per day and work your way up to four. If an increased amount brings back the stomach cramps have no iron tablets for 24 hours and go back to the dose that was fine.

Even if you have to stop at two per day that is more iron than what is in Spatone.

[Mighty_mum in reply to bluebug]

I've just checked my prescription which I stopped taking because of the gut ache, and its Ferrous sulphate. I'll see if the dr can prescribe either gluconate or bisglycinate or an infusion tomorrow when i go for the appointment

[bluebug in reply to Mighty_mum]

He has to refer you for the infusion.

Make sure you read the prescription before you leave the consulting room as he's like to prescribe you ferrous fumerate first. He will think you don't know that it is as that's the other iron salt that is recommended on the NHS. Ferrous fumerate makes your guts hurt more than ferrous sulphate.

If you have changed practices within the last 10 years and where anaemic before you change practices, tell him you have had it and it made your stomach hurt worse.

[humanbean in reply to bluebug]

I would disagree about ferrous sulphate and ferrous fumarate. I tried both and taking sulphate was agony for me. I tolerate ferrous fumarate reasonably well. I think it is one of those things people just have to try for themselves.

[bluebug in reply to Mighty_mum]

The problem is that there is no FT3 result.

So while your T4 is high and your TSH is low because they haven't tested FT3 there is no way to confirm whether you are converting T4 to T3.

The exhaustion is likely from having such a low ferritin level. I'm actually surprised you can actually move.

[Mighty_mum in reply to bluebug]

Ha! Its a struggle!