GP says my routine bloods are normal. Really?

[NotSoIronMan]

Their guide was that Ferratin levels should be between 15 and 300. Mine were 36.
My serum folate was 3.3 (should range between 2 to 9000).
My b12 was 147 (should be between 120-900)
My vitamin D was 47 (should be 50+).

He said it was satisfactory with no further action, but I could take iron tablets if I wanted to.

I have felt very low in mood and with brain fog etc and he said this is unlikely to be why.
I’m 28.

Surely it’s a bit worrying still?

You sound like me when my B12 was in my boots (as the doctor said), even though my blood tests came back within the normal realms my doctor said that every person is different and what might not be considered low for one person could lead another to become unwell. So while your tests might be satisfactory in the doctors eyes it’s not satisfactory for your body to function normally. Start taking supplements would be my advice, if they help then go back to the doctor and discuss a long term plan.

Yes. I get low ferratin and it takes months to get your stores back up.

Don't bother with the iron supplements that are only 20mg. You need the high strength stuff. I think a pharmacist can give it to you.

Or I just ordered it on My Pharmacy and it came the next day. I take the 210mg. Have reduced it to one a day now. It can upset your stomach but I find it fine, other than the inevitable black poos. If you have difficulty, you can get oral equivalent.

I was waking in the night feeling like I was having a panic attack because my heart was racing. No return of this since I started ferrous fuminate.

It is an issue that runs in my family so think I have poor ability to absorb iron.

Some are practically at the bottom of the range.
I was in the same position and they did nothing - bar suggest that I might be menopausal....😁
I had to limp along until I was admitted to a&e and it turned out I was hyper thyroid.

Yes, B12 is low - typically outside of the UK a b12 level of that would warrant treatment. This is generally a massive problem for people, levels of B12 deficiency are very undiagnosed because of this. Do you eat meat? Could it be a nutritional deficiency? If you eat meat (or other sources of B12) regularly (or take B12 supplements) but you have this level then it could mean that you are having difficulty absorbing or transporting B12.
Not sure what you should do - have a look at the pernicious anaemia society online, and also the pernicious anaemia and b12 deficiency forum on health unlocked. If you post the same question there you will get lots of good advice.

And yes to the hair loss @Plumtop11 . I was shedding masses and it was thin and limp.

I know that I keep ending up low , especially with peri symptoms where I am losing a lot of blood.

I have never tried online before but they were here within 24 hours https://www.mypharmacy.co.uk/product/ferrous-fumarate-tablets-84/?gad_source=1&gclid=Cj0KCQiAqsitBhDlARIsAGMR1RjmBGn-oVp0Juf74JKOLGHK5KrQI5P_f7VyaKZfonDfEcxWlpbPEvwaAtHoEALw_wcB

Sudda, op can BUY supplements it's time people started to take responsibility for their own health!

Brain fog is a common long covid symptom

And I've just googled and it seems hail loss can be too

Does that fit your timelines? If so, can you get referred to a long covid clinic?

Years ago I had a b12 level of 176 and felt awful. Reference range according to my GP was 180+ so they (somewhat reluctantly) treated it with injections despite being very skeptical that such a borderline result could cause the symptoms I was experiencing. Felt miles better within a couple of months.

The problem is the GP is looking at the blood results and not listening to the patient. The patient is stating she has symptoms so if these blood markers are not the problem then what is the GP doing next to try and solve the issue.

Those levels are low. I would start supplements pronto.

if I do not take iron I can literally become depressed and if I do not take b12 I get terrible mouth ulcers. Despite a healthy diet and no vices.

I would never trust the Nhs guidelines!

Now i’m interested in what they mean by normal. Normal is not the same as healthy.

With the clear majority of women in the UK now being overweight or obese, that is now normal, but it’s still not healthy.

Does the NHS mean the normal range or the healthy range?

With those results it doesn’t sound like the GP needs to do anything. However because you feel rubbish and are at lower end of normal you possibly need to have a look at your diet and lifestyle and perhaps see if there are any aspects you can improve on. I think there is a risk that we are becoming an over medicalised society, in some cases we just need to improve our nutrition and other lifestyle factors to feel better.

