12 Year olds blood test results

[Refat]

Hi all my daughters bloods are now back

tsh 0.25 ref range 0.2 to 4.5

T4 19 ref range 11 to 22.6

Vitamin d 116

Ferritin 29 ref range starts 10 to 322

Last b12 in jan 2020 was 572 havent given any vitamin B's for almost a year.

Surgery has said no further action required. Plz advise.

[SeasideSusie Remembering]

Refat

Ferritin 29 ref range starts 10 to 322

Surgery has said no further action required.

I don't know if this applies to children but I expect it should do:

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

I would point this out to your doctor and say that your daughter's ferritin level comes into the iron deficiency category, will he please do an iron panel to confirm this and a full blood count to see if there is anaemia. You can have iron deficiency with or without anaemia.

Be aware that iron tests should be done after a 12 hour fast (water allowed) so early morning is probably the best time.

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Symptoms of iron deficiency:

◾Persistent fatigue

◾Pale skin

◾Shortness of breath

◾Headaches

◾Dizziness

◾Heart palpitations

◾Dry skin

◾Brittle hair and hair loss

◾Swelling or soreness of the tongue or mouth

◾Restless legs

◾Brittle or ridged nails

[Refat in reply to SeasideSusie]

Thank you for your reply, a full blood count was done and receptionist stated all was again normal. I will aim to get print out, therefore dont think she has anaemia as yet but may get there if ferritin levels reduce further. I will supplement her with iron as I have done before for a short period as it have her a noticable boost. Then try and maintain it by eating well.

[helvella Administrator Thyroid UK in reply to Refat]

The receptionist is absolutely NOT qualified to utter the word "normal". (At most, they could have said "within the standard reference intervals".)

And does the receptionist appreciate that reference intervals might be different for 12-year-olds? Or require more thoughtful interpretation?

Does the doctor know you have supplemented with iron? That might shed a different light on the iron-deficiency/anaemia questions. Repeatedly lowering of iron is something that is a concern in itself. Even if it is not, it needs careful dosing to ensure that iron levels are maintained, long-term, without significant cycling between deficiency and repletion.

You just might find the article below (and the full paper which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...

[SeasideSusie Remembering in reply to Refat]

I echo what helvella has said about the doctor knowing that you have given your daughter iron. Iron deficiency is not something we should supplement ourselves, iron is complicated, leave it to the doctors but be insistent that NICE says a level below 30ug/L confirms iron deficiency. When taking iron tablets it's important to monitor levels regularly, your GP should be doing this and keeping an eye on your daughter's levels, aiming to bring them up to a decent level especially as she is now menstruating.