Dad is 76, we already know that his T4/T3 is low. No diagnosis of Thyroid issues. He has Alzheimer’s for the last 10yrs but it is progressing very very slowly and when I quizzed my mum she said there were no lesions as far as she knew and the last scan made the consultant frown because he was expecting to see a marked difference in brain scans from his first ones. I’m rather rocking the boat a little (when he was first diagnosed I was knee deep in life with 4kids under 6 and we don’t live in the same country)
MCH 32.3 pg 27-32)
MCHC 362g/L (315-350)
Platelet count 176 10^9L (150-400)
Total white cell count 3.9 10^9/L (4-10)
Serum sodium 145nmol/L (133-146)
Serum total protein 68g/L (60-80)
I’ve only posted those results that have stood out. He had FBC, Liver function and electrolytes tested.
These are his Medichecks results that prompted us to get a more blood tests.
TSH 2.48 (0.27-4.2)
FT3 4.24 (3.1-6.8)
FT4 13.2 (12-22)
No autoimmunity
Ferritin 29.2 (30-400)
Folate 4.49 (>3.89)
Active B12 69.2 (37.5-188)
Vit D 57.9 (50-175)
He is also on an anti anxiety medication and others for the Alzheimer’s.
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Does the doctor have any idea of what is reducing his white cell count? Can any of the meds he is taking do that?
Hopefully Seasidesusie will respond on vitamins but I've seen it said on this forum that below 70 active vitamin B12 levels should be investigated for vitamin B12 deficiency/anaemia. Folate looks low to me as well, I would want mine higher.
It might be worth joining Sling the Mesh especially if he has had corrective surgery using Mesh recognised connections with this product especially with autoimmune conditions and a plethora of body rejection problems
Yes we are a closed group so you would have to join on behalf of your father , there are many male hernia mesh victims . We have achieved at last recognition by government and there is a major Review at present led by Baroness Cumbernauld into the devastating health effects of using this product One of the concerns we have is the silent elderly group of Mesh injured who are fobbed off by GP ,swho make no connection with the devastating health effects of inserted plastic x
An infection would raise his white blood cell count but it is below range rather than elevated. I don't know much about it but I think it needs an explanation - at least I would want one.
I think it can also be from infection? However I’ve rarely ever known my dad to have an infection. Something I’ve gained from him. I had my first cold in years last weekend. I got it from hubby, cough and temps. Hubbys lasted 2wks. Mine lasted 48hrs 😬
According to labs online UK website it can be due to infection but also low B12, folate, medication etc. If you have a look at the website you'll get good information.
I've seen it said that in older people TSH will be higher so that TSH may not be a surprise. His FT4 is definitely low.
Ferritin 29.2 (30-400)
This should be investigated, low ferritin can suggest iron deficiency anaemia.
It's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.
Symptoms of low ferritin are listed within this article (ignore reference to supplements, I'm linking purely for the symptom list)
He should not self supplement, this needs further investigation by his GP.
MCH 32.3 pg 27-32)
MCHC 362g/L (315-350)
High MCH can be a sign of macrocytic anemia which is when the blood cells are too big, which can be a result of not having enough vitamin B12 or folic acid in the body.
Folate 4.49 (>3.89)
Not folate deficiency but very low, without a proper reference range I'd want my level to be in double figures.
Active B12 69.2 (37.5-188)
Low in range and Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' hospital - see:
List any symptoms he may have to discuss with his GP when asking for further tests for B12 deficiency/pernicious anaemia.
Vit D 57.9 nmol/L (50-175) = 23.16ng/ml
Within the "sufficiency" category but much lower than the level recommended by the Vit D Council/Vit D Society which is 100-150nmol/L. He should be supplementing with an appropriate amount of D3 along with it's important cofactors - magnesium and Vit K2 MK7.
To reach the recommended level from his current level, based on the Vit D Council's suggestions he could supplement with 3,700iu D3 daily (nearest is 4,000)
Doctor's Best softgels give excellent absorption and are a very good supplement at a reasonable price. Tablets and capsules should be avoided as absorption is poor compared to softgels.
When he's reached the recommended level then he'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. He can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking tablets/capsules/softgels, no necessity if using an oral spray
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking tablets/capsules, no necessity if using topical forms of magnesium.
In range but near the top. Does he drink enough? Dehydration can be a cause of high sodium, but bear in mind that this is in range so wouldn't be classed as high.
Thanks SeasideSusie. Yes everything you have said backs up my own thinking. My Dads GP will NOT be following up on any of these results as they have said that the are all in range or only very slightly out and nothing to worry about. So we are on our own here. The only one I’m worried about self medicating is Iron.
My Dads GP will NOT be following up on any of these results as they have said that the are all in range or only very slightly out and nothing to worry about.
I think that is one of the more stupid things that doctors say. My response would be "Why have a range if it's going to be ignored. A range is for a reason, you're either in range or out of range, and if out of range there has to be a reason that needs investigation."
Can he see a different doctor. I think it's essential that his low ferritin is investigated along with his MCHC.
You can read through the NICE Clinical Knowledge Summary for iron deficiency anaemia here:
Work through the different headings and see what you think.
Get him to also check the signs/symptoms of B12 deficiency.
And I should think top of the list is finding another doctor who wont ignore these poor results.
Vit D is easily managed himself, or maybe buy the supplements for him and give instructions when to take them, but remembering that monitoring level is important and adjusting dose when necessary.
It will be difficult to get my parents to see a different Dr. Ofcourse I will encourage them. But predominantly we’re on our own. I’m still trying to understand the Alzheimer’s diagnosis if there are no lesions on his brain.
His low iron levels were investigated at the same time as his diagnosis of Alzheimer’s (all in and around a year of each other when he retired at 65 (now 76) this was because he was always a blood donor but they found his iron levels too low and that’s the last time he gave blood) they went private to try and understand the whys as everything was pointing to internal bleeding. Nothing was found and no other explanation given and no follow up. So 10yrs later this is where I enter the conversation so for me there are too many gaps and not enough follow ups. It’s like they have taken the diagnosis of Alzheimer’s and run with it. I am very very disappointed. My family live in another country, my excuse is that I had 4 children under 6yrs and dealing with my own Hashimotos I left the care and treatment to my mum and sister (my sister is medically trained and fairly high up in the NHS). Although everyone has excuses that are valid.
When I reminded my mum of the investigation over 10yrs ago she then realised that he should have been having regular follow ups.
I’ll try and touch base with my sister as my parents live with them and she goes to all his Alzheimer appointments (although I have to say my sister is one of ‘those’ NHS people and so very dismissive 😩)
Yes those articles are what is leading me to push for more testing and trying to get someone to listen. My mums on board but liaising is trickier because I’m not at home any more.
My father was diagnosed with dementia when he actually had pernicious anaemia - low B12 and folate - by the time the "mistake" was discovered there was too much nerve damage to be correctable, so get that B12 and folate looked at (esp given over range mchc and mch). Ferritin is also awful so he is probably iron-deficiency anaemic as well
I insisted that he was tested for "everything" after he fell through a window and the test was positive for PA and severe B12 deficiency. GP said no mistake was made and he obviously had dementia as well (well, I suspect he did by then). He had a couple of B12 injections but didn't really get any better and then he died (after having to go into a home, which he hated as they wouldn't let him go outside in case he wandered off)
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