Thyroid UK
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Latest blood results...any help appreciated

My GP reluctantly did some tests that my dermatologist requested he do. I'd seen the dermatologist for hair loss. She had said that there were a few things going on and that my long term low ferritin needed sorting out. She also said that there was a possibility I was hypothyroid (history of borderline, linked with alopecia and strong family history, many symptoms).

My GP pulled his face and felt irritated that he'd been asked to do these tests, according to him I'm normal (in range).

Here's what he requested and results:

TSH: 4.0. (0.35-5.5)

Serum Ferritin 23. (10-291)

Serum iron 11.6. (9.0-30.0)

Serum transferrin 2.65 (2.50-3.80)

Percentage iron saturation 17% (15.0-45.0)

Haemoglobin estimation 126 g/l (115-165)

Red blood cell count 3.69 10*12/L (3.80-5.80) LOW

Haematocrit 0.37 L/L (0.37-0.47)

Mean corpuscular volume 100.3 fL (84.0-105.0)

Red blood cell distribut width 11.9 (11.5-14.5)

Mean corpuscular haemoglobin 34.1 pg (27.0 -32.0) HIGH

Total white cell count 5.7 10*9L (4.0-11.0)

Neutrophil count 3.2 10*9L (1.8-7.5)

Lymphocyte count 1.7 10*9L (1.0-4.0)

Monocyte count 0.5 10*9L (0.2-0.8)

Eosinophil count 0.2 10*9L (0.0-0.4)

Basophil count 0.0 10*9L (0.0-0.1)

Platelet count 282 10*9L (150.0-4.50)

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Serum Ferritin 23. (10-291)

Serum iron 11.6. (9.0-30.0)

Serum transferrin 2.65 (2.50-3.80)

Percentage iron saturation 17% (15.0-45.0)

Red blood cell count 3.69 10*12/L (3.80-5.80) LOW

All the above suggest you need more iron. Your haemoglobin isn't low so you aren't officially anaemic. But low iron by itself will make you feel awful. And improving your iron may/should improve your low red blood cell count.

The optimum levels for iron results in people with thyroid problems are listed here :

rt3-adrenals.org/Iron_test_...

Low iron is implicated in hair loss, fatigue, breathlessness, also restless legs, spasm, twitching and cramp, also adds to brain fog.

And I think you've copied this wrong :

Platelet count 282 10*9L (150.0-4.50)

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Haemoglobin estimation 126 g/l (115-165)

Red blood cell count 3.69 10*12/L (3.80-5.80) LOW

I should point out that I've never seen someone have haemoglobin well in range before, but have under range red blood cell count. It's an odd combination of results. It might be important or it might not, I don't know. I'm not medically trained.

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Yes, it does seem odd doesn't it. I'm seeing the GP this evening it'll be interesting to see if he picks up on that.

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Hi,

Thanks very much for your reply.

Thanks for the link.

I'm hoping my GP will treat properly as I really need some help, my ferritin has been low for around 11 years and he's maintained his decision that it's normal.

I did copy that wrong, it's (150.0-450.0)

Thanks.

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You could buy your own iron supplements. My doctor prescribed me ferrous fumarate 210mg, 1 to be taken 3 times a day. When she stopped prescribing I bought my own without prescription.

Your iron isn't bad enough to need 3 pills a day, you would only need 2 I think.

But there are lots of different kinds of iron supplement available. Offline,

the stronger ones are only available from pharmacies, and choice would be limited. Online you have oodles of choice.

The important thing to be aware of is the pure iron content of any supplement you took.

The pills I took meant I was taking 207mg pure iron per day. I would consider that to be (roughly) the maximum anyone should take.

Some people buy Spatone, which has 5mg of pure iron per sachet, then wonder why their iron isn't improving, although some rare people have apparently improved their iron a little bit.

A very popular supplement is known as "Gentle Iron". It is actually ferrous bisglycinate or iron bisglycinate (same thing, slightly different name). It is available on supplement sites.

