Help Please: Blood test results for my Ma... speaking to a Dr tomorrow, Wednesday...many thanks for your help.

[Poppy_the_cat]

Hello Folks,

My Ma takes levo.

She was started on it at the beginning of this year, on the minimal dose.

She is also now experiencing serious hair loss which is very upsetting to her, though nobody seems to be too bothered at the new surgery. Our surgery closed down in March. All our Dr's have disappeared or suddenly retired, the phlebotomists have all gone! The new surgery we have been amalgamated with is very alien and none of the dr's are as good. So its not a good time for us at the moment. Friends and neighbours are all telling us a similar story, if not identical, one of disappointment and great anxiety at being essentially left to our own devices.

The blood tests were taken on the 15th. There has been no follow up since, so eventually my mother called and asked for the results to be emailed to us.

She has been supplementing with Biotin, B12, B complex, taking zinc, vitamin D and later then sitting in the garden throughout the summer, building up a golden tan on face, arms and hands.

Last year she had a strange heart episode. The angina spray that she has never needed to use in 10 years, she had to resort to and it it failed three times (it was a new spray, but was having no effect), so we rushed her to hospital. She was kept in over night for observation. Blood tests showed she had not suffered a heart attack, though her oxygen saturation levels were very low. They could not explain why?

I had a hunch but naturally was dismissed outright.

She takes Omeprazole. Due to it lowering stomach acid, thereby affecting iron absorption, I wondered whether she didn't have the sufficient haemoglobin load required to keep her oxygen saturation levels higher, or something along those lines?? My observation was ignored. She was sent home, to be 'observed' in July 2019, but we never heard anything since...

These are her latest blood Results: On a fasting test.

TSH ... 1.99 mLU/L [0.3 - 5.0] 'Consistent with adequate replacement'.

FULL BLOOD COUNT

Full blood count (424..)

Total white blood count (XaldY) ... 6.1 10*9/l [4.0 - 11.0]

Red blood cell count (426..) ... 4.38 10*12/l [3.5 - 5.5]

Haemoglobin concentration (Xa96v) ... 123 g/l [115.0 - 165.0]

Haematocrit (X76tb) .... 0.396 l/l [0.37 - 0.47]

Mean cell volume (42A..) ... 90.4 fl [78.0 - 100.0]

Mean cell haemoglobin level (XE2pb) ... 28.1 pg [27.0 - 32.0]

Mean cell haemoglobin concentration ... 311 g/l [320.0 360.0] comment - below range - below low reference limit.

Red blood cell distribution width (XE2mO) ... 14.3% [11.5 - 15.5]

Platelet count - observation (42P..) .... 279 10*9/l [150.0 - 400.0]

Mean platelet volume (42Z5.) .... 10.0 fl [8.0 - 12.0]

Neutrophil count (42J..) .... 4.2 10*9/L [2.0 - 7.5]

Lymphocyte count (42M..) .... 1.2 10*9/L [1.5 - 4.5] comment below low reference range

Monocyte count - observation (42N..) ..... 0.49 10*9/L [0.2 - 1.0]

Eosinophil count observation (42K..) .... 0.15 10*9/L [0.04 - 0.4]

Basophil count (42L..) .... 0.1 10*9/L [<0.3]

Haemoglobin A1c level - IFCC Standardised (XaPbt)

Result:

46 mmol/mol HbA0, HbA1c 42-47 mmol/mol: High diabetes risk. Provide intensive lifestyle advice & monitor HbA1c at least annually.

IF patient is NOT diabetic, please consider onward referral to National Diabetic prevention programme for lifestyle modification.

HbA1c may give false indication of glycaemia IF rapidly changing or if abnormal red cell turnover.

Serum Creatinine level (XE2q5)

Comment: Above range.

Result:

85 umol/L [45.0 - 84.0] Above high reference limit. No baseline creatinine available in the last 12 months. Unable to exclude A KI or CKD, if concern suggest repeat.

Glomerular filtration rate (XSFyN)

Result 56 ml/min/1.73m*2 Estimated GFR: 30-59. Reduced eGFR. If chronic, indicates stage 3 chronic kidney disease. Caution some exceptoins to the calculations apply: see;- renal.org/eGFR. Afro-Caribbean decent does not apply. NOTE, as of 03/10/16, CKD-EDI equation used to estimate GFR.

