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 can buy it online for less than £2, cheaper than a prescription https://www.mypharmacy.co.uk/product/ferrous-sulfate-200mg-tablets/?gad_source=1&gclid=CjwKCAiA8NKtBhBtEiwAq5aX2IuGd-I7IdGus2Q1KQ1k67inwfIj95KZ6HcG7qw92sza5REI-ZPwmRoCpuAQAvD_BwE

Rather than buying supplements which are poorly regulated can cause issues if taken in excess how about looking at your diet? I would suggest tracking on cronometer for a few days to see what you are lacking and addressing that way. I found out my b12 intake was 800% of the rda but b5 was just 25% so I have made sure to adjust my food accordingly.

https://www.everydayhealth.com/news/supplements-risks-every-women-should-know/

That's weird. I've asked in a number of pharmacies around here and in the next town over time (as it tends to be one of those things I'll get when I am out and about for other things,) and the only time they've said no is because they don't currently have any in.

I do get where the pharamacists are coming from. Routinely low iron should be investigated, in practice most GPs don’t bother as they put it down to periods if you’re female. Easier to throw iron tablets at you and not think about anything else. But potentially someone could have a malabsorption issue like coeliac disease and should be tested, they could even (unlikely) have internal bleeding/cancer and there should be some sort of discussion to rule that out.

Gp marked my ACR result of 33 as normal. A quick Google says it's not normal. The app also says patient informed. I haven't been informed by the doc. I know i have kidney disease and my results are probably what they would expect but would prefer things to be labelled as abnormal but expected. By saying something is normal I feel it is denying that I have a problem.

I only tried one pharmacy, maybe I should have looked further afield. I imagine if you’ve had that experience then it was a one off problem with the pharmacy rather than a general issue.

GP means no evidence of disease which appears true.

You may benefit from vitamin d and inc iron in diet. But sounds like your low mood is the problem.

It has taken 8 years and my hitting peak don't give a shit peri for them to admit perhaps I have a malabsorbtion issue.
My partner has been discharged with heart failure rather than admit he may have not completed the angioplasty he stopped, then rushed properly. So blond faith in the nhs is not a good idea

suddha I am NHS

• the NHS has calibrated analysers and the normal results for that analyser and for the measured value are given after the result in brackets, highlighted in red if abnormal. So the results range is accurate. As I said other countries use both different units and different analysers so can't directly compare.

Also consider:

• if a result is at lower limit of normal then in the context of the clinical picture a repeat in a certain time span might be needed, or general monitoring
• some tests can only be repeated after a certain time including B12, Folate , ferritin as stores last for specific periods so you have to wait until the stores may have been depleted think it's 3 months but the lab states it on the results form and rejects earlier samples.
• both GPs and hospital Drs follow guidelines regarding red flags, electrolyte replacement, hypothyroid treatment etc. they are guidelines, we can still treat slightly differently with good reason on clinical judgement but that has to stand up to scrutiny. Some treatments will be based on clinical experience and expertise of what has worked before- guidelines are great so all clinicians can easily find them and use them but experienced clinicians can use judgement too.

If people feel they have been incorrectly informed of results or something has been missed that's entirely different. But the lab is usually accurate and there is no conspiracy to under treat.

@reflecting2023 lots of people feel unwell at levels the NHS regards as “normal”, me included 🤷‍♀️

And vit D has a normal and a borderline range.
I just get fed up of people making such inaccurate statements because they've decided to have an opinion which isn't based on any reality.
Another thing to consider is

• some ' abnormal' results are of no clinical significance ( some of the fbc results) and don't need to be acted on

I understand that, but that could be for a variety of reasons. Some might need further investigation and looking at other things abd taking the whole picture into consideration

I agree I wouldn't want my B12 at lower limit if normal, or vit D I'd probably take supplements

It is interesting to me that these do seem to be largely women who are struggling with low levels of iron/D, which is obviously because we menstruate. If half of the men you knew regularly had to buy supplements every month to stay awake and not get depressed, do we not think the NHS might consider doing something about it?

Are you currently taking any supplements at all?

If you want to take vit D iron and folate supplements just buy them or change your diet

Reminds self to chase GP about mine. Consultant said folate was low and I told GP this, but no action. Plus I wonder what else was low?

For me personally, if ferritin levels were lower normal and lower limit serum iron, and there had been previously abnormal low levels I wouldn't be against someone taking iron supplements at low level to keep it in normal range,in the context of a woman of child bearing age and no red flags. Maybe a low dose daily or a week a month.

Folate is largely diet related so easy to keep normal level

Folate normal. Are you sure upper limit is 9000? Not that it matters but usually people on supplements often have >2000 but it's usually due to poor diet so usually continue them lifelong esp on elderly or with background disease

• think that B12 level might be an intermediate level but will have to check when back in work

But the issue is many GPs don’t do further investigation. Mine haven’t. They said the blood tests show nothing so case closed and basically accused me of it all being in my head. It’s not, I have felt unwell for a long time. They don’t give a shit. I love the NHS and there are many hardworking and wonderful people within it, but the system is broken and there are a lot of unwell people who aren’t getting the support they need at all.

Yes exactly! Blood tests are clear so you get told to go away. So many other things your pain could be - Lyme disease, crumbling spine, MS, etc. But your bloods are clear so it must be anxiety, off you go without an MRI.

I would trust Dr Mumsnet much more than a qualified GP. Agree with you.

I don’t think that’s the situation, sometimes you’re so into it you need someone else to say - you’re not crazy, keep pushing to get the support you need or not.

Are these the NHS guideline values for vit D?
Serum concentration of 25-OH D (total vitamin D)

• <25 nmol/L – DEFICIENT
• 25-50 nmol/L – INSUFFICIENT
• 50-75 nmol/L – ADEQUATE
• >75 nmol/L – OPTIMUM

Is Vit D recommended blood concentration from NHS really so different in 'many' other countries?