Arsed off with doctors ignoring blood results

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…because they are “just out of range” - therefore don’t need actioning

At some point, I presume some very clever people got in a room and decided the “normal” range for every blood test conceivable. So why is it ok for a doctor to look at results outside of the range and say “don’t worry about it”, “it’s only just outside”, Presumably the clever people have already agreed what is normal and what isn’t? So why does Dr Smith get to decide it’s actually ok and doesn’t need any follow up or treatment because it’s “nearly there”

I have been on these for years, after taking different ones (I have IBS so need something gentle on the stomach). I too have had tests and a colonoscopy to rule out Coeliac and other things after years of iron deficiency without anaemia. All negative. Anecdotal but just been diagnosed with ADHD and there is growing evidence that low Vit D, B12 and iron is common in the ADHD community.

Solgar gentle iron:

https://amzn.eu/d/0jjz9OxD

Also this high strength Vit C at same time:

https://amzn.eu/d/02eSD45y

Also worth researching things which inhibit iron absorption, such as tannins in tea and alcohol (one of the reasons I've all but given up booze).

I had a full blood count done recently. Test was out of range so was asked to complete again in a month's time.
When the second tests came back ,still out of range and the word 'other' appeared on my record.
When I googled other it means that as two test are out of range you should see your doctor to try to find out the cause and potentially have other tests done. A week went by and a commentary appeared saying 'patient informed' but I hadn't been. If I hadn't looked up other I would have had no idea I was supposed to make an appointment.
When I pointed this out a doctor sent an email apologising and suggesting I make an appointment to discuss the results. Apparently her ginger had slipped on the wrong button resulting in patient informed when I hadn't been.
It seems to me they had no intention of getting me to make an appointment and by putting ,'patient informed' on the record it covers their back if I'd had a stroke or something and no tests had been done. It would look like I knew the advice was to come on but had chosen to ignore it.
When I did get an appointment, they just said that there was no need for investigations as the results were ',,just out of range:. No queries about my general health even though I told them of being very fatigued lately. As I haven't seen a doctor in ten years, I told them I was concerned about something and the bloods were slightly off you would think this would warrant at least some further investigation. What is happening to our precious NHS! I would be interested to hear a doctor:s take on this, especially in bore of the untrue patient informed. Is there now a culture of over worked doctors fobbing off as much as possible?

https://www.bbc.co.uk/news/articles/c8ex68544xko

Too many GPs look at the blood tests on the computer screen and disregard the symptoms. If they want to argue that these blood test results do not account for the symptoms (maybe they are right although seem low to me) then what is their next action for investigating what the cause of the symptoms is. A negative result does not mean you are well rather that they haven't done the correct diagnostic test yet. And even if they believe it is all in your head what action are they taking to give you the mental health support to help.

So from that, your ferritin is low, but what do you want the NHS to do? They can’t force you to take an iron tablet. There isn’t really at this stage anything else to action. You need to take some iron and likely change your diet (more iron rich foods, less of stuff that might irritate your digestive tract and impact absorption like alcohol).

Can you start an iron supplement OP? I had ferritin of 17 recently and started taking a supplement, gentle iron bisglycinate in the evening with vitamin C.

It's so annoying - GP also told me my B12 was fine even though it's in the low range of NHS ranges. Googling it says it's alarmingly low along with a number of other concerning things on my blood test.

Have you asked them to check for coeliac disease at all?

Coeliac is normal

Appreicate the “improve your diet advice” but respectfully my diet is very good.

I eat liver once a week, red meat twice a week. Spinach everyday in a smoothie. Greens with almost every meal. One coffee a day and hardly drink. Do you know how much red meat you need to eat to get enough iron? It’s something silly like 5kgs a week.

What more would I like them to do? I’d like an acknowledgment that this odd thing has happened so in light of that we aren’t going to just dismiss out of range tests. I’m perfectly able to advocate for myself - what about the people who aren’t?

My question was actually about ranges - and how easily they are dismissed (see multiple examples on just this thread). The range has been agreed, what gives GPs the ok to dismiss results outside of them? Presumably the ranges were set by people who also (like GPs) know what they are talking about. Isn’t that the point of NICE guidelines?

On a similar vein, I had twenty years of "your blood tests are normal so you can't get ill" only to discover I had been ill all that time but not with something they had been testing for!

