test results (part 1), any help would be appreciated.

[ecie]

OK, here we go; part 1 of several for test results. These are the ones done on th NHS. They said they would test my free t3, thryoid antibodies, B12 and iron. They did not do these.

I am completely unable to tolerate stress well. I've turned into a nervous wreck these lasdt few years and I've been even worse since I changed my medication to bed time and added all those vits. Seeing these tests has completely done a number on me and I know I'm overreacting but I'm terrified, panicked, and just want to burst into tears. This is stupid. I'm an adult and I can't behave like one. Sorry for this...

-Plasma fasting glucose level: 4.1mmol/L (3.0-6.0)

-Bone profile: 54 iu/L (35.0-105.0)

-Serum alkaline phosphatase level: 2.39 mmol/L (2.2-2.6)

-Serum calcium level: 2.30 mmol/L (2.2-2.6)

-SERUM INORGANIC PHOSPHATE LEVEL: 1.4 (0.8 to 1.4) OUTSIDE REFERENCE RANGE: hyperphosphatemia indicative of thyroid problems, hypoparathyroidism, and others

-Serum total protein level: 70 g/L (60.0-80.0)

-Serum albinum level: 49 g/L (35.0-50.0) INDICATIVE OF ADRENAL PROBLEM

-Serum globulin level: (20.0-37.0)

-Serum free T4 level: 14.9 pmol/L (12.0 – 22.0)

-Serum TSH level: 0.98 mu/L (0.4-4.0)

There are many other tests but for now I will include the ones that are above or below range:

-Red blood cell distribution width: 17.3% (10.0-15.0) =ABOVE RANGE. INDICATIVE OF HORMONAL ABNORMALITIES amonngst many others

-Neutrophil count: 1.9 10*9/L (2.5-7.5) = BELOW RANGE = Nuetropenia INDICATIVE OF AUTO IMMUNE DISEASE, amongst many others

-Eosinophil count – observation: 0.6 10*9/ (0.0-0.4) = ABOVE RANGE = INDICATIVE OF AUTO IMMUNE DISEASE amongst many others

[PinkNinja]

No need to apologise. You have good reason for feeling and reacting the way you did. It looks to me like you may have adrenal insufficiency due to your poor thyroid function. This is likely why you are a "nervous wreck" at the moment. Sorting out your thyroid should help with sorting out your adrenals although you will have to work on that too.

As your haematology results are indicative of auto immune disease, I was wondering if you have Hashimotos. If they had bothered to do the antibody tests, this would have confirmed it. Given these results please ask again for the thyroid antibody test.

I am very surprised they didn't test iron. B12 is another matter. Ask again if they can test the iron, especially if they say you don't need to do anything about your thyroid. If you thyroid is fine (which I don't think it is then they need to find out why you feel so bad so iron tests and B12 and folate would make sense. Please do persevere. Take someone with you next time if you think it would help.

Given these test results, I would ask for the other tests again, especially the T3 and antibodies. Your T4 is low normal so it would be wise to test T3 but the lab may refuse given that your TSH is within range (even though we know that means nothing).

Are you taking thyroid meds? If so what are you taking and how much? It looks like you need more thyroid hormone looking at your free T4. If you are not taking enough thyroid hormone this is likely to cause adrenal issues. Sometimes adding in some T3 can help with this.

I hope I have been able to help a little.

Carolyn x

[ecie]

hi Carolyn,

I'm pretty sure I have Hashi's. Definitely got some sort of goiter action going on with the gluten intolerance, choking feeling and frequent inability to swallow. Try getting the GP to listen to me though, or my family really.

I'm surprised they didn't do those tests either, especially after they ticked them on the test forms and added their own notes. As for requesting the tests, I can't manage to get an appointment with them until the new year now. The GP refused to test my t3; I had to ask the NHS endo for that one. He has now discharged me because he feels I would be better served by someone else.

I'm taking 50mcg levothyroxine. The GP refuses to diagnose T3 meds. I had to pay to see a private endocrinologist who says he could prescribe it on a trial period but only after upping my T3 first for several months. I'm considering buying it from abroad, but I'm also worried about using it without treating my adrenals first...

[PinkNinja in reply to ecie]

It would be a good idea to treat your adrenals but T3 can help as long as you take it slowly. You could try upping the T4 to see what happens, after all your T4 is on the low side of normal so that may help. It sounds like your endo is following the guidelines pretty tightly but these may be more about protecting his career (we've all seen what's been happening to the good Dr S) so he can continue to prescribe T3, rather than him being unsympathetic.

As Rod says, iron and B12 can play an important part in all of this and it does look like these need testing. My MCV was high until I had been taking B12 for a while. Was MCV tested? I have this tested every time I have routine bloods done so it shouldn't be a problem for the GP to do. If yours is high it may be worth starting B12 supplements. If it is low, ask again for the iron tests.

Good luck with it all and don't give up!

Carolyn x

[helvella]

Elevated red blood cell distribution width can occur with low B12, low iron or both.

The low B12 results in (some) over-sized red blood cells. Folates will correct that but leave you B12 deficient and with the consequent damage to nerves.

Low iron results in under-sized red blood cells.

Both together can result in a fairly normal Mean Cell Volume (MCV) but an increased distribution width. (MCV could also be out of range.)

[ecie]

Hi Helvella,

My last iron test a year ago revealed I was scarily low; a pitiful 5. Yes, 5. The lowest acceptable level is apparently 50!!

My B12 was apparently normal, but I don't know the exact level as the results were given to me over the phone. All the receptionist said was that my iron was 5 which was very low, and my B12 was normal, but didn't elaborate (and silly me I didn't think to ask).

MCV; is that 'mean cell volume'? If so, is it interchangeable with Mean Corpuscular Volume? Here are a few more results (not sure how relevant they are though)

Full blood count: 4.9 10*9/L (4.0 - 11.0)

Total white blood count: 12.6 g/dL (11.5 -1 6.5)

Haemoglobin concentration: 199 10*9/L (130.0 - 400.0)

Mean cell volume: 83.0 fL (76.0 - 96.0)

Plasma parathyroid hormone level: 2.5 pmol/L (1.1 - 6.9)

[helvella in reply to ecie]

Yes mean corpuscular volume is the same. And you obviously now realise the need for your B12 result as a number.