I'm a 45 yr old female with typical boringly long history of nagging health complaints- anxiety (well controlled on fluoxetine), extreme tiredness and lethargy, frequent headaches,skin complaints including very dry skin and funny bumpy rashes on elbows and knees that come and go,and a twenty year history of irritable bowel type symptoms, now I get out of breath and exhausted easily.
I've had blood tests in the past which just showed slight anaemia.
I went back to the GP recently asked to be tested for coeliac-and she also ran a full panel-liver and kidney function and glucose etc were all fine. Here are my others:
TSH: 2.8 mu/L. 0.27 - 4.20mu/L
Calcium: 2.18 mmol/L. 2.15 - 2.55mmol/L
Vit D: 31 - abnormal-gp recommended supplements
Haemoglobin estimation: 109g/l. 120-150 g/l
Ferritin: 5 ug/l. 13 - 150ug/l
B12: 228 pg/mL. 180-914pg/l
Serum folate: 4.4 ng/ml. 3.10-20.00ng/ml
ESR: 31 mm/h. 0-12mm/h
Coeliac screen- normal- IgA- 0.8, igG 0.9
Obviously from this I'm anaemic and ferritin is very low, and because my ESR is also high my gp referred me to gastroenterologist for bowel investigations.Gastro was pretty dismissive and thinks I just have IBS, he basically shrugged when I mentioned my ferritin level is 5. He is going to do a colonoscopy just to be sure though. In his clinic letter he said the anaemia doesn't warrant further investigation as I still have periods. Even though they are normal and not heavy.
The gp will discuss iron supplements etc once I have had the colonoscopy. I did ask for more detailed thyroid tests: free t3 and 4 and thyroid antibodies but she refused, saying my thyroid result was dead normal and my symptoms were probably just caused by anaemia, which goes against a lot of the advice I have seen, but I don't feel I can argue with my doctor, even though a lot of my values are at the bottom end, like B12, but she won't do further testing as they are 'normal'.
Any thoughts? I really don't want to feel this grotty for the next twenty years!
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Chris1802p
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Based on your ferritin levels you are very anaemic, even though ferritin is not definitive yours is very low. I'm guessing your GP doesn't want to supplement iron until after the colonoscopy because it might interfere with the ability to observe the bowel (just a guess, not knowledge). Although I don't believe low iron affects the thyroid to any extent there is some evidence that it might at these very low levels. I'd be tempted to wait until your iron levels are better before pushing for investigations for your thyroid. Dry skin is a very good marker for hypothyroidism but I suggest you wait and see how it goes when your iron is sorted. The breathlessness is likely related to your aneamia as the iron in blood carries oxygen. Given you have to wait until after the colonoscopy before your anaemia is treated I would push to have the colonoscopy soon. If that is not possible maybe ask the gastroenterologist whether you need to delay iron supplementation until after the colonoscopy.
Hi Kris, Can you go online to hypothyroid mom or thyroid pharmacist? You definitely have some issues going on. They can be corrected with the right help. Please, try these two sites.
Funny bumpy rashes might be indicative of Coeliac. Thing is, blood tests and endoscopies don’t always find it. The rashes are known as dermatitis herpetiform.
Just so you know, the rash varies from person to person, so the pictures there might not look like your symptoms.
Frankly it seems wrong to leave you without treatment until the colonoscopy, but I suppose 2 weeks isn’t a very long time to wait. I think with iron levels that low I’d be asking about an iron infusion - it’s going to take an awfully long time to come up by taking iron tablets.
And that comment about the periods - really odd thing to say. Periods shouldn’t make you anaemic. Not sure the doctor truly knows his stuff - but did you get to see the specialist himself or just one of his house officers?
And I doubt I'll get very far asking for an iron infusion, at this rate I'll be lucky to be prescribed anything. My GP has already told me to just buy my own Vit D supplement.
Er, they did B12, ferritin and folate once my fbc showed microcytic anaemia - I didn't realise there was more. But when I ask if perhaps they should run more (like a full thyroid panel) they just refuse saying it isn't necessary
They don’t think anything more than FT4 and TSH is needed. It’s what the lab and the computer tells them.
But they should almost certainly see the need to do an iron profile to gauge how anaemic you are (as in iron deficiency anaemia). Iron infusions aren’t that uncommon and if you are as anaemic as I think you might be, it would be the quickest way of getting you feeling better again.
