Blood tests = Can of Worms. Anaemia or Hyperthyroidism? B12 & Serum Folate too low or OK? Other results all over the place! Any ideas?

[ChronicTonic]

Hi All,

I have no idea what any of this means, but even I know some of it looks skewiffy! A couple of the results were flagged by the test itself; these are RDW and MCHC which may relate to thyroid function. Also the Serum Folate and B12 look a bit low so may be affecting my thyroid too.

Are you able to help explain the results?

I feel awful all the time but I'm used to it: I've had ME for 30 years and Fibromyalgia, was paralysed with Guillain-Barré 4 years ago (still weak legs and hand grip), and have had Long COVID since March 2020. I was born with one kidney.

As I've said before "I'm hypothyroid (self-prescribe additional T3 with help of this forum) and have been taking thyroid meds for around 25 years. Currently I take I take 125mcg T4 and 18.75mcg T3 in the morning, and 18.75mcg T3 in the evening." I don't feel overmedicated - and I know how that feels!

I had this lovely comprehensive set of NHS blood tests back on May 25th, but I haven't been contacted by any doctors since - and it's now mid July. Hence needing your input, as some results clearly aren't normal, even to the untrained eye!

In the absence of medical interest/ input, I need help pulling these results together to give me an overall picture of my health, potentially to start a conversation with my GP if you guys think it would be appropriate.

Thank you in advance for your time. I really do appreciate all comments.

And I do hope you're sitting comfortably...!

Each result will have the following layout:

Test: My result (Ranges Given & Measurement)

---

AST: 30 (5 – 40 u/L)

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Bone Profile:

Total Protein: 73 (60 – 80 g/L)

Albumin: 42 (35-50 g/L)

ALP: 60 (20 -150 u/L) Low-ish?

Calcium: 2.36 mmol/L

Adjusted Calcium: 2.32 (2.2 – 2.6mmol/L)

Globulin: 31 (20 – 35g/L )

Phosphate: 0.99 (0.8-1.5mmol/L) Low-ish?

---

C-Reactive Protein: 1 (0 - 5mg/L) Low-ish?

---

Electrolytes & Creatinine

Sodium: 137 (133-146 mmol/L)

Potassium : 4.7 (3.5 - 5.3mmol/L)

Creatinine: 83 (50-98umol/L)

---

EPI eGFR Result/ 1.73m2: 74 (60 - 120 mL/Min) Low-ish? I only have one kidney so it'd be useful to know!

Dr Google(!) indicates:

Stage 2 (G2) – A slightly reduced eGFR of 60 to 89ml/min (my result is 74) = Mildly reduced renal function/ Kidney damage with mild decrease and other signs of kidney damage. Control of blood pressure and cardiovascular risk factors.

Aged 40–49 (my age range), the average GFR is 99

---

Full Blood Count

Haemoglobin: 131 (120 – 150 g/L)

White Cell Count: 6.4 (4 – 10 10*9/L) Low-ish?

Platelets: 247 (150 – 410 10*9/L)

RBC: 4.4 (3.8 – 4.8 10*12/L)

HCT: 0.37 (0.36 – 0.46 L/L) - V low??

MCV: 85 (83 – 101fl) – V low?

MCH: 29.9 (27 – 32pg)

MCHC: 352 (315 – 345g/L) – Def high (flagged by test itself)

RDW 11.5 (11.6 – 14 %CV) – def low (flagged by test itself)

Neutrophils: 3.7 (2 – 710*/L)

Lymphocytes: 2.1 (1 – 3 10*9/L)

Monocytes: 0.4 (0.2 – 1 10*9L)

Eosinophils: 0.2 (0.02 – 0.5 10*9L)

Basophils: 0 (0 – 0.1 10*9L) – V low? Allergies – related to Mast cells, allergic reactions or infections

Absolute NRBC: 0 (0 – 0.09 10*9L) – V low?

---

Liver Function

Total Bilirubin: 7 (2 – 21mol/L) – Low-ish?

ALT: 39 (5 – 40 u/L) - High?

