To wonder why the NHS has such a high threshold for blood work?

[SailAwaySandra]

In a nutshell, my folate levels are actually low after all. But they’re NHS borderline.

For about 6 months now, I’ve felt like utter death. Really stanage symptoms, fatigue and joint pain making me feel like walking through treacle.

It turns out my folate levels are borderline and actually low. And the ideal is that they’re much better than they are!

I’ve had 3 blood tests via the NHS, each time going to the GP very worried as I am only 26 and physically felt like my body was aging! Sometimes I had to flinch to move a leg, for example, if I had to sit for a minute or so and get up again

GPs kept saying all was normal. Nothing to worry about.

Paid for a blood test and told within 72 hours that my folate levels are too low. And to take folic acid (I’ve already put loads of it in my diet)

Why or why did no GP say ‘it’s within normal range but your folate is in the low side. You might want to consider buying some folic acid and introducing more of it into the diet’?

But they're wasting money by not diagnosing and treating correctly in the first place.

The normal ranges cover 95% of the population with the rest naturally running higher or lower. As bloods are hardly ever checked when people are well, their own natural range is usually unknown.

As a GP I generally treat if the lowish or highish results fit with the symptoms and then review after an interval to see how things are going.

I’ve been round the block a few times, however, and am not afraid to follow my instincts rather than slavishly sticking to the current protocols.

There are regional differences in normal ranges too, which is crazy. When I worked in the northeast, Ferritin normal range was 40-400. In the midlands normal is 13-400. Bonkers. For hair loss the Dermatologists suggest aiming for Ferritin of 60+

I always ask for my blood tests results. It's not being awkward, it's the fact that my condition was missed for the best part of 8 years until a visiting GP opened all my blood tests

8 years ago I had a blood test that said neutropenic with left shift neutrophils (more immature ones) and nobody bothered. Spent years in and out the doctor with infection after infection and nearly lost my job due to sickness. All blood tests "normal" (but they weren't)
Was eventually diagnosed when my neutrophils hit rock bottom (0.2 at diagnosis)

Agree with the PP, why not just buy over the counter supplements?

Firstly you can’t always buy over the counter supplements. Some are available over the counter but not all, and not at the high dose you’d need if you had a deficiency. For example you can buy Vitamin D pills over the counter which are 1000iu, but you can’t buy the 20,000iu pills that you need to treat a deficiency.

Secondly, you can poison yourself by taking excess vitamins you don’t need. This is exactly why you can’t buy them over the counter and have to get them on prescription!

You need a blood test to diagnose what vitamins you’re deficient in, so you’re only taking the supplements you need. Pushing your levels too high is just as dangerous as letting them drop too low.

It's not about their tolerance being too high for blood work. They don't have enough money to service the population.

You do know that you can ask you your blood test results and see what all the results are. You can either get a printout from your GP practice or see it online via your NHS records if you have access that way. No need to pay for a private test if the GP has already done the work for you.

You can buy those vitamin D tablets over the counter or online (just in case anyone is reading who needs them!)

That's not true you can buy the high dose ones over the counter you just buy them online. Although I know some people who take them all the time which is a bad idea. But you certainly can buy high dose good quality vitamin D yourself.

Agreed

For vitamin D, which I was severely deficient in a few years ago, I found the sublingual spray really excellent and would highly recommend it.

That’s nuts! My ferritin reading was 17, the range being 15 - 300. So only just within “normal” - and if I lived in the Midlands rather than Wales it would be below normal! What’s that about!!!

I think it’s because the minimum is set to “probably won’t die”. I moved country and my endos here just brilliant (happy to keep tsh and near 1 where I feel best and suggest ferritin should be around 60 for women) . Tbf my UK GP was great but she seems to have been a rarity.

I still work with “northeast normal” so you’d have got a prescription 😁

This is a problem in the uk that impacts many different types of testing including blood pressure. I was reading recently that many lives could be saved for different heart related conditions of the BP limits were changed because again what nhs considers normal or borderline actually is in the danger zone. I'm assuming it's because they just want to offer the bare minimum and changing these thresholds would mean more ppl to see.

The NHS is shit sadly. DH went for an x-ray yesterday for his hip. He got one, one x-ray to the front. He queried and apparently that's all the NHS pay for. When he had his last one, privately, they did several. The response from the radiologist was that if it wasn't clear, had would have to come back for another "one" and so on. So inefficient. Also he needs an ultrasound, but couldn't have it at the same time, because, you know, NHS.

Could I ask where you get private blood tests? I've recently had an NHS one which shows borderline high cholesterol in a few areas, as well as low calcium (which they didn't bother to tell me about - told me all tests were normal then saw that it actually had flagged as low when I asked for the print out!). I'd like to try and address these and then get a follow up test in a few months but doubt the NHS will find another blood test!

Ask the reception to allow you to see your health record on NHS app, you can then see all your blood tests / GP comments etc. We rely on that to look at the blood results properly as DD (16) has been low in so many things over the last 4yrs. This way I can see anything that’s borderline etc too.

I totally agree with some of the people on here, I had loads of blood tests as I was exhausted all the time, ached etc, the Dr kept saying oh your thyroid levels are low but not low enough, even though I pointed out underactive thyroid runs in my family after 4 years it dropped low enough for levothyroxine and I feel a lot better but why did I have to wait four years for it!

You can't get thyroxine OTC. You need a prescription.
NHS prescribing of thyroxine is woefully poor, and it can cause a whole host of cardiac treatments if not treated adequately. It's well known outside the NHS thyroxine should be prescribed once the TSH level is failing, as this indicates it's not working, but the NHS refuse to do this, much to the chagrin of many endocrinologists.

What it means is I’m not on Hrt. I am on thyroxine. I have fibromyalgia, brain fog, and low energy.

It would be good to make sure I’m on the best levels of HRT, amitriptine and thyroxine to minimise brain fog and maximise energy.

I can’t tell if the fatigue and brain fog are the result of underlying conditions, under medication or over/unsuitable medication.

I don’t know whether to increase amitriptiline to reduce pain fatigue or whether that will increase brain fog. HRT seemed to make brain fog worse, but maybe the right one will make the fatigue and joint pain better.

It may not seem scientific to you but it’s my situation and it would be nice to understand it better.

Drugs don’t only interact with each other, they interact with symptoms and side effects.

Are you a doctor?

OTC iron supplements aren't at the therapeutic dose to treat iron deficiency. You need prescription ones. It used to be fairly easy to go into a chemist and buy a pack of ferrous sulphate/fumarate, but now they are very very reluctant to sell them due to the quite serious side effects that too much iron in the body can have.

And I’m on a massive dose of Vitamin D which could potentially cause issues, but my vit D doesn’t quite reach normal.

On the nhs app I can see the past 20+ years of history - interesting to see trends

Part of the push into privatisation.... it worked. You went private. As did others on this thread....

Agree.. almost everyone I know, including myself, has had to pay privately, sometimes several times, in the last five years / we are all 60+ so naturally various health issues popping up