Any doctors able to help me - blood test results?

[Trinity69]

Is anyone able to provide me with an insight on these blood test results? Patient is F, 14y 6m, diagnosed with Hashimoto’s disease and is AuDHD if that’s relevant. ADHD is currently unmedicated.

I’ve suspected anaemia for a while so have been supplementing but stopped a week prior to this test to get a true result. This is not the first time her B12 serum, lymphocyte’s and eosinophils have been high.

Since starting her Levothyroxine in November her periods have been crazy heavy and I have requested an ultrasound to try and discover the cause before putting her on the pill (which is all our GP suggested) but haven’t heard anything back yet.

The poor kid is exhausted all the time, suffers with leg pains and occasionally complains of stinging when she passes urine but not often. We have been to out of hours a couple of times with stomach pains but they always concluded it’s constipation and give laxido despite her stating quite clearly she has been passing stools. Stomach pains are always the week after her period.

I hope I’ve included all of the important information and someone can help me advocate for her. I’m so sick of being fobbed off.

What dose of levothyroxine is she on? I only felt better with Hashimoto’s when TSH was closer to 1.0, she looks under medicated.

25nmg/50nmg alternating. I think her TSH should be nearer to 1 but I had to really lose my shit at the GP to get her dose increased that much. Not seeing our Endocrinologist again until July. No idea why they haven’t tested T4 and I’m aware labs seldom test T3. I’m wondering if the increased lymphocytes and eosinophils are related to the Hashimoto’s or something else.

Disclaimer: not a doctor but a long-time sufferer from Hashimoto's.

So sorry to hear your daughter is so unwell! Autoimmune diseases really suck.

FT4 won't be tested if TSH is in the normal range, which it is. Honestly at 1.9 TSH is OK. It would be helpful to get FT4 and FT3 levels but you'd have to do it via a private test or a fingerprick home test like Medichecks. Just to rule out any abnormalities there.

Has she been supplementing B12? If so that would account for the raised B12 levels. She'd have to be off it for more than a week to return to her normal level. There's also something called 'paradoxical' B12 deficiency that can occur even when B12 levels are over range.

I'd also get a full iron panel to rule out any iron deficiency anaemia, and check Vit D levels too.

She has been taking a multivitamin that does contain B12 but this is the second time it’s been high and she wasn’t supplementing then. I will have to try and find another vitamin for her with no B12 or iodine!
I need to book her another thyroid function test before her appointment with the endocrinologist so hopefully I’ll get the T4 from that but I know they won’t test T3. I’ll ask for it though and see what happens!
I’m hoping the GP will ring me to discuss but I’m not holding my breath.

Why does she need a multivitamin? She has a lot going on and a general multivitamin is usually not recommended. If she has a deficiency, iron for example, I would treat the deficiency, but ditch the multivitamin because it could be interfering with all sorts of stuff while she tries to just find some stability.

I started her on the multivitamin because her diet is awful. She rarely eats what is cooked for her. I’ll stop it for now and see how she goes. I just thought it might be helpful for the tiredness and general lethargy but I’m aware that’s a symptom of the Hashimoto’s so maybe it’s not needed. I feel a little bit like she has a diagnosis and we’ve been left to figure it out.

T4 and T3 results only ever seem to appear if TSH is over 4 or under 1

as between those parameters is considered notmal

( normal is based, apparently on a study of 20 medical students - how true that is I’m unsure)

I function far better at 1 or under but strive to not be over medicated due to obvious danger to heart. Fortunately my initial gp was very good and now my gp has changed my dose, seen it goes under active over 6 months and had altered the dose back

id seriously be asking “Gemini” AI for some questions to ask your gp on this. Gemini is far better AI for science than chat gpt

go to your doctor armed with questions and hopefully get some results

I’d also paste the photo graph of the results into AI and get the conclusion

very high b12 - above normal range. (Taking to much.)
mild anemia.
Eosinophils slightly high. (Allergies, inflammation sometimes infection.)
normal tsh.
rest is fine. Nothing really to be concerned about but definitely knock the b12 on the head.

You suspect she's anemic but they haven't checked iron or ferritin at all. I would also get vitamin D checked, as this can also cause fatigue and is commonly low. Her gp might be reluctant to test but you can get privately from places like medicheck.

Also that B12 and folate level aren't worrying. They are water soluble vitamins and do not build up in the body to dangerous levels as they are urinated out. My levels of B12 are generally over 1000 as I have injections. They use super huge doses of B12 to treat carbon monoxide poisoning - it's a safe vitamin.

I wouldn't rely on AI for medical advice as a previous comment suggested

wouldn't rely on AI for medical advice as a previous comment suggested

there is a difference between using AI for information, to relying on it for answers and used sensibly it can be helpful

Eosinophils can be linked to some cases of asthma, something to consider if she has respiratory symptoms.

Couldn’t agree more with this. I fed it my blood results recently and the insights and potential other things to look out for were excellent. I’m obviously also under the care of medical professionals.

My advice would be to use Claude, not ChatGPT. It’s better at this kind of work.