Help with "normal" blood test results but feeling terrible

[carer999]

Can anyone help with these test results I have been struggling for over a month feeling tired, going hot and cold, tired/achey, headache feeling like my brain was in fog, poor memory, subtle off balance feeling. She sent me for blood tests but has said "No action required" even though some results are above or below the reference range. Can anyone advise where I could start a discussion with my GP/what I can do to get optimal results as although tests are "normal" I am not and I am feeling down and fed up with feeling like this. I have B12 jabs and take Vit D. and 62.5 mcg levothyroxine. Thanks

Plasma TSH level 1.82 mu/L [0.3 - 5.6]

Plasma cortisol level 486 nmol/L [140.0 - 690.0]

Plasma prolactin level 205 mu/L [0.0 - 566.0]

Serum total 25-hydroxy vitamin D level 114 nmol/L [40.0 - 250.0]

Plasma iron level 10.0 umol/L [10.7 - 32.2] Below reference limit

Serum vitamin B12 level > 1500 pg/mL [180.0 - 914.0] Above reference limit

Plasma folate level 14 ng/mL [4.0 - 20.0]

Plasma total iron binding capacity 52 umol/L [40.0 - 70.0]

Haemoglobin A1c level - IFCC standardised 39 mmol/mol >=48 mmol/mol - type 2 diabetes. 42-47 mmol/mol - at risk of developing diabetes.

Erythrocyte sedimentation rate 20 mm/h [0.0 - 7.0] Above reference limit

Haemoglobin concentration 141 g/L [120.0 - 150.0]

Total white blood count 7.2 10*9/L [4.0 - 10.0]

Platelet count - observation 274 10*9/L [150.0 - 450.0]

Haematocrit 0.409 l/l [0.36 - 0.46]

Mean cell volume 92.3 fL [83.0 - 101.0]

Mean cell haemoglobin level 31.8 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 345 g/L [315.0 - 345.0]

Red blood cell distribution width 11.7 % [11.6 - 14.0]

Red blood cell count 4.43 10*12/L [3.8 - 4.8]

Neutrophil count 4.0 10*9/L [2.0 - 7.0]

Lymphocyte count 2.4 10*9/L [1.1 - 3.5]

Monocyte count - observation 0.6 10*9/L [0.2 - 1.0]

Eosinophil count - observation 0.1 10*9/L [0.0 - 0.5]

Basophil count 0.0 10*9/L [0.0 - 0.1]

Percentage neutrophil count 56 %

Percentage lymphocyte count 34 %

Percentage monocyte count 8 %

Percentage eosinophil count 2 %

Percentage basophil count 0 %

Plasma sodium level 140 mmol/L [133.0 - 146.0]

Plasma potassium level 3.9 mmol/L [3.5 - 5.3]

Plasma urea level 4.6 mmol/L [2.5 - 7.8]

Plasma creatinine level 65 umol/L [49.0 - 90.0]

Plasma calcium level 2.45 mmol/L

Plasma adjusted calcium concentration 2.39 mmol/L [2.2 - 2.6]

Plasma alkaline phosphatase level 79 iu/L [32.0 - 130.0]

Plasma total protein level 71 g/L [60.0 - 80.0]

Plasma albumin level 43 g/L [35.0 - 50.0]

Plasma globulin level 28 g/L [23.0 - 35.0]

Plasma total bilirubin level 6 umol/L [0.0 - 21.0]

Plasma alanine aminotransferase level 12 iu/L [0.0 - 35.0]

Serum cholesterol level 6.94 mmol/L [0.0 - 5.2]

Plasma triglyceride level 3.44 mmol/L [0.0 - 1.7]

Serum C reactive protein level 6.6 mg/L [0.0 - 5.0] Above reference limit

[greygoose]

Can't help you with all of those, but don't worry about your over-range vit B12. It's high because you have injections. But, it's water-soluble, so excess will be excreted.

What is worrying is your low iron. I think you need to insist that your doctor looks into that. Saying no action with that low iron is not acceptable. Wasn't the ferritin tested?

The high Erythrocyte sedimentation rate is saying you have inflammation somewhere in the body, which is backed up by the high CRP.

Your serum cholesterol is over-range, so I'm assuming you have low FT3 - and that's probably why your TSH is too high. The cholesterol will go down as the T3 comes up. High cholesterol is nothing to worry about, it is a symptom, not a disease.

[carer999 in reply to greygoose]

greygoose thanks for you response. Ferririn wasn't tested. Do you know what is the difference between the iron and ferritin test. Is it more detailed.

Looking back over my records my Erythrocyte sedimentation rate has been high for some years and nothing has been done about it, but the CRP results have all previously been about mid range.

[greygoose in reply to carer999]

Iron and ferritin tests don't test the same thing. Iron is what it says it is, iron in the blood, and ferritin is the protein that stores iron - like the difference between money in the bank and the money in your pocket.

There's not much that can be done about inflammation, except seek out its source. In your case it's likely to be due to you being hypo. You really do need full thyroid bloods done, but it's rare to get a doctor to do those in the UK.

[Hidden]

I can't really comment on some of the results, but your low Iron needs sorting asap, and your TSH should probably be lower at least below 1.

What about your other thyroid results, T4, T3 and antibodies?

[Angel_of_the_North]

Low iron and pre-diabetes (Hba1c high) will make you feel rough, and high CRP mean that there is inflammation somewhere. I would discuss those with doctor (esp the pre-diabetes).

[HLAB35]

It is possible to lower inflammatory markers by taking a good dose of Magnesium each day.. well it worked for me. Your iron needs further investigation as well. If you are not already taking Magnesium, now would be a good time to try.. Look up 'CRP and Magnesium' in a search and try and source a good quality one, such as Magnesium. If you drink a lot of black coffee and tea Magnesium levels will be low ( iron too).

[SlowDragon Administrator]

Your Levothyroxine dose is very small

Most patients eventually need somewhere between 100mcg and 200mcg

Aim of Levothyroxine is to increase the dose slowly in 25mcg steps until TSH is around one

Just testing TSH is completely inadequate

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12

Your iron is too low. You need ferritin tested too, likely too low. Iron supplements of possibly iron infusion

No folate test?

Vitamin D is fine and B12

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Is this how you do your tests?

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins

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 special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

If never had thyroid antibodies tested, these need doing, plus folate

You likely have low FT3 and FT4 and need dose increase in Levothyroxine

Getting full private testing is next step

High cholesterol is linked to being hypothyroid and should drop with correct Thyroid Treatment

nhs.uk/conditions/statins/c...

[carer999 in reply to SlowDragon]

SlowDragon Sorry must have missed it out of the list. My Plasma folate level was14 ng/mL [4.0 - 20.0]

[Daisy50 in reply to SlowDragon]

My gp told me that it was very on herad of when I was on 200mcg of levothyroxine she said it was very strange for me to need a dose of 200mcg and she had never seen it

[SlowDragon Administrator in reply to Daisy50]

The most common dose is probably 100 or 125mcg

But frequently we are under medicated on that

Eg - when T3 is added Levo often isn’t reduced. Eg most common combined dose is probably 100mcg Levo plus 20mcg Liothyronine (20mcg T3 = approx 60-100mcg Levo)

It’s just that often many people can’t tolerate high enough dose of just Levo, even though they probably need it in order to get FT3 to good level

[Daisy50 in reply to SlowDragon]

Over here they will only give levothyroxine

[SlowDragon Administrator in reply to Daisy50]

Over where.... USA?

[Daisy50 in reply to SlowDragon]

Channel Islands