What blood tests to ask GP for for anaemia or thyroid?

[AbsentmindedWoman]

I've had lots of scattered testing over last few years, but never thyroid antibodies for example, so feel like other stuff could be missed - and I get confused and overwhelmed.

My issues continue getting worse and finally managed to get a GP appointment today and want to go armed.

Symptoms are - fatigue, joint pain, numbness, tingling, strange sensations like water being poured on my head/ limbs, blurred vision, hair falling out, dizzyness (sometimes fainting on my period) and palpitations (often for no fucking reason other than say, sitting up in bed!).

What should I ask for?

I just don't know enough about anaemia or thyroid issues, but get worried because I'm definitely getting worse and if it's something treatable that keeps being missed - I will never stop resenting that.

Thyroid and Vit D I would say. If you feel you’ll get jumbled asking and then the Doc says what symptoms, simply state there are many things but Thyroid and Vit D issues are prevalent on your mums side.

You can ask but the GP will decide what tests to do depending on your symptoms and family history.

Commonly they will do full blood count, TSH and haemoglobin.

If you are lucky they will additionally do one or more of vitamin D, ferritin, vitamin B12 and folate. For the latter ones you need to show/explain why they are relevant. Even then depending on the GP they may make comments like testing for them is a fad or everyone is deficient in vitamin D.

Oh and if you do get tested make sure you get a printed copy of your results.

Thanks both. What thyroid ones though? This is my question because they generally just do the basic one, each year because as a type 1 diabetic I'm more susceptible to thyroid things.

I think I've had T4 checked too but there's T3 and antibodies too?

But I don't know all the different parts of the test?

I know the Dr decides but I am hopeful they are interested in helping me.

Vit D is always low when tested every winter, 24 was my lowest, maybe it's sunk again and is making me feel more shit than usual.

A lot of your symptoms sound like they are neurological to me. Could you ask for an MRI? I have MS and I've had all of your symptoms except the hair falling out, which could be another issue entirely. Ask for the blood tests sure but I would aak for further testing. Hope all goes well.

Give the GP your symptoms and let them plan the investigations. Really annoying when a patient has arrived already deciding what tests they need. Maybe 1 in 10 times they are right, usually they have been listening to duff advice on the internet and are convinced they need their serum rhubarb checking and it's rubbish.

I've been in and out to appointments for this for two and a half years, gradually worsening - so forgive me if I've lost some faith in the gp.

I've also had type 1 diabetes for over twenty years since a kid and believe me what you learn along the way of having chronic illness is that some doctors know very little about specific medical problems. I've had plenty of gps who barely know the difference in type 1 and type 2, and a few memorable ones who gave downright dangerous misinformation.

One Dr did mention MS but said probably not and did some bloods (over a year ago) and nobody has mentioned it again. Again, POTS has come up a few times but it goes no further. Then uget stressed out and don't know what direction to push in? And I don't want to look like a massive drama queen and like I just want loads of tests. I fucking don't! I just want to be sure we're not missing something fixable/ improvable that could lead to lessening of symptoms.

But this is what I mean, I just don't know enough to know what's going on - I desperately need a sharp GP to help me figure it out.

B12, folate and ferritin levels urgently

Take a look at B12d.org you have a lot of symptoms and the uk is seriously out of step with the rest of the world ( hopefully about to change)

T3 and T4 also. Hope you get it sorted

As far as thyroid tests are concerned; GPs can ask for TSH in this area and will get TSH /T4 Results but they cannot request T3 as that is for endocrine consultants only. They can only request thyroid antibodies if there is a good clinical reason to do so.
You will either have to trust your doctor to plan your investigations as they see fit or change doctors

Sorry, posted too soon and I didn't mean to be abrupt but I just wanted to say that it is important that you trust your GP particularly when you have chronic illness. If there is a communication break down maybe you need to change doctor.

I think I've had T4 checked too but there's T3 and antibodies too?
But I don't know all the different parts of the test?
I know the Dr decides but I am hopeful they are interested in helping me

It's not as simple as that. Your GP doesn't have carte blanche to order any test you want. Labs won't normally process (test) thyroid antibodies or free T3 or T4 if TSH is normal, for example.

