Could anyone help with my blood results?

[InSpaceNooneCanHearYouScream]

I see such an enormous amount of knowledgeable advice given from you lovely people that I wonder if you can help me?
I'm a 45 yr old female with typical boringly long history of nagging health complaints- anxiety (well controlled on fluoxetine), extreme tiredness and lethargy, frequent headaches,skin complaints including very dry skin and funny bumpy rashes on elbows and knees that come and go,and a twenty year history of irritable bowel type symptoms.

I've had blood tests in the past which just showed slight anaemia.

I went back to the GP recently asked to be tested for coeliac-and she also ran a full panel-liver and kidney function came back dead normal but others are as follows;

TSH: 2.8 mu/L. 0.27 - 4.20mu/L
Calcium: 2.18 mmol/L. 2.15 - 2.55mmol/L
Vit D: 31 - abnormal-gp recommends supplements
Haemoglobin estimation: 109g/l. 120-150 g/l
Ferritin: 5 ug/l. 13 - 150ug/l
B12: 228 pg/mL. 180-914pg/l
Serum folate: 4.4 ng/ml. 3.10-20.00ng/ml
ESR: 31 mm/h. 0-12mm/h
Coeliac screen- normal

Obviously from this I'm anaemic and ferritin is very low, and because my ESR is also high my gp referred me to gastroenterologist for bowel investigations.Gastro was pretty dismissive and thinks I just have IBS, he basically shrugged when I mentioned my ferritin level is 5. He is going to do a colonoscopy just to be sure though. In his clinic letter he said the anaemia doesn't warrant further investigation as I still have periods. Even though they are normal and not heavy. 

The gp will discuss iron supplements etc once I have had the colonoscopy. I did ask for more detailed thyroid tests: free t3 and 4 and thyroid antibodies but she refused, saying my thyroid result was dead normal and my symptoms were probably just caused by anaemia, which goes against a lot of the advice I have seen, but I don't feel I can argue with my doctor, even though a lot of my values are at the bottom end, like B12, but she won't do further testing as they are 'normal'.

Any thoughts? I really don't want to feel this grotty for the next twenty years!

Just to add to this, I now have a printout of my coeliac screen test:

Tissue Transglutaminase IgA 0.8
Tissue Transglutaminase IgG 0.9 u/ml

Reference ranges: 10u/ml- Positive

So by this range my coeliac result is very negative. But my levels seem VERY low- does anyone know if that might be relevant at all?

Thyroid Stimulating Hormone - Well within normal range. However, there doesn't seem to be a result for T4.

Normal levels of TSH don't necessarily mean you're in the clear.

A T4 test for thyroxine shows how the thyroid is actually working.

Someone could have a normal TSH score but still have an underactive thyroid.

Calcium is at the lower end of normal.

Vitamin D is insufficient (if measured in nmol/l) - talk to your GP

Haemoglobin is below normal range - anaemic

Your ferritin is definitely low. Ferritin is used by the body to store iron.

B12 is at the lower end of normal. But it's within normal range. Your anaemia isn't pernicious.

Serum folate is another indicator of pernicious anaemia. Your levels are the lower end of normal.

ESR or erythrocyte sedimentation rate is a crude test for inflammation. Yours is well beyond normal range.

Your coeliac screen is normal.

Spruce up your diet and include plenty of dark green, leafy veg, a little uncured red meat (if you're not veggie) and supplement your diet with B, D3 and iron supplements.

If, after you've done this and nothing has changed over 6
3 months, talk to your doctor about T4, PTH, ESR and CRP tests.

3 months.

What is your diet like?

Honestly? I would go completely gluten free and try a paleo type diet. Your digestive system sounds shot. I would eat plenty oily fish. Take a magnesium supplement daily as it will help to raise the vitamin Dlevels.

Sugar as low as possible. Lots of green leafy veg, good quality red meat and eggs.

Thank you, my diet is good- plenty of meat, dairy, veg etc

I asked for free t3 and t4 tests and GP refused

For the IBS alone I would trial gluten and dairy free in an elimination basis.

Could you eat liver for iron?

