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

If you get the NHS app, you can access all your results on there without having to ask for them to be printed.

GPs don't seem to look at the actual readings, they just see the "normal range" and tick the "satisfactory-patient can be informed" box.

It's often not even the nurse/GP that you consulted with and ordered the blood test who reviews the results, and they don't check the system to read the notes as to why.

I have T2 diabetes and for the last 3 annual "check ups" when I phoned the reception for results, they just said "doctors says it's ok", so I just thought things were good. (They take the blood during the consultation, so the nurse doesn't have the results obviously when during the review, whilst checking feet, blood pressure etc)

I got a GP appointment for something else and casually mentioned the diabetes and that I was well under control, etc and he said, no, it wasn't under control at all, the blood sugars were going up year after year and were too high for the medication I was on - they were in the "normal" range for a diabetic apparently, but not one who was one 3 different diabetic drugs!

He pinged a message to a diabetic nurse who got back to me a few weeks later and we started a monthly dialogue and monthly blood sugar blood tests to work to getting it down again. All going well, then she left. Radio silence from the surgery again. I phoned the reception for the last blood test result, and it was back to the old "GP says it's satisfactory". I asked for a consultation with a diabetic nurse, but receptionist said they can't because GP had put on system that the blood was satisfactory! I was assertive and the receptionist finally said she'd ping this random GP to tell her my comments and ask what to do. She rang back a few days later with the same "GP says it's satisfactory" and just to wait until the next annual review!

Just had that annual review and blood tests have come back - still too high, and they were still too high last time too. So a new diabetic nurse will be contacting me shortly!

It's not just that GP's take too much reliance on the "normal range", nor that they don't read the notes on the system, but by doing so, they block the patient from seeking further advice from the actual staff who know what they're doing!

Wrongly gatekeeping!

I had a blood test recently and went to the surgery to pick up the results - was told “all normal” by the receptionist. But I asked for the print out, as I wanted to know the levels. (Post memo and feeling run down, wanted to check thyroid, iron etc before fiddling around with HRT doses and tbd the female GP agreed to the test). She huffed a bit and said I had to fill in a form to get it (!) so I said I would, then she just printed it out for me anyway. So I took the print out home and went through it with Dr Google. My ferritin and B12 were on the low side of the ranges, ferritin particularly so. So now I’m talking a simple iron tablet and Berocca every other day.
I wonder if the problem is people get told “normal” but never see the actual results?

I can't remember where I read it, but the reference values are based on the Normal range - as in, the mathematical meaning of the word Normal.

And the Normal includes 95% of the populations - including very sick people.

So yes, if you're at the bottom end of the "normal" by definition this is not ok, nowhere near optimal.

Which is why there are private companies willing to take your money to check how close to optimal you are in any given factor: thriva.co/hub/blood-tests/what-are-optimal-ranges

She already had three NHS tests so it was easy enough to get supplements. She didn't, as far as I understand, get a private prescription. She was just told to take supplements at a private clinic.

NHS absolutely does blood tests for vit D. I look at blood tests as part of my clinical work.

OP, if you don't feel any better after supplementing, I suggest you ask your GP for a referral to a chronic fatigue service.

So buy over the counter iron tablets - they are widely available!

https://www.boots.com/health-pharmacy/vitaminsandsupplements/vitamins-supplements-shop-by-ingredient/iron

Does anyone know anything about ‘my future health’?

I’m wondering whether it will throw up better results for people.

I think it depends on the GP - mine has prescribed ferrous fumarate for me when my iron levels weren't quite low enough to be classed as clinically anaemic, but were causing symptoms.

We had this with DS(9) - took him to the GP for the second time because we believe he gets far too tired for a child of his age. Had blood tests both times and were told they were normal.

Fast forward a few months and DS is at an NHS paediatric dietician where I showed her his latest blood results via the NHS App. Turns out his ferritin is 1 point/whatever above ‘Low’ and yet neither GP seemingly couldn’t join the dots between the reason for the blood test and the literal borderline result. The dietician was not impressed and said it’s quite obvious that low ferritin was the issue.

I don't really get the mumsnet obsession with borderline (ie not low) ferritin, folic acid or TSH.

