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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To wonder why the NHS has such a high threshold for blood work?

157 replies

SailAwaySandra · 28/08/2024 07:11

In a nutshell, my folate levels are actually low after all. But they’re NHS borderline.

For about 6 months now, I’ve felt like utter death. Really stanage symptoms, fatigue and joint pain making me feel like walking through treacle.

It turns out my folate levels are borderline and actually low. And the ideal is that they’re much better than they are!

I’ve had 3 blood tests via the NHS, each time going to the GP very worried as I am only 26 and physically felt like my body was aging! Sometimes I had to flinch to move a leg, for example, if I had to sit for a minute or so and get up again

GPs kept saying all was normal. Nothing to worry about.

Paid for a blood test and told within 72 hours that my folate levels are too low. And to take folic acid (I’ve already put loads of it in my diet)

Why or why did no GP say ‘it’s within normal range but your folate is in the low side. You might want to consider buying some folic acid and introducing more of it into the diet’?

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Westchester4 · 22/09/2024 08:49

lljkk · 21/09/2024 23:59

I will persist in my firm belief that vitamin & mineral supplements are utterly unnecessary for me (assuming no change in evidence to date).

Presuming MNHQ haven't banned me by then or I don't die of something else first, I'll try to remember to update.

Have you done some good research eh?

Errors · 22/09/2024 07:26

sunhasgotthis · 05/09/2024 10:29

Friend had tests and were told were normal. Tiredness was dismissed as having young kids. Was offered antidepressants instead as felt like shit. Turned out things like iron levels were 'normal' but only just. It's so stupid and people's health deteriorates.

At least now with the app, it's easier to see actual results rather than being told 'normal'.

This makes me so cross!!
I am tired of women’s health being dismissed this way. We are talking about it on the Peri thread as well… low iron also causes anxiety/depression/brain fog/fatigue and I wonder how many GPs would just tell a woman presenting with these symptoms (and is 40+) that she is in peri and don’t bother treating her?! Or worse, treating her with hormones she doesn’t need…
It especially makes my blood boil that a GP would prescribe anti depressants instead of iron!!

lljkk · 21/09/2024 23:59

I will persist in my firm belief that vitamin & mineral supplements are utterly unnecessary for me (assuming no change in evidence to date).

Presuming MNHQ haven't banned me by then or I don't die of something else first, I'll try to remember to update.

TheOnlyLivingBoyInNewCross · 19/09/2024 06:42

lljkk · 18/09/2024 09:05

I guess I'll come back & update in 20 years if I have osteoP by then.

Or you could take supplements?

lljkk · 18/09/2024 09:05

Quodraceratops · 17/09/2024 19:47

You've misunderstood this - you have low levels of Vitamin D, which typically would not cause any symptoms. However this is bad for your bone health and future risk of osteoporosis. Most people with low folic acid, iron, B12 or vit D will not have symptoms.

I guess I'll come back & update in 20 years if I have osteoP by then.

spikeandbuffy24 · 17/09/2024 21:00

lljkk · 15/09/2024 10:53

I dunno, I'm not sure these tests are definitive, that's the real problem with them. Why they aren't cost effective.

Out of curiousity I had my Vitamin D tested a few years ago.
I had zero symptoms of deficiency & a summer tan (I'm outside a lot)
I was just assuming I'd come back high.
The test came back borderline too low for healthy.
Which really shocked me. All it proved was that the test wasn't reliable for indicating deficiency.
I continue to have zero signs of any Vit D deficiency.

I didn't really have any signs but I was still massively deficient
I think my level was 9. The only thing I had was a bit of shin pain which I put down to exercise and ageing
I took the high dose course and I still take them daily and don't feel different but I do it because I know it's important

Quodraceratops · 17/09/2024 19:47

lljkk · 15/09/2024 10:53

I dunno, I'm not sure these tests are definitive, that's the real problem with them. Why they aren't cost effective.

Out of curiousity I had my Vitamin D tested a few years ago.
I had zero symptoms of deficiency & a summer tan (I'm outside a lot)
I was just assuming I'd come back high.
The test came back borderline too low for healthy.
Which really shocked me. All it proved was that the test wasn't reliable for indicating deficiency.
I continue to have zero signs of any Vit D deficiency.

You've misunderstood this - you have low levels of Vitamin D, which typically would not cause any symptoms. However this is bad for your bone health and future risk of osteoporosis. Most people with low folic acid, iron, B12 or vit D will not have symptoms.

Modernfamily2011 · 17/09/2024 19:37

Just a quick update for you all…. I called the GP yesterday to discuss my Ferratin levels from the blood test taken earlier in the year.

