Discussing Doctors Blood Test

[sunnyday7]

hello all

I’ve been on previously, last year, with my daughters blood test results from medicheks.

Our Gp has just taken these bloods and here are the results. Could you please have a look and advise as she has a telephone call to discuss them.

Just a little reminder background information, she was diagnosed with ME at 15, she’s now 23.

She has many symptoms that cross over into hypothyroidism. We have lots of underactive thyroid in my family and I need to know if the doctors may be missing something, and just diagnosing with ME.

It was also suggested on here previously about pernicious anaemia, I’ve noticed her B12 levels to date, August 2022 are 165 and in December 2021 measured 212, (normal range, 180-2000.)

Here as follows are her results.

Thank you everyone, we so appreciate your knowledge and time.

31.8.22 test done at 8:30am no B vits for 7 days previous.

Serum c reactive protein

12mg. Normal range 0-5

Red blood cell count

4.55 ( 10.12/L) Normal range 3.8-5.5

Haemaglobin estimate

138gl Normal range 120-150

Haematocrit

0.418. Normal range 0.37-0.47

Mean corpuscular vol

92fl Normal range 80-100

Red blood cell distribution

12.4/. Normal range 0-16

Mean corpusc haemoglobin mch

30.4 pg. Normal range 27-32

Mean corpusc he. conc MCHC

331g/l. Normal range 280-350

Platelet count

269. Normal range 150-450

Total white cell count

10.1. Normal range 4-10

Neutrophil count

3.6. Normal range 1.8-7.5

Lymphocyte count

2.7. Normal range 1-4

Monocyte count

0.6. Normal range 0.2-1

Urea and electrolytes

Serum sodium

141. Normal range 133-146

Serum potassium

4.1. Normal range 3.5-5.3

Serum creatinine

66 Normal range 45-84

Serum urea

2.8. Normal range 2.5-7.8

CKDEPI

>90. Normal range 60-150

Serum vit B12

165 Normal range 180-2000

Serum folate

13.1. Normal range 3.1-18.3

Serum ferritin

109. Normal range 13-150

Thank you again

serum free T4

15.1 Normal range 11-24

Serum TSH

4.78 Normal range 0.35-4.5

1/12/21 TSH was 3.52

[SlowDragon Administrator]

Serum vit B12

165 Normal range 180-2000

She urgently needs testing for Pernicious Anaemia before starting on B12 injections

Is she vegetarian or vegan?

Low B12 symptoms

b12deficiency.info/signs-an...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

TSH is far too high

No Ft4 test

No Ft3 test

No thyroid antibodies

No vitamin D test

STRONGLY recommend getting full thyroid and vitamin testing done yourself privately

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

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

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

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

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

List of private testing options and money off codes

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

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

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

Only do private testing early Monday or Tuesday morning. Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/wp-content/up...

[sunnyday7 in reply to SlowDragon]

Thank you so much. Lots of research to do!

[SeasideSusie Remembering]

sunnnyday7

C Reactive Protein is over range and suggesting inflammation somewhere. It's a non- specific inflammation marker so can't tell us where the inflammation is.

Full Blood Count all looks good, no anaemia suggested.

Us & Es all in range.

Serum vit B12- 165 Normal range 180-2000

This is a concern being below range, it was very low in range previously.

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Do she have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If she does then list them to discuss with her GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.

With such a low result I'd be surprised if she doesn't have any signs/symptoms and need B12 injections.

You could pop over to the Pernicious Anaemia forum here on Health Unlocked for further comments, listing all signs/symptoms she has as well as her test results (plus reference ranges) for B12 and folate:

healthunlocked.com/pasoc

Folate result looks good.

Serum ferritin -109. Normal range 13-150

Ferritin is raised when inflammation is present. Because her CRP is raised and showing inflammation then this ferritin result is likely to be unreliable, her true ferritin result is more than likely less than what has been measured - how much lower I can't say but here is a list of symptoms of low ferritin:

◾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

It would help if her GP does a full iron panel to include:

Serum iron

Total Iron Binding Capacity

Transferrin Saturation Percentage

Ferritin

[sunnyday7 in reply to SeasideSusie]

Thank you so much, lots of research to do!

[Gingernut44]

SlowDragon for info only sunyday7 Your daughters FT4 is only 31.54% through the range and her TSH is above range. She should be asking for more investigation into low B12.

[sunnyday7 in reply to Gingernut44]

Thank you for your reply

[SlowDragon Administrator in reply to sunnyday7]

once she gets B12 deficiency addressed by starting on B12 injections, very common for TSH to increase further and get diagnosed as hypothyroid and then start on levothyroxine

Low vitamins can mask how hypothyroid patient may be

she will initially need several injections over 2-3 weeks…(known as loading injections) ….

then it’s once every 2-3 months

They usually offer 3 monthly, but if that’s too long can request more frequent

[sunnyday7 in reply to SlowDragon]

thank you so much for your advice