For me my borderline ferritin level meant my hair fell out, levels not low enough for NHS treatment but not high enough to support hair growth.

Agree with the PP, why not just buy over the counter supplements?

How do you know what to supplement if you don’t have the tests? Unfortunately, the levels required to boost certain deficiencies aren’t available OTC so you do have to go private to get a prescription.

Why did you have to pay for a private test?

Because for some tests, the NHS simply won’t do them any more, such as vitamin D. Also with private tests you get a GP interpretation and recommendation.

My ferritin was 3; I was hallucinating and passing out while pregnant. I had to beg, plead, cry and explain I thought that I would die to get iron infusions. They saved my life.

My blood test results said "your ferritin is a little low. Iron supplements should help"

I have a condition that means iron isn't absorbed which is on my medical records.

Agree with the PP, why not just buy over the counter supplements? Why did you have to pay for a private test? They would show exactly the same values as three of your NHS tests.
I would imagine that blood results as well as everything else done in the NHS are governed by NICE guidelines. It means that the clinical body looked at population-level evidence of what are normal levels. It doesn't actually cost anything to your GP to say "take supplements" so I don't see where you think they are saving money by suggesting your levels are normal.
NICE also look at risks vs benefits and cost vs benefits. And yes, sometimes on a population level the risks and the costs are too high. And they cannot assess or assume risks for your individual situation. They can only look at what research data tells them.
Private clinics are "pay to play", very different. They are not bound by NICE guidelines and don't care about costs because you are the one paying.
Funny how people object to private ADHD diagnosis but have no problems whatsoever with other diagnoses from private providers. It's the same, isn't it? You pay and they give you what you want.

Same here, it was my T4 dropping that triggered it and they gave me 25mcg (I'm 5ft 10 and heavy) which did fuck all
Eventually for 75mcg which got my level to 4.5 TSH which they said was perfect

I changed GP and now on 100mcg

What are the ranges the NHS think ok and the ones others suggest?

Dh is finally understanding this issue, he is facing 6 weeks of daily treatments for an issue we’re not sure he actually has. The NHS believes it’s not worth the blood test and surgeon appointment until we see if the treatment works. It’s maddening and can’t possibly save money in the long term (never mind the cost to the health of the patients)

This is, in fact, a massive massive problem with the GPs.
It is not because of time, or workload, or money, is it? The test is done, it is in front of them.

Why didn't you just buy folic acid over the counter if you were that concerned? I don't really get the mumsnet obsession with borderline (ie not low) ferritin, folic acid or TSH. Iron tablets have side effects (constipation & black tarry poo), and overtreating sub clinical hypothyroidism will cause hyperthyroidism. Folic acid deficiency doesn't usually cause symptoms unless you are anaemic.

@Cantfindanavailablename I’d be interested to hear your experience - did you have a low TSH too? What was it, what meds did you go on and how have they helped you?

The NHS is a public health organisation, it is set up to treat society as a whole.

Private medicine is set up to treat the individual.

This is one of the implications of that. It’s in the same bracket as the NHS deciding that certain drugs are too expensive for them to offer. There’s no flexibility to say “this is normally considered normal but it obviously isn’t for you”.

Same with TSH (thyroid) - when I finally saw an endocrinologist (after a decade of trying to be referred) he said the lower limit should be 0.5, not 0.1.

I can only imagine the reason is costs… cheaper to leave people undiagnosed and unmediated.

Also, most of these issues affect only women. And women’s health is not a priority in healthcare.

Totally agree. Private blood test options (no consultation needed) exist now and would just skip the begging the GP but, but obviously not affordable for all situations.

Spending a bit more on diagnostics and treating deficiencies like yours would save the NHS in the long-term and in GP appointments. Just pointless gatekeeping.

OMG yes. I've been in the floor with this. Been just above threshold but my symptoms have been horrific. I was treated on NHS in this case. But agree with other posters in general though, the aim isn't for optimal sadly.

Personally I would not believe anything then NHS told me unless I was able to verify it from other sources.

The entire aim is to save money and treat as many people as possible as cheaply as possible.

No interest in helping the individual to have quality of life.