The body can absorb iron more easily when taken with 500mg - 1000mg vitamin C per dose of iron.

If you take thyroid meds they should be taken 4 hours away from iron supplements because iron reduces or stops absorption of thyroid meds.

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Thanks.

I've been taking a supplement with ferrous bisglycunate in it and having Vitamin C with meals and lots of red meat and beans etc but ferritin still dropped?

Be interesting to see what the GP says later, probably not much.

Thanks for the information, really helpful.

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What was the iron content of your supplement, and how many were you taking per day?

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It's Swiss and has 17mg iron. Also has Spirulina 200mg and Vitamin C 17mg.

Dose is one daily.

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Well, there's your answer. 17mg iron is just a tiny sliver above the normal iron requirement for a healthy person. And if your absorption is not good it won't prevent your ferritin or iron from dropping.

.

At one time I didn't know that prescription-strength iron could be bought without a prescription. I didn't know what dose was required to fix low iron. I didn't know how to test anything privately without involving a doctor. So I bought standard iron supplements from supermarkets.

By the time the cause of my low ferritin was found (it took several years), I was taking 9 supermarket iron pills per day, and my ferritin was still dropping slowly. (I had a GI bleed, which I knew about but doctors didn't believe in.)

I don't think you will raise your iron or your ferritin with 17mg iron per day.

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Ah, yes, that makes sense.

I've been having heavy and prolonged blood loss when menstruating so the GP and dermatologist reckon (I've had many years of heavy periods) that's the reasonfor the low ferritin.

Oh, I hope I have a successful appointment.

Thanksfor that. I'm glad you got your GI bleed investigated.

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If you've had low iron and heavy periods for many years, it has been found by some women that improving their iron levels has reduced the amount of bleeding they have during periods. It sounds as if that should be the other way around, but apparently its true.

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That's very interesting!

I really hope that that's the case for me.

Fingerscrossed.

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I forgot to say... If you start supplementing iron, you need to be aware that raising your iron levels too high is poisonous, so regular testing is essential.

medichecks.com/tests/iron-s...

And this would be worth doing occasionally too :

medichecks.com/tests/fbc-fu...

I would suggest doing the iron status check at least every 3 months, but it does depend on how quickly you absorb it.

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Thanks, I'm really hoping my GP will monitor and treat as I have little energy and the surgery is nearby.

This is good to know for a plan B.

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Would suggest full Thyroid testing, not just a TSH (which is high indicating a problem) and vitamin D, folate and B12 too

GP very unlikely to be able to do FT3, or both thyroid antibodies

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers. DIY finger prick test or option to pay extra for private blood draw.

All thyroid tests should be done as early as possible in morning and fasting

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Thanks for that. I'm looking into having all the thyroid panel done soon, I can't see my GP doing it.

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GP in my experience simply wont entertain a full thyroid test if you are in range (your TSH is in range albeit high end). I am certain that there is a real crackdown within the NHS now of reducing spend when deemed un-necessary.

I used Medi-Checks for my thyroid tests and I can't rate them highly enough - I like the way that once you sign up and register, everything is interactive and you can log your health stats and follow them online over time. This is the way the NHS should be in my view, enable patients to become more pro-active in their own health monitoring instead of just reacting to problems. I also like the way you can track your delivery etc.

HV

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I'm thinking the same as you. All about budgets and prioritising.

Medi-checks sounds good, I like the idea of being able to keep track of results too and monitor.

Thanks for that.

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Medichecks have offers every Thursday

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Thanks for that.

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how do i find out more about med checks to

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Start at Thyroid UK site. There was a post yesterday re that day's offers.

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I am really impressed with their site and their turnaround time. You could argue that it is a costly exercise to get test results privately like this but to be perfectly honest, I am tired of making appointments with the GP (which can take weeks) to only then have a literal battle to get a test authorised and even then, it is a battle to get the full result (reference range etc) - it is exhausting.

Medichecks have qualified doctors who will interpret your results and it is all save online to view.

HV

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I know what you mean about the exhausting battle with a GP, you'd think they'd want to help.

