Can anyone explain my blood test results? (Copied from another post) - please ask if you need to know anything

[tigerlily72]

I've been signed off as unfit for work for 2 weeks with Nerve Pain as I was told the Dr had to "put something" on the medical certificate and she thinks it's nerve related. Told to double and even triple up on my amitriptyline and she's booked me an appointment to see my registered Dr next week to review.

I remembered to ask for a printout of my blood tests - there's pages of it!!!

So, here goes: (copied as per printout)

Haemoglobin A1c level - IFCC standardised (XaPbt) = 43 mmol/mol. For monitoring QOF control targets are 59, 64, 75 mmol/mol

Full Blood Count:-

Total White Blood Count 8.6 10*9/l (4.0-11.0)

Red Blood Cell Count 4.86 10*12/l (3.5-5.5)

Haemoglobin concentration (Xa96v) 146 g/l (115-165.0)

Haematocrit (X76tb) 0.431 l/l (0.37-0.47)

Mean Cell Volume (42A) 88.7fl (78.0-100.0)

Mean Cell Haemoglobin level (XE2pb) 30.0pg (27.0-32.0)

Mean Cell haemoglobin concentration 339g/l (320-360)

Red Blood Cell distribution width (XE2mO) 12.4% (11.5-15.5)

Platelet count - observation 302 10*9/l (150.0-400.0)

Mean Platelet volume 10.6 fl (8.0-12.0)

Neutrophil count 4.3 10*9/L (2.0-7.5)

Lymphocyte count 3.4 10*9/L (1.5-4.5)

Monocyte count - observation 0.60 10*9/L (0.2-1.0)

Eosinophil count - observation 0.29 10*9/L (0.04-0.4)

Basophil count 0.1 10*9/L (<0.3)

Serum TSH level (XaELV) 4.38 mIU/L (0.3-5.0) TSH within limits excludes primary but not secondary hypothyroidism.

Plasma Viscosity (XE2pd) Above Range 1.76 mPa.s (1.5-1.72). Above high reference limit.

Plasma fasting glucose level. 5.0 mmol/L (3.3-6.0)

Serum ferritin level (XE24r) 50 ng/ml (15.0-350.0)

If it's relevant I also have a whole load of figures for Liver function and serum and a calcium profile. Although it may as well be written in a foreign language!

But to my untrained eye, no full thyroid tests from what I can tell.

[poing]

Your serum TSH is raised even though it's not out of range. Normal is around 1 to 2. What time of day were your bloods taken? If in the afternoon then get retested first thing in the morning as TSH is highest when you wake up and then falls during the day.

[tigerlily72 in reply to poing]

Test was around 8.20am (that was my appointment time). Should I query this with my own Dr?

[poing in reply to tigerlily72]

If your TSH was only just under 5 in the afternoon, odds are that it would be over 5 in the morning you see and then your GP would take more notice. But if your bloods were drawn in the morning, then that's not going to help you I'm afraid.

The NHS will only test the actual hormone levels (T3 and T4) when TSH is out of range, which it isn't. Otherwise you would need to get a private test.

You could still ask for antibody tests, if you have ongoing thyroid-like symptoms. Autoimmunity is the most common reason for low thyroid.

[hellybaybee]

TSH is high, need T4 and T3 checked -likely you have hypothyroidism. NHS tend to treat at 5.0 (which is quite high imo, particularly as other countries often treat at 3.0) so you are just below their remits. Ask for a retest in the morning, as early as possible, with T4 and T3.

[tigerlily72 in reply to hellybaybee]

Thank you for your advice. My bloods were taken around 8.20am and also after fasting. I'll ask my Dr if I can be retested and for T3 and T4.

[Bonnitac]

TSH definitely too high. If you have nerve pain like tingling or numbness, I'd really recommend a Vit B12 test as deficiency can cause these symptoms. Many hypothyroid people here have both.