I stated that I thought the level of 27 seemed quite low and she instantly agreed with me and prescribed me Ferrous Sulphate, her exact words were ‘That is very low and you must feel a bit rubbish’

I’d like to thank @SailAwaySandra for starting this thread as I genuinely had no idea about the threshold until reading this and would Never have checked my own results if it wasn’t for this

lljkk · 15/09/2024 10:53

I dunno, I'm not sure these tests are definitive, that's the real problem with them. Why they aren't cost effective.

Out of curiousity I had my Vitamin D tested a few years ago.
I had zero symptoms of deficiency & a summer tan (I'm outside a lot)
I was just assuming I'd come back high.
The test came back borderline too low for healthy.
Which really shocked me. All it proved was that the test wasn't reliable for indicating deficiency.
I continue to have zero signs of any Vit D deficiency.

Courgettesareready · 15/09/2024 10:47

Q2C4 · 15/09/2024 09:31

@Courgettesareready I don't read the comments from individuals (and I'm definitely not anti vax!) but I found the guides really useful. My ferritin was 7, I was having weird food cravings, my hair was falling out, my nails were a state and my GP was useless.

Ah ok yes that's good! The comments were hair raising !

Q2C4 · 15/09/2024 09:33

I also found this article linking low iron levels with long covid interesting - www.cam.ac.uk/research/news/low-iron-levels-resulting-from-infection-could-be-key-trigger-of-long-covid

Q2C4 · 15/09/2024 09:31

@Courgettesareready I don't read the comments from individuals (and I'm definitely not anti vax!) but I found the guides really useful. My ferritin was 7, I was having weird food cravings, my hair was falling out, my nails were a state and my GP was useless.

Courgettesareready · 15/09/2024 09:12

Q2C4 · 15/09/2024 04:05

@Modernfamily2011 and anyone else concerned about their ferritin levels, this FB group contains detailed factual guides on ferritin - what it does, what happens when it's low, the role of transferrin, how to supplement, what cofactors you need & how to interpret iron panel test results: www.facebook.com/share/g/aRYUCU7sifVcXcv9/?mibextid=K35XfP

I've found it to be a really useful source of information.

Sorry but I found that group quite dangerous, there's a lot of anti vaxxer types on it, lots of dismissing the conventional medical community (which I know can be lacking often) it just goes down a lot of peculiar rabbit holes.

Q2C4 · 15/09/2024 04:05

@Modernfamily2011 and anyone else concerned about their ferritin levels, this FB group contains detailed factual guides on ferritin - what it does, what happens when it's low, the role of transferrin, how to supplement, what cofactors you need & how to interpret iron panel test results: www.facebook.com/share/g/aRYUCU7sifVcXcv9/?mibextid=K35XfP

I've found it to be a really useful source of information.

Potsgirl · 14/09/2024 22:33

spikeandbuffy24 · 14/09/2024 22:26

You can buy the exact same iron - any chemist, or online chemist sells it
I bought ferrous fumerate online

Well ok maybe you can. But would you know to buy it, if your GP says your iron is "normal"? That's the issue. GPs don't tell people they need ferrous fumerate. They tell them their iron is fine when it's 17 or something. And those people might think "ok well I'll take a supplement to be sure" but they take the 14mg iron you can buy on shelves and their iron doesn't increase and they keep feeling like shit.

Courgettesareready · 14/09/2024 22:32

You can definitely buy high dose ferrous fumarate on line, I take 3 x 210 mg per day. A normal multi but and min tablet is useless as contains so little

spikeandbuffy24 · 14/09/2024 22:26

Potsgirl · 14/09/2024 20:51

Have had very similar issues to everyone above.

I have Hashimoto's and couldn't get prescribed Levothyroxine for a long time. My T4 was below range, but because my TSH was within range (by 0.2 mind!) the GP refused to prescribe meds.
I saw a private thyroid doctor who rolled her eyes when I told her this and immediately prescribed medication.

I've also had issues with ferritin. On the NICE guidelines it says ferritin is deficient if below 30. But the lab reference ranges say different, so when mine was 28 it got ignored. I then had a different GP tell me that "ideally, for good health, ferritin should be 100"

To those saying "just buy supplements!" - you've clearly never been deficient in anything. For a start you can't buy all medications (levothyroxine for example), but also shop bought iron contains around 14mg. Prescribed iron contains 210mg. Its just not comparable and doesn't work.

You can buy the exact same iron - any chemist, or online chemist sells it
I bought ferrous fumerate online

Pixiedust1234 · 14/09/2024 22:20

@Modernfamily2011 my understanding is that ferritin needs to be around 70 for healthy hair growth. You need to supplement if yours is only 27.

Remember to take the supplement with Vitamin C, and no caffeine such as coffee, tea or cola 2 hours either side of taking it. I usually take mine at night washed down with an effervescent vit c drink so I only have to worry about the caffeine 2 hours prior.

EDIT - agree with above regarding supplements but if the GP won't even admit a person is low there's no point in arguing. If it's supplements or waiting until you collapse years later, then at least try the supplements first.