Liver Function tests (X77WP) specimen serum

Serum bilirubin level (44E..) ... 8 umol/L [<22.0]

Serum alkaline phosphatase level (XE2px) .... 54 IU/L [30.0 - 130.0]

Serum total protein level (XE2e9) ... 65 g/L [60.0 - 80.0]

Serum albumen level (XE2eA) .... 40 g/L [35.0 - 50.0]

Serum alanine aminotransferase level (XaLJx) ... 10 IU/L [10.0 - 40.0]

Serum globulin level (XE2eB) ... 25 g/L [18.0 - 34.0]

Serum Urea level (XM0lt) Specimen: SERUM

Result: 4.9 mmol/L [2.5 - 7.8]

Total VITAMIN D (serum)

Specimen: Serum

NORMALITY - Below range

RESULT - 50 nmol/L [>50.0] Below low reference limit, please note, this total 25-OH Vitamin D result has been produced using an immunoassay method.

)

Interpretation of total 25-OH Vitamin D result:

<30 nmol/L Severe vitamin D deficiency. Vitamin D replacement is required.

30-50 nmol/L Vitamin D insufficiency. Advise on safe sun exposure & diet & supplementation.

>50 nmol/L adequate Vitamin D.

Serum Vitamin B12 level (XE2pf)

Specimen: serum .... 309 ng/l [200.0 - 960.0]

Serum Ferritin level (XE24r) .... 20 ng/ml [20.0 - 350.0]

Serum folate level (42U5) .... 3.4 ng/ml [3.0 - 18.0]

Since supplementing with biotin, B12, B complex & zinc because she had 'hour glass' thumb and finger nails, curling right over...so I thought we should take action, (I found an excellent article detailing the effects of these fellows when depleted, especially with regard to Thyroid function)... her finger nails and thumb nails have all straightened out, grow ell and are a lot thicker and nowhere near as brittle.

But the hair loss is very distressing. The onset of a mature age comes to us all, but neglecting the elderly and ignoring their distress over hair loss is no excuse.

The new Dr agreed that T3 needed to be tested for too....but it looks like the lab yet again have taken it upon themselves not to test, as I see nothing to indicate T3 was tested.

Although the test results indicate than an increase beyond 25mcg of thyroxine is not necessary, based upon their findings.... surely her hair loss should be considered as a symptom of possibly an under medicated thyroid?

My Ma has her own questions too:

1/ Are the tests indicating she is anaemic?

2/ A below range of Lymphocytes? What does this mean?

3/ Diabetes???? This is the first we've heard of this and naturally she is very concerned. They didn't test her cholesterol, should they not have?

4/ Creatinine issues? Kidney disease?

5/ Vitamin D levels low?...after a whole summer in the sun

She has all these questions, and had we not called, we would have been non the wiser. She is being called by 'a doctor' tomorrow Wednesday, so please any thoughts would be greatly appreciated.

Thank-you in advance.

Poppy the cat

[Serendipitious]

Hello and welcome back Poppy! Haven’t seen you for a while. One of the first things that stood out is your mother’s Ferritin. It’s far too low for hair growth and thyroid function. It should really be much higher. I’m also struggling with hair loss too.

According to Dr Izabella Wentz, optimal ferritin level for thyroid function is between 90-110 ng/ml.

Oh and taking PPIs will not help. I’m in a similar situation regarding my Ferritin levels but I have other reasons for it not rising. Eating liver on a regular basis does help.

More guidance is here:

thyroidpharmacist.com/artic...

By the way I messaged you about water Kefir a few weeks ago. Not sure if you’ve seen my message?

[Jazzw]

I think she needs a full iron panel—would agree with Serendipitious on ferritin looking very low. And low iron is very often behind hair loss.

As for prediabetes (cos that’s the range she’s fallen into), I think that, just as with statins, Big Pharma have identified a problem to fix which might not need fixing. Not everyone who falls into that range goes on to develop full blown diabetes. sciencemag.org/news/2019/03...

So it’s a warning of potential trouble to come, rather than “Eek you have diabetes”.

How old is she Poppy? I suspect most of us as we get older are going to fall into this marvellous prediabetic range.

[humanbean]

Regarding Biotin... it is a good idea to stop taking biotin for several days before doing any testing at all, of anything. It might cause no problems or it might interfere with test results. Unfortunately finding out whether biotin affects the testing machinery at the place the tests were done is very difficult to find out. For a couple of links on the subject :

healthunlocked.com/thyroidu......

healthunlocked.com/thyroidu...

