Help! Just had vaguely worrying meeting with GP

[Icicles]

who said that (in a nutshell) things could get pretty awful for me and to look out for signs of anaemia. She examined spleen, lymph nodes and talked me through these results which she said were fine and that I wasn’t anaemic! This may not be the right place for this question, but I don’t really trust the medical professionals any more, why are my results so low in the range and doesn’t that make me anaemic? Always have a problem giving blood, they tell me I am anaemic and borderline as to whether they can take it! Feeling slightly hysterical after what she told me! But having a cup of tea instead of running around in a circle!

[SlowDragon Administrator]

For any thyroid hormones to work well....that's Levo, T3 or NDT .....we need good vitamin levels

In particular ferritin, folate, B12 and vitamin D

You can have low iron and normal or high ferritin, but it's unlikely

Why is GP not prescribing iron supplements?

When did you last have any of these levels tested ?

Add results and ranges if you have them

humanbean is our resident iron expert

[Icicles in reply to SlowDragon]

Thank you, SlowDragon. I had them tested not long ago and had been taking ferrous fumarate. SeasideSusie advised me to stop as the results were good and advised me to take thorn basic b which I have been taking for nearly two months as my folate was poor. I’ll post them when I get home

[SeasideSusie Remembering in reply to Icicles]

Icicles

I don't advise anybody to do anything, I am not medically qualified, what I do is make suggestions based on my own experience or what I would do in the circumstances being discussed. Members should decide for themselves what they want to do, and research where necessary. I give links to pertinent information where I can and always say if I don't know enough to comment. Forum guideline #11 states:

"Posts, replies and comments posted on the website should be designed to support, not replace, medical advice."

I didn't advise you to "stop" taking ferrous fumarate. This is what I said

Ferritin is at a good level now at 120ng/ml so if that was my result I wouldn't be taking Ferrous Fumarate every day now, I'd just take a maintenance dose say once or twice a week, or eat liver every couple of weeks (or liver pate or black pudding).

Your serum iron is quite low in range, your transferrin is below range and your saturation % a bit lower than optimal. However, if you continued Ferrous Fumarate daily to try and optimise those, it would also raise your ferritin too high.

and I also said

Iron is complicated. I honestly don't know how you improve the other levels in the iron panel but keep your Ferritin at the right level. Maybe your doctor will know.

This is your previous post with your results:

healthunlocked.com/thyroidu...

[Icicles in reply to SeasideSusie]

Sorry SeasideSusie, I didn’t mean to imply that you had given me advice, I was very grateful for what you said, which has been of far more use to me than anything my stupid doctor has said, and I was trying to reply on my phone, and what you said seemed very reasonable in the circumstances. I think that you indeed noticed something which was staring my GP in the face and which she appears reluctant to act on. I have been taking the Thorn Basic B for a little while and expected things to improve. But they’re not really, and she told me this morning that I might actually be quite ill and to look out for signs of anaemia, and I thought that my blood results did indicate that, and the fact that I always have a fight to donate blood, because they say I’m anaemic. I had taken your suggestion to take an iron supplement and that’s why my iron result was so good. I feel absolutely mortified that you appear to think that I have somehow accused you of doing something. I’m really sorry. That wasn’t my intention. It’s just that what she said was a bit shocking and now I’m having a total meltdown. I’m sorry.

[SeasideSusie Remembering in reply to Icicles]

Don't worry, it's probably just a case of using the wrong word here "advice"

I just wanted to make it clear to other readers that nobody here can give advice, all we can do is try and help by making suggestions, often through personal experience and maybe research. There have been instances where some members are under the mistaken impression that there are medically qualified people replying to posts - I'm not suggesting that you are by the way

I think it's important to protect ThyroidUK and responding members by explaining that replies can't be taken as medical advice.

Thorne Basic B will help with your folate level (but not your iron panel) and it's a nice balance of B vitamins without any being too over the top. It's a very good supplement and raised my bottom of range folate level to top of range in 2.5 months by taking 1 capsule daily. There have been very few members who haven't done well with it or had a bad reaction to it.

