Arsed off with doctors ignoring blood results

[Outsidetheclickclack]

…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”

Im not sure thats what the poster was saying was it though?

I thought the gist was the GP said 'nothing to see here' in terms of the low levels, simply because she is menstruating

Whereas surely the answer from the GP should be 'you're menstruating and therefore your levels being low needs treatment'

So its not saying it needs more investigation but if you're pre menopause AND have anaemia then its treatment you need surely

So sorry this happened to your DD :-(

It seems common especially when it comes to ferritin blood tests. In my trust the lowest end of the normal range was 11. Mine was 8 and has only just came up to 11 after 3 months of supplements and GP wanted to stop the supplements. In the end she prescribed another 3 months because my symptoms hadnt improved but I’ve decided I will buy it from an online chemist once the 3 months is up and continue taking for at least another 3-6 months. I have terribly heavy cycles and feel each month just depletes any stores that have built up.

go back and challenge the gp OP. Or just buy ferrous furmurate online. It’s about £8 for 3 months worth.

My ferritin dropped during peri (erratic bleeding) GP didn't act upon it although I asked for the results. I managed to proactively correct it with supplements. I took a high dose of ferrous fumarate for a while and now take around 20mg/day as maintenance and more if I'm menstruating. I use a combination of Nutrition Geeks Iron Energy Plus and Feroglobin Plus and I'm now full of energy again. I do train heavily (6 days a week) and I'm a heavy sweater and bleeder so obviously need more than some others may.

Sorry I haven't RTFT

But this is so commonplace and it sucks. I have a good GP now who would say stores are low if they're not above 50 and to use ferrous fumerate. However I was battling with low iron for about 15 years on and off supplements with doctors saying "it's just your period there's nothing we can do" before I was prescribed tranexamic acid. I feel like we are just expected to get on with stuff.

I hope you find a resolution. I use ferrous fumerate 210mg with high strength vitamin c on an empty stomach. I use it every other day as apparently high dose iron releases some chemical in your body which reduces the absorption rate so taking it every day can cause more side effects but be less effective

YABU.

The human body is not a machine. Every single person has different biology. it’s a bit like looking at the height chart in the baby red book and saying a 6’ woman is abnormal because she is off the top of the chart. The chart covers most people but not everyone.

Plus the tests themselves might not be an exact science.

That said, you are obviously worried and it is fine to contact your doctor (or perhaps better still a different one) and discuss things further. Perhaps you need some other blood tests or investigations. Hope you feel better soon.

You are mildly iron deficient very common in women of child bearing age. Many oral iron containing mulri vits are availible otc. You don't need an iron or blood transfusion. What do you want your doctor to do ?

This exact scenario happened to me today. I had a blood test for liver function as i am on some medication that can in some people, be toxic for the liver, and when I looked on the NHS app, my serum ald level was outside of range. The normal range is 15 to 55 and mine was 60 and when I looked back at results from 6 months ago, it was 17 so that's quite a jump. I then noticed a statement asking me to contact the surgery and when I did, they said it was nothing to worry about as it would need to be double to warrant further investigation. This just ridicules the normal range then and makes no sense at all. I have another routine blood test in about 6 weeks so will see what that comes back as.

A ferritin under 30 should always be treated. Refer them to the WHO guidance. However I’ve had this problem for years with GPs so just buy myself the 200mg iron tablets

My ferritin is 17 too. The report says consider iron replacement but My results say satisfactory no further action. Not even a text to say take an iron supplement.

I had Thriva blood tests done at £240 for the ones I chose and went to the doctor. They were all outside the normal range so I framed the conversation when he tried to fob me off with ‘all my family are dead of stuff indicated by this shit so I want optimum results, I’m prepared to buy my own stuff I just want you to do your job and tell me what contra indicates as you know more than me’

that went MUCH better ^^ He’d also not read my notes so I told him I spent £17k of my own money on reducing my obesity he was a lot more helpful.

this was about 4 years ago, now I can work it out much better with ChatGPT and not bother the health service.

I spoke to one of the GPs at our surgery (I never say 'my GP' as its never the same one twice) and he refused, utterly refused to talk to me about supplements that I was buying/wanting to buy. Presumbly because they werent prescribed on the NHS

I got told your blood sugar is 53 that’s a great result. I told them last test was 50 so I was concerned, was told that’s still a good figure all is ok. I was told it’s probably just a blip that will sort it self out don’t worry about it

this thread has made me want to take it further

Its almost like doctors want women to suffer

Anaemia should be investigated even in menstruating women, if NICE guidelines are that it shouldn't then the guidelines are wrong. Women should not suffer undiagnosed coeliac disease or gastrointestinal bleeding or anything else just because they also have periods. And when it is down to periods it still needs to be treated (supplementation, infusions, trying different contraceptives to try to lessen bleeding etc.), it absolutely is medical misogyny to just say this is normal for women, get used to it.

At some point, I presume some very clever people got in a room and decided the “normal” range for every blood test conceivable.

There is a significant difference between a (statistically) normal range for a (statistical) population, and a desirable range for you.

If you take the readings for all "healthy" people in the world, across all ages and genders you end up with a vast range of numbers. Somewhere in that set you'll end up with an average (either mean or median) and a range where 60% of the readings live.

