Can anyone help with these blood test results please?

[littlecupcake]

Brief background - went to GP last week because I was worried about my heart racing all the time, even when resting. Not sure how long it's been going on but I would say at least three weeks.

She asked about history of anaemia (have been prescribed iron tablets in the past, during and after pregnancy), family history of thyroid (there are thyroid problems in the family, on my DM's side) and stress (oh yes, plenty of that with two small DC, a house move and heavy workload). I also told her about my 'brain fog', inability to remember even simple things, being exhausted all the time and a general feeling of the world rushing by. She sent me for an ECG and blood test.

The ECG looked normal according to the nurse, although she said my pulse was fast and the GP will discuss the results with me. I got my blood results over the phone on Friday and have a call booked with the GP tomorrow to discuss them and the EGG. The thing is, the results were all within the normal range, but I don't understand why I feel so dreadful and really don't want to be fobbed off.

Can anyone look at these results to give me an idea of the sorts of things I might push for? I'm not asking for a diagnosis, just some moral support really - it's a year since the last test and the results were much the same, so I feel I've put up with this for long enough! Thanks for sticking with me if you got this far!

Results (normal range in brackets)

Haemoglobin 125 (115-160)
White cells 5.4 (4.0-10.5)
Red blood cells 4.12 (4.0-5.2)
Serum TSH 2.3 (0.27-4.2)
Serum ferritin 29 (13-150)
Serum glucose 4.4 (2.7-11.0)
Serum vitamin B12 353 (197-866)

Your ferritin level is on the low side although within normal. If mine is that low I get told to go back on the iron tablets (I have anaemia and am hypothyroid).

Thanks Fairylea. Hopefully the doctor will suggest something to make me feel better. I struggle with the ferritin levels - last year they were 7 and I felt appalling!

DH woke me up with a cuppa at 7 when he went to work and told me the DC were downstairs. At 5 and 1.10 I don't leave them alone for longer than a few minutes but this morning I feel asleep for 20 mins. I never feel refreshed after sleeping all night. On Friday DS fell asleep in the car and rather than wake him I let him sleep because I was exhausted. I ended up dozing and mnetting for two and a half hours. All weekend I've felt lethargic. Are iron tablets going to be like a magic wand? How long should it take before I feel a bit more 'normal' (whatever that is)? It's the brain fog and forgetfulness that I am finding the worst.

Odd that they didn't check your vitamin d levels. Vitamin D deficiency can absolutely cause fatigue and lethargy (among other things). You haven't mentioned your age, but if you are over 40 did the gp bring up the possibility of peri-menopausal symptoms? The heart racing and fatigue are both common peri-menopausal symptoms (which can be treated by going on the pill).

Will GP be willing to refer you to an endocrinologist?. Many GPs are seemingly not up to speed at all when it comes to such issues.

I would think that thyroid problems are to blame here particularly if there is familial history.

Thanks for your replies.

I'm 37, sorry should have said that in original post!

Periods have always been heavy but I had a mirena put in in Match and things seem to be selling down at last. Hoping once I get get the iron levels up they might stand more of a chance of staying up now.

Atilla, can you help me with what my TSH levels should be? I find all sorts of numbers on the net and don't know which I should be aiming for. If the results are borderline I could try to push for a referral, especially as you say, there is a family history.

Vit D test are very expensive and it is very hard to get a gp to test levels for that reason.

I've got other things on the results pages but picked out what I thought were the pertinent ones with words I can spell Is there another name for vitamin D?

Your T4 &T3 levels have come back within normal range ,( the normal levels vary between different health trusts) otherwise they would be noted.

There weren't any T3 or T4 levels on the results sheets, only TSH.

You sound very like me cupcake. I've ended up self medicating. I have an under active thyroid. There are many things I didn't know, eg taking thyroxine on an empty stomach. Visit thyroid UK on the net it's helped me so much. Your blood test results are quite low, even if they are within the "normal range" . You could be having absorption (of the thyroxine )problems. The stress you have been through affects the adrenal glands, which in turn affects the thyroid. There are some very knowledgeable people on the forum on thyroid UK, do go and explain your problems. Good luck

Watching with interest as having a similar experience and symptoms, although I've also been unable to get pregnant for over 2.5 years, which I think is linked. Am also waiting for a load of blood test results.

Re Vit D I sent off for a finger prick test that you do yourself and send back. My levels came back as being high so that wasn't the answer.

Littlecupcakes, there weren't any t4 t3 as they are normal thats why only the tsh shows as your tsh for thyroid is normal level,

Assuming you are not on treatment for your thyroid, your TSH is too high and your doctor needs to do further investigations to rule in or out a thyroid problem. You would expect a TSH of around 1 in a healthy, unmedicated person. In addition your ferritin needs to be at least mid-range, so around 80 and your vitamin B12 is low enough to cause neurological symptoms and needs to be raised to above 500. You can supplement the iron and B12 yourself, but the combination of slightly raised TSH, low ferritin and lowish B12 suggests, as I say, that your thyroid should be investigated in more detail and you should ask for folate and vitamin D to be tested as well as these are likely to be low as well. The racing heart and other symptoms you describe all fit in with this sort of picture as well.