Potsgirl · 14/09/2024 20:51

Have had very similar issues to everyone above.

I have Hashimoto's and couldn't get prescribed Levothyroxine for a long time. My T4 was below range, but because my TSH was within range (by 0.2 mind!) the GP refused to prescribe meds.
I saw a private thyroid doctor who rolled her eyes when I told her this and immediately prescribed medication.

I've also had issues with ferritin. On the NICE guidelines it says ferritin is deficient if below 30. But the lab reference ranges say different, so when mine was 28 it got ignored. I then had a different GP tell me that "ideally, for good health, ferritin should be 100"

To those saying "just buy supplements!" - you've clearly never been deficient in anything. For a start you can't buy all medications (levothyroxine for example), but also shop bought iron contains around 14mg. Prescribed iron contains 210mg. Its just not comparable and doesn't work.

Modernfamily2011 · 14/09/2024 20:12

This thread is very interesting

I’ve suffered with hair loss since my early 20’s, at the time I was told my Ferratin levels were very low and prescribed Ferrous Sulphate

My hair never fully recovered and I was never re-tested and i’m now in my 40’s with young children!

Earlier in the year, I went to the GP because I was so tired and lethargic and I had multiple bloods taken. My Ferratin was 27 and Thyroid 12 (normal range is up to 22.7). It’s all on my NHS app but It states all results were normal, after reading this thread, i’m wondering whether my Ferratin is actually quite low and I should be taking supplements? Any thoughts please 😊

taxguru · 14/09/2024 15:32

@LovedFedAndNoonesDead

I take vitamin D, calcium, folic acid as well as other medications for chronic conditions but they never make a note of that on the clinical information when doing bloods for me. So my results come back borderline and get marked as “Normal; No action required” and filed but that’s not taking into account the supplements.

That happens regularly with my type 2 diabetes and my HBA1C blood test results. For the last three years, they've been 65 which is above normal but the GP has marked them "satisfactory" meaning no follow up.

What he's ignored is that I'm on the maximum dose of tablets (3 different tablets) and when so highly medicated, I should be much lower, no more than 55! The GP has either not noticed I was diabetic or not noticed what medication I was on.

All I got after the blood tests was either a phone message or text message saying something like "blood tests satisfactory, no action required". I wasn't told the numbers and our GP surgery weren't putting blood test results on the NHS app at that time.

I only found out during a GP consultation for something else when I just casually asked the numbers, and both the GP (different) and I were shocked at the levels being consistently too high year on year. He referred me to the diabetic nurses to get it down!

Then after a few phone calls with the diabetic nurses, who were likewise surprised it was so high yet marked as satisfactory, they both left, and my next HBA1C test still showed the same high level. Yet again, the same GP marked it as satisfactory. Because he'd done that, the receptionists wouldn't make a consultation appointment with the diabetic nurses because the system showed it satisfactory, no further action.

It was quite a battle to actually get them to see sense and make an appointment to discuss whether I need to go on injections or not.

Shouldn't be so hard, and GP's really should take a bit more care about reviewing blood tests, especially when the receptionists "gate keep" to prevent you getting review appointments if the GP wrongly marks it down as "satisfactory".

LovedFedAndNoonesDead · 14/09/2024 08:26

Another thing not always taken into account when having blood tests is when a patent is already on supplementation but results are borderline or out of range!!

I take vitamin D, calcium, folic acid as well as other medications for chronic conditions but they never make a note of that on the clinical information when doing bloods for me. So my results come back borderline and get marked as “Normal; No action required” and filed but that’s not taking into account the supplements.

This week I’ve had bloods done at the GP because some done by the hospital at a pre-op assessment appointment last month were out of range - but, the hospital where my GP surgery get bloods analysed is not the same hospital that did the bloods last month, and the reference ranges for a lot of them are different. The GP surgery don’t automatically receive blood results from the hospital that requested they be re-checked, because they don’t communicate between the different systems and the letter from the pre-op clinic only mentioned B12 & Hb as a precursor to requesting they do an anti intrinsic factor blood test. There was no mention of my ferritin being 6 or my PTH being 9.4. So now they’ve been repeated and reported by GP as being “normal; no further action” despite it being noted on the results that they are out of range.

So 2 different labs have reported that results are abnormal but the GP surgery have filed them under NFA 🤷🏼‍♀️🤷🏼‍♀️

MotherOfCatBoy · 13/09/2024 23:05

@Pixiedust1234 so glad you got the actual results! Good luck with follow up 👍

Pixiedust1234 · 13/09/2024 17:10

That is one thing I've learnt from being on here... we need to see those figures!

Thank you for the heads up Smile

Westchester4 · 13/09/2024 16:23

@Pixiedust1234 I looked into the Waitrose ones but unfortunately it doesn't give you an actual number value for whatever you're testing for, just a 'yes/no' as to whether they're in the normal range Sad

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