Take a very good omega 3 supplement

I think there is a lot you can do but you are wasting your time with the GP

Is there a Total IgA result? Coeliac test relies on measuring IgA and may coeliacs (and non) don't make enough to measure making the test inconclusive.

No, serial they didn't test total IgA,and I dare say if I ask for it my gp will refuse

Print off the NICE guidelines and go back. Coeliac test is useless without total IgA. I've just moved and changed doctors and decided to ask about my old coeliac test results as both my mother and DS1 are IgA deficient. I discovered that my total IgA wasn't measured.
So I am booked in to ask for a repeat test and will be insisting on the total IgA being included. I may well not be coeliac like my son but at the moment they have I no evidence either way and I suspect it runs through my side of the family.

Whilst not free, private tests like Blue Horizon aren't too horrendous and something to wave under a GPs nose when they don't have the time or money to investigate properly. Currently doing that with a separate issue but have the confidence and language to challenge them about coeliac protocols due to DS1.

I've learned the hard way over the last few years that GPs are not Gods and you HAVE to advocate and push for yourself and your DC. If I hadn't, DS1 would be a different boy now, and not in a good way.

Thankyou serial- I agree- I'll push for total IgA

I have now had Active b12 results back and full thyroid panel as per photos

Just to update- I asked my GP if I should be tested for total IgA, as I had read that the coeliac tests can be meaningless without it, and he simply stared at me and said 'You do not need further testing. Total IgA is not available on the NHS'
Which is total bollocks. Total IgA is recommended on both NICE guidelines and Coeliac UK. But I feel I can't argue further for fear of totally alienating my GP.

Go see another gp!
For what it's worth, your OP describes me very well.

Have you had a full course of vit D from your gp yet?
I felt loads better about 2 mo the after I started mine, so pretty much the end of the course.
Also had two bouts of low folate a couple of years ago about a year apart.
Again, had felt shocking before, lots better afterwards.

Have had negative tests for thyroid and coeliac, and IBD too. So 'just' ibs.

I have better days/weeks (and am currently pg so who knows what's going on apart from being aenemic) but often think I get a lot more aches and pains than others too.

In my anxious moments I wonder if I have fibromyalgia or something, but in the cold light of day I think probably not.

Hth, it's hard not having the answers

Thankyou foody, and congrats!
That's another thing, my GP told me just buy Vit D supplements, 800 iu. Which I think will be totally inadequate. I asked if that was enough, he said it is, and I wouldn't need higher doses unless my level was 30 or below. Mine is 31!!!!! Aaarrggh- brick wall.

If you take those daily they might be enough?
Mine were 20,000 units but only taken once a week

Well I've bought 1000iu and they'll retest after two months so I'll see then I suppose.

This isn't easy to follow, but might help?
www.vitamindcouncil.org/i-tested-my-vitamin-d-level-what-do-my-results-mean/

I came across this document some time after I had the coeliac blood test...
South Derbyshire Coeliac Disease Test Guidelines

Going by the chart on page 3, some areas only test total IgA if tTG result is 0.3 or below.

But even when it is that low they don't seem to bother. My tTG IgA result was 0.3, they really should have tested my total IgA but didn't.

You are right to want and need the extra tests, but unfortunately just because something is written in the NICE guidelines doesn't mean the NHS has to adopt it as protocol, as at the end of the day it is a 'guide' not a directive, hence why your doctor may say this test is not available on the NHS.
I would consider taking your test results to a reputable naturopath on the best way forward as your GP is not working with you here. A naturopath would review things like thyroids/adrenal glands in different ways, they often use a narrower reference range which may result in interpreting your blood tests differently. They can help you with potential gut problems too. They take a more wholistic approach rather than leaving it just to the blood result (although these are really helpful)
Alternatively if your own supplementation does not work, keep returning to Gp with symptoms.
Good luck

Thank you all

I thought I would attach a pic of the rash I get - it appears periodically on one elbow or knee at a time, starts with a burning feeling and then progresses to a very itchy bumpy rash before disappearing a week later. I wondered if this fits with Dermatitis Herpetiformis

Another pic

Uurgh attached the same pic twice

Now it won't let me attach any other pics. Ugh. Hate technology