Yes, that sounds so smooth and easy and stress Free in comparison.

Is the finger prick easy to do? I'm not sure I'd get enough blood into the tube.

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I have done both.

I am fortunate in that my sister is a nurse and so my first tests I had her draw blood for me without the need to arrange a site visit to a phlebotomy place whereas the second test, I ordered the finger prick.

The tube was smaller (obviously) but it did take some doing to fill it up and I had to use 3 fingers to draw the blood - now I know why they provide 4 lancets! My forefinger was the best and I wish I used it first (instead of my thumb). You also need to stand up and do it so that the blood flows downwards - I also did it near my fireplace so my fingers were nice and warm!

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My mum used to be a nurse (as did I) and was really good at bloods. She's retired now though.

That's really good to know about your experience with the finger prick test, really helpful as I do think I'd struggle with that.

Thanks.

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It may be worth getting your B12 and folate levels checked too. Your mean cell volume (MCV) is high in range (and it is an unusually high range!). Low iron / ferritin generally leads to a low/below range MCV where as low B12 / folate deficiency may lead to a high / raised MCV. It is possible an iron deficiency and a B12 deficiency can co-exist and both individually can cause deficiencies and symptoms without overt anaemia. Many of the symptoms of a B12 deficiency overlap with those of thyroid problems too so is well worth checking into.

Symptoms: pernicious-anaemia-society.... and b12deficiency.info/signs-an...

It is important to NOT take any supplements containing B12 until the tests have been done as these may skew the results. I would also ask them to test for anti-intrinsic factor antibodies too to see if you have pernicious anaemia (though the test is far from perfect.).

There is a pernicious anaemia society forum here on health unlocked if you want more input and info on B12 deficiency / PA and getting tested etc. :-) (I am one of the admins there.) healthunlocked.com/pasoc

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Thanks very much for that information. I'll look into that.

I saw my GP last evening and he said that all my bloods were fine, though some on the low side so he's given me some iron tablets and I get tested again in eight weeks.

I do take a high strength sublingual B12 supplement methyl and my B12 levels in my blood is always high...not sure if that means its not being used/absorbed and also not sure if it's a good idea to have consistently high levels of B12 in the blood? I take them for cognition as I get brain fog.

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How are your folate levels?

High serum B12 is usually only a problem if it occurs without supplementation as it may indicate liver or haematological issues which may need investigating. If you are taking high strength supplements and have a high serum B12 then it looks like you can absorb it ok. :-)

High serum B12 does not mean it necessarily can be used at cell level, however. Things like measuring MMA or homocysteine may give you more of an idea at a biochemical level, but, 1 or both of these tests can be affected by things like renal problems, folate deficiency and hypothroidism so may not necessarily be very helpful to you. :-(

Guidelines for treating B12 and folate disorders: pernicious-anaemia-society....

Good luck!

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I haven't had folate bloods done recently, if ever?

It's good to know that I'm absorbing B12 OK.

If things don't improve when ferritin is increased I'll ask my GP about the bloods you mention, sometimes he's cooperative and interested.

Thanks for your help and the guidelines, I appreciate it.

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Low folate can also lead to large red blood cells (increased MCV) as it is also involved with DNA replication (in conjunction with B12). It is often measured at the same time as B12 so if you've had your B12 measured it would be unusual to not have had folate also tested at some point. Folate levels usually follow folate/folic acid dietary intake.

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Thanks, I'll check back through older blood results and see what it's like.

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Hi - apart from all the good advice given to you about vitamins etc. I think your TSH sounds quite high. Could you get your doctor to check to antibodies and establish if you have Hashimotos thyroiditis? He should start you off on levothyroxine 25 or 50 msg in my opinion (but I'm not a doctor).

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Hi,

My GP is really stubborn. He simply says that my TSH is normal.

I'm thinking of having the blood panel done privately after my ferritin has been sorted.

It's frustrating when NICE sets the guidelines as it does, my GP sticks to what the computer says.

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