My GP won't even do FT4, only TSH. Which she declared completely bang in the middle of normal at 2.8.
Because my haemoglobin was 10 and my ferritin was 5, the gastro just stated in my clinic letter that I have 'slight' microcytic anaemia and low ferritin.
My GP won't even do FT4, only TSH. Which she declared completely bang in the middle of normal at 2.8.
Your GP obviously thinks that the distribution of TSH in healthy people is a normal distribution i.e. a bell-shaped curve. But she is wrong. See this post for more info :
Well, you could change your GP. It might help. But before doing that, some suggestions :
1) Always attend doctor's appointments with a witness, preferably male, and always must be someone who will support you rather than undermine you if necessary. They don't have to say anything (if you don't want them to). If you said it is appalling in this day and age to have to advise this, I would totally agree. But since going to appointments with my husband I've discovered for almost the first time in my life that far more doctors are capable of being polite than I ever thought possible.
2) From that post I linked to... Print out the graph and all the statistics on the page and give it to your doctor :
She can't claim that your result is absolutely bang in the middle based on that graph.
You could also print out the paper that led to that graph, if you wanted, but I doubt your doctor would read it. If your doctor pointed out that the paper is rather old then ask why TSH should have changed in the healthy population in the meantime.
Once you have had colonoscopy I would recommend trying a gluten free diet. This should help with anaemia but you alos need to supplement for low Vit D, B12, folate and ferritin. Seaside Susie on here gives very good advice.
All your vitamins are terrible. This suggests low stomach acid and/or gluten intolerance
Vitamin D. Needs improving to at least 80nmol, but around 100nmol better
Suggest you try Vitamin D mouth spray as this avoids poor gut function
Retesting in 2-3 months and then twice yearly. Trial and error what dose you to improve levels and what dose for maintenance.
Vitamindtest.org.uk £29
Look at importance of adding magnesium and vitamin K2 Mk7, when supplementing vitamin D
Folate and B12 are both very low. Has GP tested for Pernicious Anaemia and intrinsic factor? Your TG antibodies on other post are slightly raised, this can be linked to PA
Would definitely rerun full Thyroid testing 4-6 months after improving all vitamins and being on absolutely strictly gluten free diet
All thyroid tests should be done as early as possible in morning and fasting. This gives highest TSH and most consistent results. (Patient to patient tip, GP will be unaware)
Hi- really helpful info, thanks, no GP hasn’t done a full iron panel, or a total IgA, or Intrinsic factor, but when I ask for things they tend to be refused!
Non-update alert!! Just returning to this feeling a bit pissed off and not sure where to turn next.
Since all of the above 6 months ago, not a lot has changed. I’m technically not anaemic anymore as my haemoglobin is now 147. Been on iron tablets ( ferrous fumarate) all this time- can’t take them everyday as they upset my IBS. My ferritin has managed to crawl up to 30 from my initial 5. That was last tested a couple months ago so prob a bit higher now.
I’ve been supplementing Vit D and sublingual B12 and folate for the last 4 months or so.
Still feel like shit most of the time. Utterly exhausted, frequent headaches, IBS,
All the same old same old.
I returned to my GP as I feel no better despite addressing the Anaemia and low Vitamins, and they reran bloods and added an ANA (negative), and prothrombin screen (normal). My TSH is now 3.1. My ESR is consistently raised at about 30 but not enough to bother GP.
Because I’ve now been back and forth a few times and all my tests come back relatively OK I am now loathe to keep going back as I’m sure they have me down as a munchhausens case or something.
B12 and folate look really low. SlowDragon has already suggested ruling out Pernicious anaemia and I think it's a good idea given low B vitamin levels. Don't give up its important to sort your health out and get the help you need. Since you've corrected iron levels and still feel unwell, there must be some other factor. So pursue it and get instrinsic factor antibodies checked. It's not conclusive for pernicious anaemia apparently so even if you don't have the antibodies you still need to address the low B12 and folate. Have you retested your B vitamin levels recently?
My coeliac screen came back negative and my surgery refused to do IF, saying I ‘didn’t need further testing’😡 and they won’t test B12 again as they don’t consider 230 to be low. I’ll get a private active b12 done at some point.
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