[whispers60]

As has been said you could do with t4 and t3 testing, but as you are in the UK the t3 test will be refused by the lab going on your tsh result, if my tsh was that high i would be feeling iill too. did they also do a full iron as can onky see ferritin on your list and that is low and also needs addressing, i am guessing that your vitd b12 and ithe iron levels will also be on the low side.

If you are on facebook, there is a page called the wheatbelly, it has a lot of information on diet for diabetes have a look and see if any if the info fits with your symptoms, but even if it doesn't it gives many recipies for people controlling diabetes by diet alone. Ive started ysing the recipies as they are so tasty and I don't have diabites lol .

[hellybaybee in reply to whispers60]

Not necessarily... my current gp requested T3 and T4 and I received results for both. At my last dr, nurse requested T3 and T4 and they just did T4. It really depends on gp and lab so I know what you're saying but definitely worth asking. I also agree with others about b12 and vitamin d - I have problems with both and have the nerve problems (they've more or less gone since having b12 injections)

[tigerlily72 in reply to whispers60]

Thank you. I am on Facebook so I'll have a look at the page you've recommended. I've had my b12 tested in the past (it was prob Sept/Oct) last year - told it was ok but never saw any figures! I'm so glad I've actually got my full results and the figures so I can hopefully push for more testing. My registered Dr has been pretty good so far. Fingers crossed I can challenge things!

[tigerlily72]

Thank you for your advice. Can you explain a little more about the ferritin level please?

[poing in reply to tigerlily72]

Ferritin is related to the level of iron stores in your body. If it's very low then its an indicator of iron deficiency, and your thyroid can't function without iron. The official line is that ferritin needs to be over 50 to rule out iron deficiency. With a result of 50 then you're not severely iron deficient, but you may still have iron balance problems because ferritin levels are affected by inflammation. Inflammation increases ferritin, so your iron stores may not be as good as the result suggests and are at the lower end of the scale. The big problem with inflammation is that it decreases serum iron, which is the iron available for your cells to use. That's a different blood test and wasn't tested here (not a routine test on the NHS). I disagree with the other poster who says a ferritin of 175 is the right place to be. High iron levels are a problem too. A ferritin of 175 either means your iron levels are higher than ideal or that you have lots of inflammation. My understanding is that a ferritin of 50-100 is ideal, but the level at which you feel well may be personal to you.

[tigerlily72 in reply to poing]

Thanks for explaining that. Some absolutely brilliantly, helpful people on here. Really grateful for the support

[Angel_of_the_North]

Statistically, anyone with a TSH at the top end of the range is likely not to be healthy as the majority of people have TSH in the range 1 -1.5, Shame doctors don't know stats. No Free t4 or Free T3 so doesn't really tell you anything. Ferritin is lower than optimum. No B12 or Folate

High plasma viscosity means inflammation, but doesn't tell you why. Eg temporal arteritis, giant cell arteritis, polymyalgia rheumatica, hughes syndrome, hashis, etc. Might be worth asking for a referral to rheumatology as they often seem fairly clued up about thyroid.

[tigerlily72 in reply to Angel_of_the_North]

Thank you. When I queried the inflammation result (1.76) I was told t might be because I may have had a cold or something - I don't and I didn't!!! Aarrrghhh!

It looks like I need to ask for T3 & 4 and maybe ask to be referred to Rheumatology.

[poing]

I agree with you for folate and B12, but iron is another matter. I've been on the wrong end of severe iron imbalances, so this is a subject I've looked into very, very closely and feel that I know what I'm talking about. Iron is not best mid-range. Ranges are also doubtful as they are so different for men and women, and are based on what's out there in the population rather than what's best. (Women's ranges are a lot narrower than mens simply because we menstruate, which keeps iron levels lower, but does that mean men should aim for a completely different level?).

Some people may feel better with ferritin higher, but only because they are very inflamed, while others chase such high levels as a target when they'd probably do better with a lower value. I've had severe iron deficiency symptoms with a ferritin of 19 (my thyroid was swollen as it struggled to keep up) and no symptoms at all with a ferritin of 12 (because I had resolved the inflammation and though my iron stores were super low, I had put enough iron into me to function again.)