Help with making sense of my results please?

[jjjam]

Hello everybody,

I wondered if somebody could help me see where I go from here now I have a printout of my results please? My blood was taken on 12 July at 7.50am and I had fasted from 10pm the previous evening.

I recently visited GP for first time with symptoms of mainly weight gain, tingling in feet/legs, and sometimes hands, tiredness, and really dry skin (which seems to have come on suddenly). I have a family history of thyroid problems.

I was phoned by the surgery the day after the test, and told my blood count would need repeating in 6 months time (which doesn't fit with the path lab suggestion to retest full blood count in 2-3 weeks - see below) and my cholesterol was a bit high .

Any comments and/or suggestions will be appreciated, thank you!

Full blood count, Result "Mild neutropenia - consider causes e.g. drug therapy viral infection etc - suggest repeat in 2-3 weeks. Mild neutropenia may be normal for ethnic origin" (I am only taking Vitamin D, just for 3 weeks or so before blood test, and Omega 3 and am not aware of having had a viral infection, and am white Caucasian.)

Haemoglobin 131g/L (120.0 - 150.0)

Total white blood count "Below range" 2.9 10*9 (4.0 - 11.0) Outside reference range

Platelet count 255 10*9/L (150.0 - 410.0)

Red blood cell count 4.45 10*12/L (3.8 - 4.8)

Haematocrit 0.394 L/L (0.36 - 0.46)

Mean cell volume 88.7 fL (83.0 - 101.0)

Mean cell haemoglobin level 29.5 pg (27.0 - 32.0)

Mean cell haemoglobin concentration 333g/L (315.0 - 345.0)

Red blood cell distribution width 13.8 (11.6 - 14.0)

Mean platelet volume 8.8 fL (7.5 - 11.2)

Neutrophil count "Below range" 1.6 10*9/L (2.0 - 7.00

Lymphocyte count "Below range" 0.9 10*9/L (1.0 - 3.0)

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

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

Eosinophil count 0.1 10*9/L (o.0 - 0.5)

Urea and electrolytes

Serum urea 3.7 mol/L (2.5 - 7.8)

Serum sodium 137 mol/L (133.0 - 146.0)

Serum potassium 4.3 mol/L (3.5 - 5.3)

Serum creatinine "Below range" 51 umol/L (53.0 - 97.0)

GFR greater than 90 mL/min/1.73m2

Blood glucose

Plasma glucose 4.8 mol/L (4.0 - 6.0), Fasting

Liver function tests

Serum total protein 73 g/L (61.0 - 79.0)

Serum albumin 43 g/L (35.0 - 50.0)

Serum total bilirubin 10 mol/L (3.0 - 20.0)

Serum alkaline phosphatase 56 u/L (30.0 - 130.0)

Serum alanine aminotransferase 15 u/L (7.0 - 35.0)

Serum vitamin D 53 mol/L (30.0 - 300.0)

Serum TSH level 3.95 mu/L (0.35 - 5.0)

Serum lipids

Serum cholesterol 7.13 mol/L

Serum HDL cholesterol 2.14 (0.9 - 2.21)

Total cholesterol:HDL ratio 3.3 ratio

Serum vitamin B12 140ng/l (130.0 - 800.0)

[Nanaedake]

B12 is extremely low in range, given the fact that your white blood cell count is also off, I would press for more speedy investigation. Particularly as you have symptoms of B12 deficiency such as tingling in feet, legs and tiredness. Your GP needs to rule out pernicious anaemia by testing intrinsic factor antibodies.

Do you have a result for thyroid antibodies?

Your TSH is higher than most people taking Levothyroxine would want it to be but is still in range. Are you taking Levothyroxine?

Vitamin D is also low which may be a result of poor nutrients absorption. Vit D is better mid lab range if you have thyroid disease. Do you have autoimmune thyroid condition?

[Nanaedake]

Just read your previous post and it doesn't look like you've been diagnosed with thyroid disease or are taking Levothyroxine so probably need to investigate low b12 as cause if symptoms. However there is no result for thyroid antibodies TPO and TgAb and you need those to rule out thyroid disease.