[MaisieGray]

Re. Blood draws, I always take any reason/excuse for operator failure, with a pinch of salt - I've often been told by some phlebotomists that my veins have collapsed preventing a blood draw, yet in one clinic after repeated botched attempts, the nurse was put to one side whilst the Dr immediately drew blood from the same location with perfect ease and efficiency. On another occasion I told the collapsed vein story to a phlebotomist at Cov & War hospital, who said nonsense, they don't know what they are doing, and proceeded to draw my blood with a total absence of sensation such that if I hadn't seen it happen I would have argued it hadn't....

If that's what your Dr said "in a nutshell" what did she actually say? The only result that is actually abnormal is your haematocrit, which is marginally outside the bottom of the range. In general, the hematocrit mirrors the results of the RBC count and haemoglobin, and a low hematocrit level with low RBC count and low hemoglobin indicates anaemia. Your RBC is within, albeit at the bottom of the range, and your haemoglobin is within range, below the midway mark, so both within range - remember when Drs talk about high and low levels, unlike we patients who make finer distinctions regarding optimal and not, they mean below or above range. However, some causes of a low haematocrit level include excessive loss of blood from, say, severe trauma, or chronic bleeding from the digestive tract, eg ulcers, polyps, colon cancer), but of course, also heavy menstrual bleeding - is this a problem for you? I was reading recently that there is a view that female reference ranges have been set artificially low due to a disproportionate number of menstruating women in the study population. It can also arise from nutritional deficiencies such as iron, folate or B12 deficiency; or from infection or some other drugs being taken. Severe and chronic kidney diseases lead to decreased production of erythropoietin, a hormone produced by the kidneys that stimulates RBC production by the bone marrow, so can also cause low levels. And of course, having an inflammatory disorder can also be a cause. I'm not an expert in this, but there are cofactors for your results which you would benefit from being investigated.

[Icicles in reply to MaisieGray]

Thank you for this MaisieGray, she said that the Haematologist said that i could have a genetic or hereditary problem with my blood cells which could cause Haemoysis or a low grade lymphoma and to have some other blood tests, and that if I developed signs of anaemia (he says that I am not anaemic now) then I should be referred to him. I’m afraid that I didn’t really listen very well, I think that I was kind of hoping that anaemia would explain how bloody awful I feel, but I’m not anaemic, and to top it all she showed how low my haemoglobin has been for years on her system as some kind of proof that everything was ok! I thought I was ok, but I feel pretty awful right now. I’m rambling like a bloody idiot now!

[Saya85]

To add to the above your blood cells count and haemoglobin being low do point to risk of anaenia.

If you stopped taking ferrous fumarate without any additional support or dietary changes for two months then it could well be that your levels have dipped again.

As other comment has mentioned they should probably do further testing regarding bowel issues that could be causing anaemia or infection etc (although it appears your GP is ruling that out)

You need your iron and ferritin tested again along with these new blood results to see where you can improve things.

Iron also needs plenty of vit C to absorb- so do have extra vit C with iron rich foods.

I'm glad your cup of tea has calmed you down but just on a side note- tea contains tannin which inhibits iron absorption.

If you are A frequent tea drinker especially near meal times this could also be partly the reason you have iron absorption issues.

Good luck@ I recently upped my ferritin levels and feel far better. However I have only been eating more iron rich foods and taking spatone - a liquid iron supplement

Liquid iron instead of ferritin supplements may help to balance your levels - of course a blood test should be done first regardless to see where you are

[Icicles in reply to Saya85]

Thank you Saya85

I didn’t stop completely, as my levels were good, I didn’t want to overdo it but i take ferrous fumarate at the weekend and eat liver pate. I do think that it’s my folate that is low now and I am onto that, but I will repeat tests as often as Gp will let me.

[Saya85 in reply to Icicles]

I have just read that sometimes high levels of b12 and folate can cause low iron levels.

Looking at your previous result your b12 was already quite high.

Maybe the b complex is taking it over range too?

Maybe take a separate folate supplement for now and restest.

I had low ferritin for years and GP completely ignored it even telling me I wasn't anaemic

Once I saw my results and upped it myself I've felt a lot better !

We have a Beta thalassemia trait in our family which makes blood cells smaller than normal.

I thought I didn't carry the gene but I think I might be after all too.