Not sure if related to hypothyroidism

[Miffie]

I have been on 100mcg levo for several weeks to keep GP happy. I did tell her I had been breathless with any activity for weeks before I saw her. My husband has been very concerned that there was no improvement and in this symptom and had me contact the surgery on Tuesday morning. I had a call back immediately from a paramedic and he called me into the surgery on Tuesday morning. After examining me he checked with a doctor that a blood test and chest X-ray were in order. The blood was drawn on Wednesday and chest x ray yesterday. Amazing service. The paramedic said that if the blood and chest X-ray were ok I would not hear from them. If I get worse I can all for a phone appointment, however if I have serious heart palpitations call 999. Now I know it won’t come to that, however I’d like to resolve this current situation. ( Interestingly, the examination did not cause him to comment on my heart murmur. I had forgotten to mention it when he asked about past heart health or investigation comments. I have had it for life so do not think much about it. My husband and daughter thought it unlikely it has suddenly resolved. )

The blood tests are back and he has commented on my online record ‘results satisfactory, no further action. Only a couple are below reference range so I guess I am silly to think there is anything to be concerned about. I think I probably need to keep taking vit B supplements. Will really appreciate any comments that I am silly to think there is anything else needed.

* Coded entry - Haematocrit (X76tb) 0.38 [0.36 - 0.44]

* Coded entry - Mean cell volume (42A..) 84.6 fL [77 - 98]

* Coded entry - Mean cell haemoglobin level (XE2pb) 26.5 pg [27.3 - 32.6] - Below low reference limit

* Coded entry - Red blood cell count (426..) 4.47 10^12/L [3.9 - 5]

* Coded entry - Full blood count (424..)

* Coded entry - Haemoglobin concentration (Xa96v) 119 g/L [118 - 148]

* Coded entry - Platelet count - observation (42P..) 280 10^9/L [150 - 400]

* Coded entry - Mean cell haemoglobin concentration (429..) 31.3 g/dL [31.6 - 34.9]; Below low reference limit ; This value has been converted from: 313.0 g/L

* Coded entry - Eosinophil count - observation (42K..) 0.1 10^9/L [0.03 - 0.46]

* Coded entry - Basophil count (42L..) 0.03 10^9/L [0.02 - 0.1]

* Coded entry - Percentage basophil count (XE2mS) 0.32 %

* Coded entry - Monocyte count - observation (42N..) 0.58 10^9/L [0.2 - 0.6]

* Coded entry - Total white blood count (XaIdY) 9.3 10^9/L [3.9 - 11.1]

* Coded entry - Neutrophil count (42J..) 5.81 10^9/L [1.7 - 7.5]

* Coded entry - Lymphocyte count (42M..) 2.76 10^9/L [1 - 3.2]

[Jazzw]

It looks to me that you could be anaemic (iron deficient).

Are those the only tests they did? There’s so much more they could (and should) have tested?

[Miffie in reply to Jazzw]

Thank you, yes that’s all he ordered. I was prescribed a short course of iron after shoulder surgery nearly 18 months ago. However no one has anaemia since I was much younger.

[SeasideSusie Remembering]

Miffie

I am not medically trained but the following jump out at me:

Mean cell haemoglobin level: 26.5 pg [27.3 - 32.6] - Below low reference limit

Can suggest iron deficiency anaemia.

Haemoglobin concentration: 119 g/L [118 - 148]

Low haemoglobin levels suggest anaemia, the most common form being iron deficiency anaemia

Mean cell haemoglobin concentration: 31.3 g/dL [31.6 - 34.9]; Below low reference limit

Low MCHC shows that the red blood cells do not have enough haemoglobin which may indicate anemia

I had been breathless with any activity for weeks

All this could suggest anaemia or iron deficiency anaemia.

If these were my results I'd be doing the following :

1) Asking how two below range results can be considered normal. What are ranges for if they are going to ignore them.

2) Asking for an iron panel, this will show if there is iron deficiency.

[Miffie in reply to SeasideSusie]

I will follow your excellent advice thanks. I have been at odds with the surgery previously when I asked a GP why they ignored NICE guidelines for hypothyroidism. There was no reply to that one, just a mumbling, I get a lot of mumbling from a few of the doctors there. Sadly my on the ball GP retired.I regularly get the feeling that they find me a pest.

Certainly when I held out with wrist pain and refused to accept that there was nothing wrong I held out and finally saw one of the original partners who diagnosed de Quervains and injected immediately.

I do not want to risk antagonising anyone about something and nothing.

[nellie237]

Hi Miffie,

I agree with Jazz and Susie

[radd]

Miffie,

Many members have deficient iron levels as a result of absorption issues caused by low thyroid hormone.

About 85% of iron is found in red blood cells in oxygen-transporting haemoglobin. If you are low in haemoglobin you will be breathless and feel fatigued. You will also be low in iron.

Ask your doctor for the full iron panel he should have conducted in response to your results above. It is no use just having ferritin measured which is a doctors usual choice to measure iron levels. Post results complete with ranges (numbers in brackets) for members to comment.

[Miffie in reply to radd]

Thank you

[Annoynomice]

Did you go straight on 100 from nothing. Normally you go on a starter dose and then build up. It can be quite a shock to suddenly go to that. I started on 50, then after 6 weeks to 75 and then 100. I am now 100 with 25 extra on mon, Wed, Fri.

[Miffie in reply to Annoynomice]

No I moved from a self sourced ndt to 50 then 100. It’s a long story.

[Hidden]

Do you have any problems with fluid retention? I have an under active thyroid and also AF and although both seem to be pretty well controlled I too am incredibly breathless at the moment. Have just been put on an extra diuretic to see if that will help my lungs.

[Miffie in reply to Hidden]

Thank you, I have taken prescription diuretics for forty years or more now. I am lucky enough to have no AF. Good luck with the new diuretic I hope it helps you.

[Hidden in reply to Miffie]

They have just increased me. One Spiranalactone and 3 Bumetanide. Hopefully plenty of kidney checks

[Miffie in reply to Hidden]

I have taken Furosemide, Losartan Potassium and bendroflumethiazide in recent years. Currently on Furosemide and Losartan. I have ckd, trust they will keep an eye on your kidney health.

[Hidden in reply to Miffie]

Had to push for a test after 18 months. Serum urea up xx

[Miffie in reply to Hidden]

Goodness that’s not good. My kidney function is constantly monitored, although not sure what prompted testing to indentify it.I hope they get the urea levels down for you.

Take care

[Hidden in reply to Miffie]

Thank you. Will Chase them a lot more now

[Pinkroses22]

Yes definitely sounds as though you may have iron deficiency anaemia. When I first went to my GP as I was very breathless doing anything, I was diagnosed with hypothyroidism & iron deficiency anaemia. I had an iron infusion & started on 100mcgs levothyroxine. I continued to have having to contact my GP with symptoms & it took 3 times complaining before my ferritin was rechecked as they assumed the iron infusion would have brought it back to normal range, it only went from 6 to 14! Hence the continued symptoms! It’s a shame you have to keep on but I really don’t understand why they don’t look for iron deficiency as you can be anaemic with a normal haemoglobin level. Really hope you get it shorted

[Miffie in reply to Pinkroses22]

Thank you