Any experts on strange blood tests?

[Chancery]

I'll say right off the bat this isn't a thyroid issue, but I didn't know where else to post this and felt that the thyroid community & pernicious anaemia forums have the most expertise with blood tests, since their lives seem to be ruled by them!

I have had high Ferritin for over a year. Recently I had it retested at a new doctors and it is just going up and up. It is not hemochromatosis as my transferrin, saturation and iron are all normal range. This means it's probably an inflammation problem, a chronic one, given how long I've had it.

On my last blood test, my doctor was looking for possible autoimmune markers (at my request) and as well as the even higher ferritin it brought up high LDH- architect (Lactate dehydrogenase). This is in all tissues but is only released into the blood when tissue is damaged. In other words, I am experiencing cell death.

I've tried Googling the two things together and get zero result. Plenty of ideas for one and plenty for the other, but not for the two together. Has anybody any ideas for why these might be occurring together, or any experience of having these two things together?

Out of the choices for high LDH, it seems unlikely to be my liver, kidneys or a heart condition. The two most likely is muscle damage (I suspected Dermatomyositis, hence me asking her to check) and cancer. Obviously the idea of cancer worries me!

If anyone has any suggestions or ideas I'd be grateful to hear them. Thanks!

[humanbean]

One thing that might be helpful in identifying the source of a problem is a blood test for LDH which separates out the various kinds of LDH there are in the body. I don't know what such a test is called nor whether the NHS would offer such a test.

My emphasis :

LDH is an enzyme that makes it possible for the body to turn sugar into energy. LDH can be found in many tissues and organs, including the kidneys, pancreas, heart, liver, brain, blood cells and skeletal muscles, notes Healthline. There are five different types of LDH enzymes, and elevation of a particular enzyme or multiple enzymes can help make a diagnosis of certain disorders. For instance, when LDH-1 is higher than LDH-2, a heart attack may have occurred; when all LDH enzymes are elevated, it can be an indicator of failure of multiple organs, while elevation of LDH-4 an LDH-5 suggests liver damage, notes Healthline. Ongoing treatment for various conditions can be tracked through regular monitoring of LDH levels.

Source : reference.com/world-view/ca...

...

And this paper discusses high ferritin and high LDH in a condition called hemolytic anemia :

ncbi.nlm.nih.gov/pmc/articl...

Title : Clinical Applications of Hemolytic Markers in the Differential Diagnosis and Management of Hemolytic Anemia

My first impression of hemolytic anemia is that the problem is caused by the destruction of red blood cells.

Something else connected with the destruction of red blood cells besides hemolytic anemia is vitamin B12 deficiency.

Having found that last sentence I promptly lost the source, so take it with a pinch of salt.

For a good source of research papers that mention both ferritin and LDH try Google Scholar and Pubmed :

scholar.google.co.uk/schola...

pubmed.ncbi.nlm.nih.gov/?te...

[Chancery in reply to humanbean]

Thanks for those links, Humanbean. It's not a B12 deficiency because I have regular injections. I did see haemolytic anaemia listed and I remember once having a blood test some years ago where haemolytic anaemia might have been raised (I believe I had irregular shaped red blood cells) but I think it went with some condition/drug or another at the time. I'll need to have a look through my records and see. I've already tried PubMed but I'll have a go on Google Scholar - thanks for that.

P.S. Yes, I'd also seen that the enzymes can be tested for separately. Unless the doc has some rivetingly plausible theory she wants to follow ,I'm going to ask if they can be done to narrow the field.

[SlowDragon Administrator]

Reading your very helpful profile

So you get regular B12 injections....how regular?

Do you also supplement a daily good quality vitamin B complex? one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

B vitamins best taken in the morning after breakfast

Igennus Super B complex are nice small tablets.

Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

How much vitamin D do you need to supplement to maintain optimal vitamin levels?

What are most recent Thyroid and vitamin results and ranges?

[SlowDragon Administrator]

Your long term ppi may be causing problems

healthunlocked.com/thyroidu...

Ppi results in very low B12 - so your B12 injections may need to be more frequent

When hypothyroid it doesn't matter how good your diet is, you absorb very little nutrients

You can't utilise vitamin D if magnesium is low

sciencedaily.com/releases/2...

High ferritin likely linked to being hypothyroid. Are you on Levothyroxine yet?

[SlowDragon Administrator]

High LDH can be result of being hypothyroid.....which your results clearly show you are

jamanetwork.com/journals/ja...

oaji.net/articles/2017/1771...

[Chancery in reply to SlowDragon]

Hi SlowDragon, I am currently spacing my B12 injections out to have them less frequently. I think I'm at about 8 weeks apart at the moment. I used to have them every 4 weeks, but don't believe they are necessary that frequently any longer. I supplement with Vit D & magnesium, so no issues there either.

My PPI consumption is a problem, but I have oesophagitis and I just can't get off them. My thyroid is a bit more iffy. Yes, I do get slightly elevated results, but equally well they often drop right down to normal again. In the middle of this perfect storm of high ferritin and LDH, they dropped down to 2.6, I think it was. Perfectly normal. Even if it is slightly underactive I don't think it's severe enough for Levo to be helpful.

I'll see what theories the doc has on Monday...

[SlowDragon Administrator in reply to Chancery]

Do you make sure to get all thyroid blood tests done as early as possible in morning and before eating or drinking anything other than water?

This gives highest TSH

Any TSH over 2 suggests hypothyroid

Median TSH graph

healthunlocked.com/thyroidu...

[Chancery in reply to SlowDragon]

Ironically, on the day I got the lowest TSH result (it was 2.3) I had been fasting, as in no breakfast. The one taken two months before that was at 6 - the highest I've ever seen it. I'll be honest, I can't make head nor tail of my thyroid results, with a drastic drop like that in two months, and also, doctors - and female doctors at that - seem to have zero concern over my elevated thyroid results. I suppose being 63 and female means these are 'normal' to them. They certainly never suggest treating it and I don't have the heart to fight them for treatment, especially as I'm not even sure it's either a problem or THE problem. I don't think hypothyroidism causes rashes, does it? Although it may cause muscle pain and breathlessness?

P.S. Thanks for the graph, very interesting, if depressing. It certainly puts me in the dysfunctional range, but if that's so then why don't doctors give a damn?

[SlowDragon Administrator in reply to Chancery]

Doctors don't diagnose anymore...they follow guidelines

Guidelines say

You can't be hypothyroid if TSH under 10 and no thyroid antibodies

You can't be hypothyroid if TSH within range and with thyroid antibodies

They completely ignore the interconnection of gut issues and low vitamins

Or central hypothyroidism

It's why there's over 104,000 members on here

[Chancery in reply to SlowDragon]

Yeah, I know we are really lucky to have the NHS (or so they keep telling us) but sometimes I feel all that gratitude we are supposed to feel is like the gratitude the poor are supposed to have when someone throws them a copper or two - i.e. be grateful you've got something rather than nothing. I'm not exaggerating when I say I have never - never ever - gone into a doctor's and had them show an interest or concern in anything I am telling them. They want to drug you and dispense you. So if you have a complex problem, or a clusterf*ck of symptoms that 'could be anything' they do NOT want to know. I still haven't worked out a way of dealing with that. Taking one problem at a time ignores the big picture and never really resolves anything, but it gets you out the door, stumbling on, and they are happy with that.

Bitter, moi?

[Chancery]

Thanks, Lora. I'll check and see if CRP has been done. If not, I'll request it