Pain in fingers and toes (and still low energy) - blood test results

[Sick-and-Tired]

Hi everyone,

I posted recently because my fingers and toes have been really painful for the last few months. I went to the doctors and she said that osteoarthritis which I have in my hand has spread to all my fingers and toes. Thank you everyone who has given me great advice!

In my appointment I asked if she could at least check my vitamin D level, and she reluctantly agreed to do this she said she would also check whether there's any inflammation.

To my surprise she seems to have done quite a lot of tests (although not for rheumatoid arthritis, which I will see if I can get).

I just wondered what everyone thought. I see that my vitamin D has dropped in spite of taking 5,000iu a day and getting lots of sun, so I will see whether she will agree to do loading doses again (which is the only thing that's ever got my levels up before)

As well as the vitamin D, I'm currently taking 100mcg levothyoxine, 100mcg K2, 1300 evening primrose oil, 14mg iron and use a magnesium oil spray.

I've been taking levothyoxine for about 18 months and felt no improvement in my energy. I know she didn't do a full thyroid panel here, and it's been suggested from previous results that my T3 is on the low side, which I want to raise with my endocrinologist.

Here are my most recent results:

Serum total 25-OH vit D level - 59nmol/L (75-200)

Serum sodium - 137mmol/L (133-146)

Serum potassium - 4.4mmol/L (3.5-5.3)

Serum urea level - 4.0mmol/L (2.5-7.8)

Serum creatinine -53umol/L (49-90)

eGFRcreat (CKD-EPI)/1.73m*2 - 90mL/min (90-120)

Serum TSH - 0.80 miu/L (0.53-4.78)

Serum total bilirubin - 32umol/L (0-20)

Serum ALT level - 16u/L (10-49)

Total white cell count - 6.3 10*9/L (4-11)

Haemoglobin estimation - 150g/L (115-165)

Platelet count - 132 10*9/L (150-450)

Red blood cell count -4.93 10*12/L (3.5-5.5)

Haematocrit -0.450 ratio (0.37-0.4)

Mean corpuscular volume - 91.3fL (75-105)

Mean corpusc. Haemoglobin (MCH) - 30.5pg (26-35)

Mean corpusc. Hb. conc (MCHC) - 334g/L (290-350)

Red Blood Cell Distribution Width - 12.5% (11-15)

Neutrophil count - 3.5 10*9/L (2-7.5)

Lymphocyte count - 2.1 10*9/L (1-4)

Eosinophil count - 0.1 10*9/L (0-0.4)

Basophil count - 0.1 10*9/L (0-0.1)

Mean platelet volume - 11.1fL (N/A)

Percentage hypochromic cells - 0.4% (N/A)

Erythrocyte sedimentation rate - 5mm/h (0-21)

Serum C reactive protein level - 4.0mg/L (0-10)

Serum calcium - 2.41 mmol/L (N/A)

Serum adjusted calcium conc - 2.29mmol/L (2.20-2.60)

Serum inorganic phosphate - 0.89 mmol/L (0.80-1.50)

Serum alkaline phosphatase - 56 u/L (30-130)

Serum albumin - 50g/L (35-50)

I noticed from looking back over past results that previously, when it was within the range, the Mean platelet volume range was 7.5-9.0. However, the last couple of times I've been over that range and suddenly it's saying N/A for the range?

Also, does anyone know anything about eGFRcreat? I notice I'm sitting right at the bottom of the range. From googling it I found something that suggested at my age (32) it's not right that it's that low, but I'm not sure whether this result takes my age into account? (Constant thirst and needing the loo are some of my symptoms, so my kidney health is a concern to me!)

I've booked an appointment to see my doctor again next week, so any suggestion of anything I should raise would be really appreciated!

Thanks

[SlowDragon Administrator]

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 important to test vitamin D, folate, ferritin and B12

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

There's no folate, B12 or ferritin test

Have you had thyroid antibodies tested previously?

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

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 vitamin or Blue Horizon Thyroid plus ten are the most popular choice. These include vitamins but NOT vitamin D (as GP has done that)

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

What vitamin supplements do you currently take?

Come back with new post once you get results and ranges

[Sick-and-Tired in reply to SlowDragon]

Thanks so much. I'll post back once I have these results.