----

Haemoglobin A1C Diagnostic (IFCC): 32.2 (20-41mmol/mol)

HbA1c% (DCCT): 5.1 % (no range given)

---

Serum Folate: 9 (3 – 20g/L) – Low-ish?

Vitamin B12: 326 (180 – 640Ng/L)

If you've read this far, thank you from the bottom of my heart ❤️

[SlowDragon Ambassador]

Currently I take I take 125mcg T4 and 18.75mcg T3 in the morning, and 18.75mcg T3 in the evening.

What vitamin supplements are you currently taking

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Do you always get same brand levothyroxine at each prescription

Ideally day before test you would split dose in 3 and take 1/2 tablet (12.5mcg) waking, mid afternoon and last dose around 9pm ….assuming 9am test

No thyroid results?

Folate and B12 low

No vitamin D result - calcium is low, so vitamin D probably low

No ferritin

Suggest you get FULL thyroid and vitamin testing done

Are you on absolutely strictly gluten free diet?

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Also EXTREMELY important to test vitamin D, folate, ferritin and B12 at least annually

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options

thyroiduk.org/getting-a-dia...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

Thriva Thyroid plus antibodies and vitamins By DIY fingerpick test

thriva.co/tests/thyroid-test

Thriva also offer just vitamin testing

If TPO or TG thyroid antibodies are high this is usually due to Hashimoto’s (commonly known in UK as autoimmune thyroid disease).

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s. Low vitamin levels are particularly common with Hashimoto’s. Gluten intolerance is often a hidden issue to.

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[ChronicTonic in reply to SlowDragon]

Thank you SlowDragon for your input.

1) What vitamin supplements are you currently taking

A multivitamin. But I took none in the week leading up to the blood test.

I accept I’ve got out of the habit of taking the sublingual separate B vits (methylcobalamin), D3+K2, ferritin, etc. I have all the appropriate kinds of each - I’ve done my research. I take all in liquid form. When I remember 😬

2) Yes always go for earliest appointment and follow protocol of this forum in preparing and going for blood tests.

3) I have been strictly gluten-free for over 25 years now.

4) This wasn’t for my thyroid (for once!) it was for everything else that’s bl00dy wrong with me 😆 But some of the results tie into thyroid function, hence me posting them here.

5) I do tend to have the same Levothyroxine brand and still have a block on Teva from all those years back (when Teva Levo really didn’t work)!

6) Thank you for taking time to write the lovely long reply above. Being a big fan of this forum I am (mostly!) familiar with the content, I just wasn’t sure how my blood tests applied to it!

And you’re absolutely right - I need updated thyroid tests and for vitamin/ mineral levels too, to go with the above. Thank you for the speedy Medichecks etc links 😃

No GP nor endocrinologist has ever mentioned Hashis to me, they’ve just consistently told me my TSH is too high, I shouldn’t be self-medicating with T3, and that my results say I’m hyperthyroid - when I don’t feel it (and like I said, I know what that feels like from starting out on T3 experimentation some years back!)

And thank you so much again for your time, as always. I really do appreciate it 😊

[ChronicTonic in reply to ChronicTonic]

And in the meantime, I’m still unsure as to how to approach the recent test results above with my GP, as I don’t really know what any of it means. So seeing as these results have been ignored/ dismissed since May, it seems the doctors are rather backwards in coming forwards to discuss them!

Surely there is some kind of medic who is able and available to look at all this as a whole, holistically, and tell me what the actual - is going on. And I’m guessing that person isn’t a GP as they’re jack of all trades rather than specialists? Argh!

I’d still be totally and utterly lost (rather than my current confusion!) without the collective expertise of the admins on here. Thank you so much again SlowDragon for listening 😃

[SlowDragon Ambassador in reply to ChronicTonic]

Low GFR would usually suggest low Ft3…..wether same applies with only one kidney…..no idea

[ChronicTonic in reply to SlowDragon]

Ooh, that’s interesting. I hadn’t picked up on a link there. It necessitates extra research, so I’ll look into it. Thank you.