[jjjam in reply to Nanaedake]

Thank you very much for your reply. No, I've not been diagnosed with thyroid disease and am not taking any prescribed medication.

I am not very knowledgeable about the various blood tests, particularly which to 'encourage' GP to request. I did ask him if I could have B12 tested, which he readily agreed to, but I had to justify asking for Vit D testing.

[Nanaedake in reply to jjjam]

On the basis of low B12 and low white blood cell count ask for intrinsic factor antibodies to be tested. And ask for antibodies tests as above for autoimmune thyroid disease on the basis of family history.

Further to this ask for coeliac disease blood tests as your vitamins absorption is poor unless your diet is absolutely rubbish and you never get out in the sun

The blood tests for pernicious anaemia and coeliac disease are not conclusive but may give an indication which direction to investigate further.

Write a list of symptoms and take those to your doctor too. There is no result for folate or ferritin and even though iron level is OK. Given low B12 level it could be worth checking ferritin which is your iron storage as well as folate I would have thought. Worth discussing along with symptoms.

I would pursue this and not leave it 6 months. Maybe see a different doctor in the practice. If they refuse to do further testing ask for that to be noted on your record and then get some tests done through online lab listed on Thyroid UK website. Prices are transparent, fingerprick testing foe many of the tests and results by email.

[jjjam in reply to Nanaedake]

Thank you again Nanaedake, I appreciate you taking the time to help me.

My diet is pretty good, and I went gluten free about 3 months ago; I can now feel it if I have accidentally eaten a food containing gluten. I do get what I would think is adequate sun exposure too.

I'll assimilate what you have told me, and go back to the surgery better-informed.

Incidentally, do you know if any of these conditions - thyroid, coeliac, Vit B12/pernicious anaemia - can give rise to receding gums. Sorry, I forgot to mention it earlier in this post, but in some ways this symptom worries me most. I can almost see my gums edging back week on week, particularly on my upper jaw. When I mentioned it to the GP in the context of my thyroid, he said he'd not heard of an association.

[Nanaedake in reply to jjjam]

If you are not eating gluten the test for coeliac disease will not show up the problem (if you have one) which it sounds like you do since you are feeling better by not eating gluten so make sure you tell the GP as test will be useless but important to register in the light of deficiencies and for further blood tests.

Try vitamin C for help with gums but I don't know what could cause your problem so it may not help gums, however, it could help overall health. I think you should visit a dentist and ask them to rule out likely causes. I take 500mg vitamin C twice a day so 1000mg altogether daily. Have you looked at the Coeliac Disease Society website for information?

The thing with Hashimotos thyroiditis, coeliac disease and pernicious anaemia is that they are all autoimmune conditions and can coexist. They all prevent proper absorption of nutrients so all your vitamin and mineral levels are likely to be low if any of these conditions are present. Ask GP to check your calcium levels too because you are intollerant to gluten. Most important to prevent skeletal deterioration if you have coeliac disease.

[jjjam in reply to Nanaedake]

Ah yes, I didn't realise that about the coeliac disease test.

I saw my dentist recently, but she didn't think my gums were particularly inflamed (which they are usually not) so just reminded me of the best way of tooth brushing. Vitamin C sounds a good idea, I'll get some.

With your help, and that of other contributors, I am starting to get more of an understanding of how all these 'separate' autoimmune diseases can sit alongside each other.

[Nanaedake in reply to jjjam]

Let us know the outcome so we can all learn more and help each other.

[Cariad123 in reply to jjjam]

There is definetly a connection between low vit d and receding gum line

[SlowDragon Administrator]

See a different GP. Point out the extremely low B12 result

Ask for folate and ferritin to be tested and testing for Pernicious Anaemia

List of low B12 symptoms

b12deficiency.info/signs-an...

Point out you are gluten intolerant

Ask for Thyroid antibodies to be tested - TPO and TG antibodies. Plus FT4 and FT3

All thyroid tests should be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

Hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

[jjjam in reply to SlowDragon]

Thank you very much for that, and to everyone who replied to me; the links are really useful too.

I am making another appointment to see GP.