Serum Vitamin B12 level (XE2pf) .... 309 ng/l [200.0 - 960.0]

Serum folate level (42U5) .... 3.4 ng/ml [3.0 - 18.0]

Your mother is supplementing vitamin B12 and a B Complex but her B12 is low in range and the folate is terrible, suggesting that she isn't absorbing her supplements very well and/or her supplement dosage is too low and/or she is taking supplements which are not of the right type e.g. many B12 supplements contain cyanocabalamin when for many people the best one for them is methylcobalamin. The best form of folate (most easily absorbed) is methylfolate. Can you tell us what B Complex she's taking and what B12 she is taking, and at what dosage?

The cause of her poor absorption is likely to be the PPI (Omeprazole), but it can't be stopped willy-nilly. How long has she been on this, and why was it prescribed? Does she take any drugs which require her stomach acid to be kept low? For example NSAIDs will damage the stomach if stomach acid is not kept low.

What other prescribed drugs is your mother on, apart from the Omeprazole?

Going back to the B12 and the folate...

Your mother will feel better if she gets her B12 up to the upper half of the reference range, and even better if she gets it up to top of range or even as high as 1000.

For folate she will feel better is she gets it up to the upper half of the reference range. For help on supplementing folate, see this link :

chriskresser.com/folate-vs-...

...

Serum Ferritin level (XE24r) .... 20 ng/ml [20.0 - 350.0]

This is a terrible result and probably explains your mother's hair loss. Most of us feel best with a ferritin (iron stores) result that is roughly mid-range i.e. 185 with the range you've given. Some people need it a bit higher. BUT there is more to supplementing iron than just looking at ferritin. You need to know what your iron level is too. This is discussed here :

healthunlocked.com/thyroidu...

Sadly, hair loss can take quite a long time to recover from. All the hair roots that have been weakened by low iron will continue to shed. But improving the iron/ferritin level will mean that new hair growth will be much healthier.

...

Vitamin D - 50 nmol/L [>50.0]

Optimal vitamin D level when measured in nmol/L is 100 - 150nmol/L or 125nmol/L depending on source of the info.

You can calculate the required dose using this link :

grassrootshealth.net/projec...

Note that there are co-factors that are required with vitamin D supplementation. Taking vitamin D would normally increase the absorption of calcium from the diet. That calcium is needed in the bones and teeth, you don't want it to line the arteries. To make this happen you need vitamin K2 and magnesium. SeasideSusie has written many replies to people on this subject. You can read her replies here :

healthunlocked.com/user/sea...

[humanbean]

Your mother's HbA1c level shows that she is pre-diabetic, and is very close to becoming overtly diabetic. I'm assuming that she is developing Type 2 diabetes which is very, very common as people get older, but be aware I have no medical training, and that other types of diabetes exist.

Diabetes can't be cured but it can be put into remission with a change of diet, usually to a low carb, high fat diet or a ketogenic diet. This change of diet may improve various other problems your mother has, such as deteriorating kidney function.

For info on putting type 2 diabetes into remission these websites are really excellent :

diabetes.co.uk/

diabetes.co.uk/forum/

dietdoctor.com/

dietdoctor.com/diabetes

And if you want research articles these links can be helpful :

lowcarbusa.org/papers/

lowcarbusa.org/articles/

[shaws Administrator]

Could your mother's "hair loss" be due to another autoimmune condition, called Alpecia?

It is not unusual for us to develop other autoimmune conditions if we already have one, unfortunately.

I think your mother should ask to be referred to a dermatolgist for a determination if she's got alopecia or hair fall.

The following is from a site called 'Stop the Thyroid Madness'

The following is re omaprozole.

Acid reflux (GERD), heartburn, and indigestion–high levels of stomach acid? Nope.

Turns out that it’s our low levels of stomach acid which cause the Big 3: acid reflux (where our undigested stomach contents press up into our esophagus via a now-relaxed esophagus value and we feel the small amount of acid), heartburn (the burning sensation in our esophagus) and indigestion (impaired digestion due to poor breakdown of bad bacteria).

And sadly, our doctors have been putting us on Proton-pump inhibitors (PPIs) like Omeprazole (Prilosec) or Lansoprazole (Prevacid) or Esomepraxole (Nexium) and more, all acid suppressors…and as if our symptoms come from excess acid! Or we head to our local pharmacy or grocery store and load up on antacids like Rolaids, Tums or others. So though they can mask symptoms, we are now made even worse.

stopthethyroidmadness.com/s...