Help with blood test results

[kahlan]

Hi everyone,

I'd really appreciate advice regarding my recent blood tests. I was diagnosed with Graves disease ~2006 and treated with block and replace therapy. After a relapse and a second round of block and replace I elected to have RAI in 2012 and have been on 100mcg thyroxine ever since. Whilst I can't say I felt brilliant it was ok and my main issue was dry eyes.

I had a private blood test in December 2016 as I was feeling tired and cold with achy joints and was curious on my T3 levels (GP never mentions those!):

TSH = 0.711 (0.27-4.2)

Free thyroxine = 17.07 (12-22)

Total thyroxine T4 = 132 (59-154)

Free T3 = 4.13 (3.1-6.8)

Thyroglobulin antibody = 25.71 (0-115)

Thyroid peroxidase antibodies = 9.39 (0-34)

Vitamin B12 = 120 (191-663)

Serum folate = 1.54 (3.89-26.8)

Ferritin = 7.18 (13-150)

So I went back to my GP in early February who insisted on a full blood test:

Serum B12 = 195 (150-99999)

Serum folate = 2.4 (4.2-19.8)

White blood count = 8 (4-13)

Haemoglobin concentration = 111 (115-165)

Haematocrit = 0.369 (0.35-0.47)

RBC count = 4.57 (3.9-5.6)

MCV = 80.7 (73-100)

Mean cell haemoglobin level = 24.3 (26-32)

Mean cell haemoglobin concentration = 301 (300-350)

RBC distribution width = 16.1 (11.8-14.8)

Serum ferritin = 6 (15-150)

Serum TSH = 2.11 (0.25-4)

Free T4 = 16 (12-22)

I am feeling awful. I am exhausted. My eyes are painfully dry and I've had a couple of episodes where there has been a small area of vision that has suddenly gone blurry which after 10 mins has passed. My skin is so dry. I drop things and my balance is sometimes off. My memory is rubbish - I forget things I've just read. I can't even remember if I listed all my symptoms to my GP.

My GP has given me iron and folate tablets. However she said my B12 is in range so that's nothing to worry about. Whilst it being in range is true is it near the bottom at 195 (150-99999) so should I still be concerned? Should I go back and push this?

Thanks for reading this far. Any advice would be gratefully received.

[bluebug]

I suggest you go to the pernious anaemia society on healthunlocked and ask them for advice on your vitamin B12 level.

You will be tired until your iron level rises and your B12 are sorted out but I've noticed your doctor hasn't tested your vitamin D level. Ask for this to be tested as it is common in people with thyroid disorders to be deficient in vitamin D. Tell the doctor that you have been feeling so tired for about a year that you have become housebound since then and are aware your vitamin D level should be tested as well. The reason for this is unless you make it very clear you don't go outside you will not be tested.

If the GP refused to test your vitamin D level then City Assays, a NHS hospital in Birmingham, do a finger prick vitamin D test for around £30. I suggest you find the link to them on the main thyroid UK website and use them. When you get your result start a new thread and post it.

[Katepots]

No wonder you are feeling shocking. Your Folate, feretin and B12 are all sooo low.

Did the dr not talk about supplementation?

B12 should be over 500, under 500 you can start to see neurological changes.

I supplement with now foods instant energy B12 and mine has come up to 499 now. (Amazon)

You need to be tested for the Intrinsic factor linked to low B12 to see if you have pernicious anemia.

Also vitamin D hugely important. I'm guessing you will be low looking at these results. Ideally it needs to be between 50&60 bnmol/L but definitely over 40nmol/L

Incompetent GP! I'd change to a different one.

Your antibodies are not particularly raised but if you still feel awful after supplementation of above then look in to Hashimotos and try a gluten/casein free diet.

[satu55555]

You need to take vit B12, folate and iron urgently. These already by themselves cause fatigue. I would also get vit C and a strong B Complex. I'd recommend seeing a functional nutritional therapist and possibly also a functional doctor for advice on how to fix fatigue. Normal doctors are not that good at it from my experience.

[Raventhorpe]

Hi I noticed you mentioned you are having trouble with your eyes, you should get them checked out as you Have graves very often you can develop thyroid eye desease, artificial tear drops can help with gritty feeling in eyes.

[ElRR]

Once you get iron and b vitamins worked out, look into your T4 levels. They are in the "normal" range, but the low end. Even a small decrease in these levels can cause us to be sick, and they likely should be in the higher range.

[MiniMum97]

You need to supplement now. Iron take about 80- 100mg a day ferrous fumerate (if you cannot tolerate this try solgar gentle iron - I took 4 tabs a day in two doses). Take them with 500mg to 1000mg vit c (to aid absorption and help with the constipation). Again I take solgar vit c. Take on an empty stomach 1 he before food or 2 hrs after).

B12 lots of members recommend 5000mg sublingual solgar or jarrows methylcobalamin lozenges. You also need B complex to balance which should also contain folate (ensure it is methylfolate not folic acid, and has no more than 60mg b6). Not sure if that is enough folate for you perhaps other members can advise? Take b vits in morning.

You MUST get your vitamin D tested which given the levels if your other vitamins I suspect you are low in. Vit D you should be aiming for about 100. If you need vit D then you need Vit d3 5000iu 8 weeks then alternate days for 8 weeks you should take it with Vit K2-mk7 (between 45 and 185 meg daily) - take d3 and k2 together with dietary fat.

Make sure you get retested (you can get private tests if GP won't) you want to get most vitamins mid range, B12 about 1000. I understand that thyroxine does not work properly when vitamins (particularly ferritin) are low which could be adding to your issues and explain why your T4 and T3 could be a bit better.

I had low ferritin only and felt ABSOLUTELY HORRENDOUS! Taking the above supplements took me about 3 months to start to feel better so don't expect an overnight fix. Am still taking supplements about 9 months later and about to retest to see if iron is now mid range

Good luck

[jacrjacr]

your iron and b12 are very very very very low....dangerously...no wonder you feel like crap....you have to start supplementing...and you may also have digestive issues if you are not absorbing nutrients...cant believe they didn't test d3 which also makes you fatigue......you have to do something immediately....

[kahlan]

Thank you lovely people for your replies. I also posted on the PA forum and from all your advice I will be going back to the GP for further B12 investigation and to get my vitD levels checked. (good advice to push the 'I don't spend much time outdoors'!). I've started with the folic acid and iron the GP gave me so it's a start. Thank you all once again.