Those results do suggest needing a vitamin supplement, however getting anywhere with thyroid testing is awful with the NHS. I’ve been symptomatic for years (likely hereditary), my hair is now the point of balding, eyebrows have disappeared, weight issues that aren’t helped with diet and exercise, brain fog and all that. Finally started to show on blood tests a few months ago, they asked me to do another blood test that showed the same. They’ve asked me to wait for yet another blood test before they make a decision about starting medication, in April 😒.

If you can afford it a lot of beauty/hair salons do vitamin b12 and vitamin c injections that may help if you don't get anywhere with the doctor.
I get b12 on the NHS and I have hypothyroid so I completely sympathise with your symptoms.

@OneInEight has it - what is often forgotten (or simply not known) by doctors is that the clinical picture should over-ride the blood test results - and clinical guidelines only compound this because they never state it. So as some levels are low-end here and the symptoms would fit with those deficiencies, supplementation should be tried as a first action.

It has to be remembered that these ranges are the averages, and some people's 'normal' will be at the high end of the range. So if they are at the low end, they will feel crap.

This is similar to thyroid and other hormonal problems, where again, the symptoms should drive the diagnosis, not the arbitrary test result range.

And it is arbitrary, even if it's the WHO who is setting it.

OP. as well as taking supplements, do you exercise much? That's the other thing I would suggest, as exercise regulates lots of hormones and neurotransmitters that lift mood and increase mental alertness.

Take supplements?

OP@NotSoIronMan "normal" for thyroid can be anything but .....thyroid treatment shouldn't be determined by TSH alone......have you had your T4, T3 and antibodies checked? NHS barely if ever checks T3 so you can see how backward our thyroid care is in this country. If your TSH is heading towards the upper limit of "normal" then its highly possible you may become hypothyroid....my TSH was "normal" for donkey years but i was chronically fatigued, I have now had to go private as NHS wont prescribe T3 containing meds. Thyroid levels need to be optimal and even people on levothyroxine can still be unwell as some people dont convert T4 to T3 well. Gut issues are very common in people with thyroid issues and this can cause malabsorption of other nutrients. If you are a young, menstruating woman who may want to conceive its really important you get your health taken care of.

ps. hair issues, brain fog ,low mood are classic symptoms of hypothyroidism and you are bottoming out on your other tests which if you are menstruating is highly relevant!

Just not true.
’Whereas an involvement of iron metabolism in RLS pathophysiology has been suspected for several decades and a number of pieces of evidence exist, the concrete role of iron in RLS remains ambiguous’.

You can experience the symptoms of low iron whilst having levels that are (technically) still in the range commonly deemed acceptable.

That happened to me and iron supplementation made a massive difference. (I didn´t just decide to supplement but was supported by my family doctor, btw.)

This is the problem with having population level parameters and applying them to individuals. You obviously have symptoms at these levels even though they are technically within normal limits. I would pay to see a nutritionist and start supplementing. Also really focus on eating whole unprocessed food. Alot of poor absorbtion can be down to how well your gut microbiome is and your body generally does better taking in nutrients from whole foods rather than for example cereal with added vit b12.

Your results for this set of blood tests were all within normal range except for vit D and you can get over counter supplement or ask GP for a prescription.
Low vitamin D does cause symptoms you describe.
I suspect we’re all low on this due to lack of sunshine in the uk.

You don’t say what your expectation is, otherwise. What is the overall context of needing these tests ?

Maybe you’re tiredness is due to something else so you could ask your GP to do more tests.

NICE guidelines state that B12 lower than 150 should be treated if the patient shows signs of deficiency (wide range of symptoms, some of which appear Neurological) so you could quote those. I had to do this myself last year.

I was treated with prescription high strength Vit D for levels of 36 a year ago.

I'd say the cumulative effects of so many things being the lower end of the range could be contributing massively to your overall health.

I now take Vit D all year round, B12 also all year round (My DD has injections as her levels were 100) and I also take Folate supplements as I was found to be Folate Anaemic at the same time as the Vit D Deficiency.

What is worrying you? That you’re low - normal in some ranges or do you feel more is going on?

What 'normal range' really means is 'most of the population fall within these limits' however the population includes people with diseases and deficiencies, of all age groups!

Please post your thyroid labs @NotSoIronMan so those of us who know about thyroid can give some input. Very often people with or developing hypothyroidism have low ferritin, B12, folate and Vit D.