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’?

Do go @Pixiedust1234 and get it, I didn’t mean to put you off! Just saying they dorn make it easy for people to just read it and draw your own conclusions. Good luck!

Just a PS to everyone on here - I noticed home blood test kits in Waitrose yesterday. Maybe that’s old news, I don’t know, but I didn’t know they existed. I knew you could send away online but didn’t realise they were in shops, have I been living under a rock?
Anyway there were ones for Vit D, iron, thyroid function and something else I can’t remember. A little finger prick test kit. A tenner each.
I’m not planning on using them, when I get my flu jab later this autumn (over 50) I’ll ask for a repeat test to see how my iron levels are - but if they say no, it’s good to know the home tests are in the supermarket.

Haven’t RTFT but YANBU.
They so it with ferritin as well, from what I have read a woman’s ferritin should be higher than a man’s so maybe that’s why. Apparently anything lower than 100 in someone who also presents with low iron symptoms should be treated

I would understand why they wouldn’t want to prescribe anything for ‘ borderline’ levels but why not say “you should consider taking an over the counter supplement” and explain what amount you need as most OTC supplements are only 100% RDA and will only keep you where you are rather than increasing levels if that makes sense

@MotherOfCatBoy Superdrug and Boots have a selection these days. I use two online companies, Medichecks and Blue Horizon. You can take your pick of tests for all sorts of stuff and then they send you are report back. They give you the option to share with your GP too.

Friend had tests and were told were normal. Tiredness was dismissed as having young kids. Was offered antidepressants instead as felt like shit. Turned out things like iron levels were 'normal' but only just. It's so stupid and people's health deteriorates.

At least now with the app, it's easier to see actual results rather than being told 'normal'.

That is very interesting as I thought it was online only too (and Waitrose??!).

I got the courage to go into GP surgery to ask for a printout of my results. Turns out I was being tested for stuff I had no idea about (function tests) but not one of them one was for vitamins/ferritin etc 😮

Anyway the conversation went a bit like this.
Me: please may I have a printout of my blood results, I have no idea if they are okay.
Them: if we didn't contact you then you are fine.
Prints them out.
Them: Oh... there's three different results that you need to see the GP for 😮

@Pixiedust1234 I looked into the Waitrose ones but unfortunately it doesn't give you an actual number value for whatever you're testing for, just a 'yes/no' as to whether they're in the normal range

That is one thing I've learnt from being on here... we need to see those figures!

Thank you for the heads up

@Pixiedust1234 so glad you got the actual results! Good luck with follow up 👍

Another thing not always taken into account when having blood tests is when a patent is already on supplementation but results are borderline or out of range!!

I take vitamin D, calcium, folic acid as well as other medications for chronic conditions but they never make a note of that on the clinical information when doing bloods for me. So my results come back borderline and get marked as “Normal; No action required” and filed but that’s not taking into account the supplements.

This week I’ve had bloods done at the GP because some done by the hospital at a pre-op assessment appointment last month were out of range - but, the hospital where my GP surgery get bloods analysed is not the same hospital that did the bloods last month, and the reference ranges for a lot of them are different. The GP surgery don’t automatically receive blood results from the hospital that requested they be re-checked, because they don’t communicate between the different systems and the letter from the pre-op clinic only mentioned B12 & Hb as a precursor to requesting they do an anti intrinsic factor blood test. There was no mention of my ferritin being 6 or my PTH being 9.4. So now they’ve been repeated and reported by GP as being “normal; no further action” despite it being noted on the results that they are out of range.

So 2 different labs have reported that results are abnormal but the GP surgery have filed them under NFA 🤷🏼‍♀️🤷🏼‍♀️

@LovedFedAndNoonesDead

I take vitamin D, calcium, folic acid as well as other medications for chronic conditions but they never make a note of that on the clinical information when doing bloods for me. So my results come back borderline and get marked as “Normal; No action required” and filed but that’s not taking into account the supplements.

That happens regularly with my type 2 diabetes and my HBA1C blood test results. For the last three years, they've been 65 which is above normal but the GP has marked them "satisfactory" meaning no follow up.

What he's ignored is that I'm on the maximum dose of tablets (3 different tablets) and when so highly medicated, I should be much lower, no more than 55! The GP has either not noticed I was diabetic or not noticed what medication I was on.

All I got after the blood tests was either a phone message or text message saying something like "blood tests satisfactory, no action required". I wasn't told the numbers and our GP surgery weren't putting blood test results on the NHS app at that time.

I only found out during a GP consultation for something else when I just casually asked the numbers, and both the GP (different) and I were shocked at the levels being consistently too high year on year. He referred me to the diabetic nurses to get it down!

Then after a few phone calls with the diabetic nurses, who were likewise surprised it was so high yet marked as satisfactory, they both left, and my next HBA1C test still showed the same high level. Yet again, the same GP marked it as satisfactory. Because he'd done that, the receptionists wouldn't make a consultation appointment with the diabetic nurses because the system showed it satisfactory, no further action.