If its still that low even with supplements have you thought about asking for a test for h pylori? Ir even getting on privately maybe? It should be going up with supplements. The fact it isn't suggests DIY have some sort of absorption issues

Have you tried iron syrup? It's much easier on your stomach!

I have the same ferritin level and its been around that point for at least 10 years. It was only this year that I realised the GPs had been telling me that its 'normal' are actually wrong!

This!! I've seen it happen over and over, you go for a problem, they do tests, nothing shows up and.....nothing then happens! No interest in finding out what the issue actually is from that point on, it's just blood test and then nothing.

Medical ranges are 95% confidence intervals for normal people, which means that 1/20 healthy people will get tests beyond the range.

A lot of the tests also vary day by day with hydration etc.

Doctors are trained to look for patterns, as well as see how they with the symptoms.

They do sometimes get it wrong but one set of blood tests slightly out of range doesn’t say very much.

It sort of does when the range is ridiculously wide though surely? Ferritin levels of 17 are not 'just outside' normal

Had this issue last week , my kidney function had dropped from 21 to 14 and I was feeling really unwell - it was reviewed as ok and if I hadn’t checked nhs app I wouldn’t have known I needed to take action urgently

My GP did this with my thyroid test. I have had Hashimotos and hypothyroidism for 20+ years. I recently lost 45kg, had a chat before blood work with the pharmacist for 'medicine review' and asked if weight loss affected thyroid medication. I was told no, it was irrelevant due to blood tests.

Made sense. Blood test comes back and, for the first time ever, says I'm borderline hyperthyroid. "Satisfactory - no further action need"

Well, that was 7 months ago and now I have night sweats, racing heart, irregular periods etc.

Is it perimenopause or thyroid medication overdose which, as I now understand, is the primary reason for hyperthyroidism in a large swathe of the population.

Who can say? Symptoms overlap so no idea.

I feel sorry for you/us. I don't understand this trend. We have to be proactive but it's hard for me to approach the same people who messed this up in the first place.

Don't have an answer but do sympathise with your position.

Well for a start the doctor could say her ferritin level is low and she ought to take iron supplements (or actually prescribe them!) rather than say everything is normal and nothing to worry about. If OP hadn't checked her results herself she wouldn't have known she needs to take iron, and there's a lot of patients who will just hear the doctor say 'everything normal' and believe that instead of checking results themselves.

All of these issues are compounded by the fact that the NICE guidelines for ferritin levels are significantly wider than comparable countries.

In France they intervene below 50. I don't know how the NHS levels are so out of kilter - perhaps the French definition of healthy is "feels in good health" but we translate it to "not in imminent need of hospitalisation".

It is low. Buy some ferrous sulphate from a chemist and take one in the morning with fruit juice & avoid tea/coffee for a couple of hours after you take it to maximise absorption. Do this for at least 3 months. If it gives you diarrhoea or constipation, move to taking one every other day.

I asked if I stabbed myself in the ovary would they operate quicker…

That ferritin is too low. The ideal number is about 100. Not encouraging you but ferrous sulphate tablets are available over the counter in a pharmacy. Your GP does not understand ferritin levels

Same. I had literal kidney failure and my GP was like hmm yes that’s low (EGFR of 55…it’s meant to be over 90). Note they only mentioned this when I called up and queried my dodgy AF blood test results

see also being extremely anemic which I had bloods done at a&e and no one mentioned it?

Further to another poster, about 3-6 months will improve the levels. I am current using iron tablets for low ferritin right now

It's not 'medical misogyny' to say that a menstruating woman with iron deficiency anaemia doesn't typically need investigations - that's following the NICE guidelines. You are losing blood. Men do not menstruate (or get pregnant and potentially have dilutional anaemia in pregnancy & lose blood in childbirth) so the guidelines will be different for males.

It's also worth pointing out that iron is very dangerous in overdose and too much iron chronically is damaging - hence why people with haemachromatosis have regular removal of blood to reduce their iron levels.

Surely they should also rule out other issues first? Dd was fobbed off for years over her anemia and was told it was because of heavy periods. Turned out she had coeliac disease.

She was going to the dr one week with low vit D and anemia, the next week with constant stomach ache and vomiting (only one symptom per appointment so you can’t discuss everything together). After 8 years of this I asked if it might be coeliac disease and it was!