[SlowDragon Ambassador in reply to ChronicTonic]

Eg

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

researchgate.net/publicatio...

[ChronicTonic in reply to SlowDragon]

Wow! Thank you Speedy Gonzalez - this is *great*! Most appreciated 😊

[SlowDragon Ambassador in reply to ChronicTonic]

No GP nor endocrinologist has ever mentioned Hashis to me, they’ve just consistently told me my TSH is too high, I shouldn’t be self-medicating with T3, and that my results say I’m hyperthyroid - when I don’t feel it

I suspect you mean “TSH too low”

On almost any dose of T3 TSH is almost always suppressed…it’s irrelevant

Most important results are ALWAYS Ft3 followed by Ft4…..plus how you feel

Being gluten intolerant is EXTREMELY Common with autoimmune thyroid disease (hashimoto’s or Ord’s thyroiditis)

Most people when gluten intolerant and autoimmune thyroid disease as well will need T3 prescribed alongside levothyroxine

Poor gut function results in poor conversion of Ft4 to ft3

[ChronicTonic in reply to SlowDragon]

Absolutely. Couldn’t agree more with the above (and thanks for putting me straight on the low TSH)!

And I still can’t get over the information contained in the first link you posted for me above, regarding ‘Interactions between thyroid disorders and kidney disease’. It’s like reading my own health history in a nutshell. So many aspects of it pertain to me personally, that I’m still digesting it all! Mind-blowing.

It’s kind of sad, too. I’m 45 now - if only I’d met someone who knew what they were doing 30+ years ago! Instead, I’ve had the same thyroid brush-off as everyone else on this forum, and every time I’ve had a kidney issue over the years - every single one mentioned in the Indian paper above (like I said, mindblowing to read now!) - medics have said the test results are dodgy, but not bad enough to do anything about.

Question is, who to approach now with what I’ve learned?

The Endocrinologist doesn’t approve of the T3 path I’ve taken, my GP won’t even treat my perimenopause properly let alone the thyroid, and my access to renal care is now non-existent. Hmm…

This is all the more important because my eldest (aged 14) has inherited some of my health issues, and I very much don’t want her to go through what I have over the years.

[humanbean]

C-Reactive Protein: 1 (0 - 5mg/L) Low-ish?

C-Reactive Protein (CRP) is a non-specific measure of inflammation, so the lower your result the better. Optimal is < 1, but I can't remember where I first read that. Your low-in-range result is very good.

[ChronicTonic in reply to humanbean]

Hurrah! Something positive I won’t have to battle the docs about. Thank you 😃

[Polaris]

Your high MCHC and low RDC could very well indicate B12 deficiency, which would also account for ME, weak legs, fatigue, etc.

Tracey Witty's excellent website below explains more about the many varied symptoms, etc. e.g. vegetarian diet or with very litttle red meat, could cause deficiency over time (this happened to my sister, who was misdiagnosed ME for years with the above symptoms......

Below is latest BMJ research document summary (full document behind a paywall), from which you'll see that there is no reliable test and symptoms are the most accurate way to diagnose.

bmj.com/content/349/bmj.g5226

b12deficiency.info/signs-an...

Dutch link below also explains more about testing, and the importance of early and adequate treatment:

stichtingb12tekort.nl/engli...

Many GPs do not understand th complexity of B12/PA symptoms so many of us self inject to avoid neurological damage.

Good luck with finding answers, Abi-Abster 🤞

[ChronicTonic in reply to Polaris]

Hi Polaris Just realised I never replied to thank you for your input. Apologies!

I chose to be vegetarian when I was a teenager, which I think increased my susceptibility to ME for exactly the reasons you mention above!

So I’ve been eating meat and fish and eggs again for the past 25+ years, and haven’t eaten gluten for this time either; my diet’s pretty good!

But I suspect I still have issues absorbing vitamins and minerals, which is why I use sublingual liquid supplements in their most bioavailable form (or whatever it’s called!).

Thank you for the links. Being B12 deficient was definitely me at one point in my life, and it’s always worth a reminder!