It's very important that GPs listen properly to patients: if you have a GP who is dismissive, go and see someone else. However, it's equally important that patients listen to (engaged, non-dismissive) GPs. Scattergun testing, based on internet advice from people with no medical knowledge will get you nowhere. Take the example above of a poster telling you to "get an MRI". Of what? The NHS does not offer whole body scanning, for very good reasons, and, even for one part of the body, there are different types of MRI, depending on what you are testing for.

The least productive type of consultation is one where GP or patient has made up their mind what the outcome should be before it starts. Please try to have an open mind and listen to what you GP advises, rather than going in with a mental list of blood tests you want - many of which your GP may not be able to provide anyway.

I have a very open mind. But I do feel like I've slipped through several cracks. I can never get an appointment with the same doctor, and they don't havetimeto review my notes.

Hit post by mistake sorry, on train. I saw a Dr who has gone the route of referrals to cardiology and I thinks syncope clinic, and said maybe neurology - I guess that depends if heart stuff is ok. I did wear a 24 hour heart monitor several years ago which said all good - there's nothing about that in my notes as I moved house and old GP said I was out of catchment so I had to move GP - but that means it's been 18 months and my notes are still not at my new surgery. That seems a bit shit tbh, as does the fact that apparently they did refer me to neurology in May but I never knew anything about it. He was quite curt but did seem to believe something isn't ok.

So I didn't ask for any blood tests as I felt that would look like I didn't believe him, or something. He is trying to help and I am grateful.

I’m in the US and see an integrative health doctor. This isn’t covered by insurance, but my doctor runs a full thyroid panel—TSH, reverse T3 and T4, T3 and T4, and TPO antibodies. You can identify thyroid issues with TSH (but I think the NHS guidelines are absymal, as over here they consider untreated TSH to be abnormal at 3.0 or higher) but you can not identify autoimmune thyroiditis (Hashimoto’s) without knowing if your antibodies are elevated.

Google to read the work of Dr Isabella Wentz, and read Stop the Thyroid Madness website to learn more about treating Hashimoto’s.

As you already have an autoimmune disease (T1) you will see that many symptoms overlap between autoimmune diseases. I have Hashimoto’s, and often have slightly elevated A1C, and I also have elevated DHEA-s, so struggle with blood sugar and hormone imbalances. I am skinny and have remained so with a thyroid condition, but endure a lot of the symptoms you described—hair loss, muscle pain, neutropathy, brain fog—when I’m having a flare.

Neuropathy, that should say.

but my doctor runs a full thyroid panel—TSH, reverse T3 and T4, T3 and T4, and TPO antibodies

Sure but, as I have explained above, this is not normally available in the UK on the NHS if TSH is normal, so it's not much help to the OP.

I know. I guess I’m trying to say that I would struggle to know where I am with thyroid health if they only tested TSH. If private is at all an option for you, OP, I would do it as a one-off to get vital bloods.

Thanks, all. Yes I might pay for some blood tests. I'm just not certain something isn't being overlooked.

It will take months for any referrals to offer me appointments at cardiology (quite rightly as it's not an emergency) so maybe getting private bloodwork done would make me feel like I was being pro active about the problem in the meantime, instead of just sitting passively feeling like I've been dug up most days.

Why do you need to know the actual names of the tests? Just ask the GP if they can test for anaemia and thyroid issues and state your symptoms.

See your GP, they will run the tests that they think are appropriate. If you are still unhappy then see a private GP

If your Vit D is always low and you have anaemia then you may have Coeliac disease. I am a Coeliac and so many family members and I had every symptom on your list. My bloods were negative initially but after further investigation, a gluten free 3 week trial and more tests I finally got my positive. Note: I had no stomach symptoms at ALL.

I've had a test for Coeliac, and all was fine! That was one of the initial things they suggested.

But as I said above, my test was clear initially. You would be wise to do a 3 week gluten free test just in case. You have nothing to lose. Only 60 percent of Coeliac’s are positive at the initial blood test and that is more likely if your symptoms are not stomach related. It’s just 3 weeks and easy to do in the UK. Life changing for many. Good luck.