It was quite a battle to actually get them to see sense and make an appointment to discuss whether I need to go on injections or not.

Shouldn't be so hard, and GP's really should take a bit more care about reviewing blood tests, especially when the receptionists "gate keep" to prevent you getting review appointments if the GP wrongly marks it down as "satisfactory".

This thread is very interesting

I’ve suffered with hair loss since my early 20’s, at the time I was told my Ferratin levels were very low and prescribed Ferrous Sulphate

My hair never fully recovered and I was never re-tested and i’m now in my 40’s with young children!

Earlier in the year, I went to the GP because I was so tired and lethargic and I had multiple bloods taken. My Ferratin was 27 and Thyroid 12 (normal range is up to 22.7). It’s all on my NHS app but It states all results were normal, after reading this thread, i’m wondering whether my Ferratin is actually quite low and I should be taking supplements? Any thoughts please 😊

Have had very similar issues to everyone above.

I have Hashimoto's and couldn't get prescribed Levothyroxine for a long time. My T4 was below range, but because my TSH was within range (by 0.2 mind!) the GP refused to prescribe meds.
I saw a private thyroid doctor who rolled her eyes when I told her this and immediately prescribed medication.

I've also had issues with ferritin. On the NICE guidelines it says ferritin is deficient if below 30. But the lab reference ranges say different, so when mine was 28 it got ignored. I then had a different GP tell me that "ideally, for good health, ferritin should be 100"

To those saying "just buy supplements!" - you've clearly never been deficient in anything. For a start you can't buy all medications (levothyroxine for example), but also shop bought iron contains around 14mg. Prescribed iron contains 210mg. Its just not comparable and doesn't work.

@Modernfamily2011 my understanding is that ferritin needs to be around 70 for healthy hair growth. You need to supplement if yours is only 27.

Remember to take the supplement with Vitamin C, and no caffeine such as coffee, tea or cola 2 hours either side of taking it. I usually take mine at night washed down with an effervescent vit c drink so I only have to worry about the caffeine 2 hours prior.

EDIT - agree with above regarding supplements but if the GP won't even admit a person is low there's no point in arguing. If it's supplements or waiting until you collapse years later, then at least try the supplements first.

You can buy the exact same iron - any chemist, or online chemist sells it
I bought ferrous fumerate online

You can definitely buy high dose ferrous fumarate on line, I take 3 x 210 mg per day. A normal multi but and min tablet is useless as contains so little

Well ok maybe you can. But would you know to buy it, if your GP says your iron is "normal"? That's the issue. GPs don't tell people they need ferrous fumerate. They tell them their iron is fine when it's 17 or something. And those people might think "ok well I'll take a supplement to be sure" but they take the 14mg iron you can buy on shelves and their iron doesn't increase and they keep feeling like shit.

@Modernfamily2011 and anyone else concerned about their ferritin levels, this FB group contains detailed factual guides on ferritin - what it does, what happens when it's low, the role of transferrin, how to supplement, what cofactors you need & how to interpret iron panel test results: www.facebook.com/share/g/aRYUCU7sifVcXcv9/?mibextid=K35XfP

I've found it to be a really useful source of information.

Sorry but I found that group quite dangerous, there's a lot of anti vaxxer types on it, lots of dismissing the conventional medical community (which I know can be lacking often) it just goes down a lot of peculiar rabbit holes.

@Courgettesareready I don't read the comments from individuals (and I'm definitely not anti vax!) but I found the guides really useful. My ferritin was 7, I was having weird food cravings, my hair was falling out, my nails were a state and my GP was useless.

I also found this article linking low iron levels with long covid interesting - www.cam.ac.uk/research/news/low-iron-levels-resulting-from-infection-could-be-key-trigger-of-long-covid

Ah ok yes that's good! The comments were hair raising !

I dunno, I'm not sure these tests are definitive, that's the real problem with them. Why they aren't cost effective.

Out of curiousity I had my Vitamin D tested a few years ago.
I had zero symptoms of deficiency & a summer tan (I'm outside a lot)
I was just assuming I'd come back high.
The test came back borderline too low for healthy.
Which really shocked me. All it proved was that the test wasn't reliable for indicating deficiency.
I continue to have zero signs of any Vit D deficiency.

Just a quick update for you all…. I called the GP yesterday to discuss my Ferratin levels from the blood test taken earlier in the year.

I stated that I thought the level of 27 seemed quite low and she instantly agreed with me and prescribed me Ferrous Sulphate, her exact words were ‘That is very low and you must feel a bit rubbish’

I’d like to thank @SailAwaySandra for starting this thread as I genuinely had no idea about the threshold until reading this and would Never have checked my own results if it wasn’t for this