That's how these numbers are calculated. You can take those numbers and do the same thing for certain ages or genders or race etc.

But ultimately you will vary from this average and that does not make you unwell. The important information is in comparison to your earlier self which indicates possibly worrying change, and in conjunction with all the other metrics.

This is not a doctor overriding the experts.

This is a doctor using the information gathered by experts and using that to inform the decision making regarding treatments.

Probably why it's best not to get medical diagnoses from the Internet

Equally, it's why it is important doctors actually listen to patients rather than just looking at their test results

After living undiagnosed with a serious and debilitating condition for 20 years because doctors kept dismissing me because my test results were normal* (even though, looking back, every time I went to a doctor during a flare there would have been clear facial clues to my condition) I am tired of the "don't Google" type advice. When doctors dismiss our struggles why shouldn't we try and seek our own answers. Especially when there is a very gendered element to dismissal of symptoms

My test results were only normal" because they didn't test for my condition.

ALP rises in children are usually just from bone, secondary to growth. There’s an upper limit for the lab, but the true upper limit can be pushed up in a child amid a growth spurt.

Totally agree with posters saying not to just completely rely on doctors reading and interpreting your blood tests accurately, and then informing you on "within normal range - no further action".

Like someone above, I've not seen the same GP twice in about five years despite going every 6-12 months for blood test related things (fatigue and unexplained historical low ferririn being one). One last year prescribed me HRT patches ready for my next visit. When I went, the next (female) GP said the usual "how can I help?" Because they seldom have the time to look at their screen before they call you in. I was there for a couple of long-standing issues, so started from scratch (again, frustrating). She looked at her screen and said with confidence "FSH levels are fine so you're not in menopause". I actually snort-laughed and told her that we all know that that blood test is wildly unreliable/can be inaccurate, and I do know my own body, so I'll have the HRT patches now please...*

*she then knew nothing about them, asked me to read her screen and help count how many I'd need, prescribed the wrong amount so I only had one month supply instead of three, didn't take my blood pressure or tell me any potential side effects just said "read the patient leaflet", and didn't tell me you can buy a 12 month NHS HRT prescription prepayment certificate for just under £20 which will save me a lot of money. All the latter info came from the very helpful Pharmacist.

I think there's a difference between googling your own condition and disparaging your doctor as OP seems to be doing.

I agree that doctors should listen to their patients, and also that patients should advocate for themselves.

All doctors are taught the difference between signs (observed, measurable) and symptoms (reported by the patient, subjective). Both are necessary to accurately diagnosis - though again, many illnesses can produce very similar effects on the body, so GPs are taught to assume and treat for the most common illnesses first, working their way through less common ones as prior treatments fail.

It sounds like your doctor ignored visible signs (facial clues) relying only on clinical tests, which is very poor practice.

But to revert to the "normal" theme It sounds like your face was "abnormal" during a flare and you could see that. If your doctor has never seen you at a healthy time that face may well seem normal for you unless you are reporting that change as a symptom. It is one of the things we seem to have lost, having a GP that knows you over the years rather than a new doctor on each visit to the surgery, and who can therefore detect those differences in you themselves.

I agree with you that the Internet has become a very useful resource for patients and GP's alike but some of my medical friends lament the fact that people present with their own 'certain' diagnosis instead of reporting their own symptoms, or (now knowing the symptoms for their perceived condition) then overemphasise those symptoms to the doctor.

I'm glad you finally got treatment for your condition. It saddens me that you've had to suffer so long.

Lots of doctor bashing on here, one poster actually saying that doctors want women to suffer going completely unchallenged.

There’s clinical judgement, which a doctor uses in conjunction with history, examination and test results. Not to mention years of study and seeing thousands of patients. If you don’t want the benefit of that then get some bloods done, do a google search and treat yourselves.

Doctors are human and do make mistakes, medicine is an art not a science and people present differently. I’m sorry some people have had a bad experience of healthcare and don’t feel listened to, genuinely- hav experience of this in my own family. But this thread is getting out of hand.

I had very clear ptosis during flares. It wasn't obvious to me (until I looked in photos later) but should have been a clear flag to drs to follow up. My facial symmetry was also asymmetric and dropping at those times and with hindsight I find it staggering no doctor looked away from their screen (showing the "normal" results) long enough to notice it.

I am afraid women in particular are often dismissed time and again this is borne out by statistics. Rather than get defensive, I would have thought female GPs would want to hear these stories and bring about change

I would hope that ALL GPs would want to improve things.

I have found, sadly, that many women GPs are even less open - perhaps something to do with having their authority challenged more often.

Ironically, I have ptosis. Always have. I don't think anyone has ever remarked on it except the optician who was suggesting I would need to get surgery at some point.

I am/was unaware that this is a signifier of some greater condition...

... I shall go Google ;)

Myasthenia gravis. The key is ptosis that worsens with fatigue /illness. It is very evident when I am ill, not at all subtle. But I am not one for gazing in mirrors so always just assumed I was blinking in the photos until I got my diagnosis and realise it explained all the patches in my life where I had gone to GPs repeatedly when struggling with severe fatigue

Ptosis is also a stroke symptom...