GP refusing to re do blood test despite worrying result, should I push it?

[TakeALookAtTheseSwatches]

My teenage daughter had some blood tests done about 3 months ago due to repeated dizzy spells. Her ferritin was very low which I expected it might be, however, one of her liver blood tests also came back really high, they repeated the test 3 weeks later and it was still very high, they said it was probably due to vitamin D deficiency so put her on a high dose of vitamin D as well as iron tablets.

They told me to get repeat bloods in 3 months so I've booked her in but they will only repeat the iron/ferritin test and are refusing to repeat the liver blood test, apparently they don't do it after vitamin D treatment which just sounds bizarre to me, surely they need to know if it's come down? Is this standard practice? Would I be unreasonable to try and insist they re test it?

You could, but I also suspect it won’t be expensive privately, I’d just do that.

I would try and insist. If not is private an option.

It does seem illogical, even without medical knowledge, to give two treatments (vitamin d and iron) and only test the outcome of one (the iron) later on to see if it worked.

Ask formally for a second opinion.

That’s nuts.

I don’t think you should have to spend money because of inadequate NHS treatment. I’d complain to the practice manager and push for second opinion.

Thanks, I'll ring up again on Monday. I don't know if I could afford to go private tbh.

They absolutely should redo the liver tests. There are various tests for liver function and you say one was really high. Obviously I can’t make any judgement on just one unspecified result. However in my department we quite often do liver biopsies on people with abnormal liver tests who are otherwise apparently healthy and the abnormal result has been found unexpectedly as part of some other investigation.
DD has a friend who had liver function tests as part of work up for going on roaccutane (acne treatment) and the results were abnormal. Turned out she has a relatively rare congenital disorder (I’ve forgotten what it’s called, sorry) involving the blood vessels in the liver and had to have major liver surgery.

Whilst the GP should do it, if you really are getting nowhere it’s not difficult to get blood tests done privately. I have used Goodbody clinic. It’s £2-300 depending on the tests. They’re really good with a GP discussion and advice afterwards.

https://goodbodyclinic.com/?gad_source=1&gad_campaignid=23276978377&gbraid=0AAAAApDqcnCq4gZpXRYE5hg9gkVHGcEpc&gclid=CjwKCAiA4KfLBhB0EiwAUY7GAd1GwDLPF4doNfgDJIkiNME-8aqB5Zl3Qm-mPEgGKmIPr6VCnET2yhoCx1YQAvD_BwE

Would it help to formally ask for it by email ? I’d definitely want it done too.

You could ask for a second opinion from another GP, although if they are from the same practice they may give the same answer.

https://www.patients-association.org.uk/getting-a-second-opinion

LFT reference ranges in children and young people can be very different from in adults. Was it the alk phos that was abnormal?

Private care may be cheaper than you think - where I work, we would only charge around £45 to do a set of LFTs, though we usually only do blood tests for patients in whom the test has already been requested by a doctor (be that one of our doctors or another one). A private GP appointment in my workplace would add another £120 on top; prices vary a bit depending on clinic and location, but we are fairly average for a private clinic outside of southeast England. Personally I wouldn't have a blood test done without a doctor who will interpret the result for you. Interpreting the test result is the hard part!

Was it alk phos? That is affected by both the liver and the bones, and is often raised in children if they've recently had a growth spurt?

Was it the bilirubin? If so, she probably has Gilbert’s syndrome which is completely harmless.

It will be alkaline phosphatase and I don’t think that it’s that unusual not to repeat it.

Yes it was alkaline phosphatase, they didn't tell me the actual numbers but rang me as soon as it was back to say it was "very high" and it remained very high after 3 weeks (they said it could have been one abnormal result but turned out not to be) she has some congenital kidney problems too so it worries me that something else could be going on.

Also she hasn't really had a growth spurt recently, her big growth spurt was a couple of years ago and her height has only changed marginally since then.