Those results are NORMAL they are all within the normal range , you are not being fobbed off.

We are talking orthodox NHS medicine, if you want to take up pleasemrstweedies approach that being " normal" isn't good enough you need to get hard evidence from her as to why these matter in an orthodox medical setting. There are many private docs that will give you B12 tablets with a normal B12 etc but there is IMHO no evidence for this. You will not get a T4 or T3 result on the NHS with a normal TSH is many areas.

How is your mood? Are you anxious?

Thanks for all your replies, it is interesting that opinions differ, no wonder we all get different responses from GPs! I wasn't expecting a call from the GP so early, so I was still in the middle of reading around the TSH issues, as suggested up thread.

The GP said that all the results were normal. There was no mention of iron supplements to bring up the ferritin level. She was going to leave it at that until I said that I need some answers as to why I feel so exhausted all of the time. I gave a couple of examples from the weekend which showed just how little energy I have. She did listen and her response was that I am suffering with anxiety and she suggested antidepressants.

I truly, truly feel that I am not depressed or anxious. After the birth of DS nearly two years ago I found life very tough, but I coped. It is only with hindsight that I think I may have had post natal depression but it was never formally diagnosed. I think a diagnosis of PND back then would have been easier for me to swallow than a diagnosis of anxiety or depression is now. With absolutely no disrespect to anyone who suffers, I am one of those who thrives on stress, gets through life, and I consider myself to be quite resilient. The only thing I have trouble coping with is maintaining my composure when I go to the GP and start talking about how I am - I think I've managed once, or maybe twice in the last two years not to cry. I have absolutely no idea why I cry - I am rarely reduced to tears at home.

I had bloods done a year ago for the same reasons and the results were very similar. I told her I have been feeling this way for well over a year now and really need to find some answers and start feeling more energetic. Previously I was prescribed Prozac but again felt that I was not depressed or anxious so I never collected the tablets, but as a compromise I went on a stress relief course and saw a counsellor for a couple of one to one sessions. On hearing this today, the GP said that she felt beta blockers would be helpful in treating the fast heart rate and would relieve some of the anxiety (that I don't feel I have!). I can't remember the name of the medication she suggested. I can see that it is worth a try but I told her that what I am struggling most with is the tiredness and that her description of how these drugs will help me did not mention in any way how the lethargy would be addressed. I also said that if I were to plot all of my results on a line which showed the 'normal ranges', then my results would be consistently at the lower end of the range, and nowhere near the middle which I would think is where the 'optimum' level is.

We ran over the five minute consultation time, so she suggested going to the surgery to see her tomorrow for a double appointment. I'll take my tissues FFS and listen to what she says but I really, honestly think that medication to treat anxiety is the answer. Not sure what else I can do other than take the tablets and see if there's an improvement.

There is of course a huge difference between being within the reference range and being at an optimal level within that range.

OP if you do not feel depressed or anxious, then push for proper consideration of your symptoms.

Vitamin D is not an expensive test. Perhaps it was once upon a time, but with all the information out there about Vitamin D deficiency, it absolutely should be checked. If you can't get your gp to do it, have it done yourself with one of the mail off tests. There are multiple threads about where to send off to. If you PM me, I will send you a copy of my father's (Bruce Ames) latest paper on Vitamin D. Also, I think that even at 37 you could be having hormonal issues. Are you by any chance in London. Some years ago when I was having troubles with a variety of things, my GP referred me to Nick Panay who solved everything by putting me on the pill. At a minimum, have a look at his website, it may be helpful.
It's possible that anti-depressants may be helpful, but it would make sense to explore everything else before trying them.

littlecupcake, did you have your calcium levels checked? It may be worth asking for this at the same time as vitamin D and parathyroid hormone (pth).

Issues with the parathyroid (primary Hyperparathyroidism) can cause brain fog, memory problems and exhaustion as well as heart arrhythmias and other symptoms.

Many doctors seem to be unaware of this condition but it is fairly common and usually easily treated by a small operation to remove the affected parathyroid gland. I'm due to have the op soon.

i went with similar symptoms to my GP last year (fast heart rate, extreme fatigue).

my ferritin was in at 23. within range but on the low side. I took iron and 4 months later it had more than doubled and I felt fine again.

took beta blockers for a while as well and it helped.

I'd ask again about the iron and if you could try upping it to see if it helps.
And vit d?

I do agree thyroid looks a tad off. Yes it's within 'guidelines' but due to family history it's worth keeping an eye on. Iirc nice guidelines say Tsh should be below 2.5 for conception (for treated hypo patients). It might be worth asking for endo referral if you wish to conceive esp if you miscarry.

A friend on lithium recently had Tsh hovering around 4. She was feeling shit. Endo put her on thyroxine as she wants to conceive. She wouldn't have been otherwise.

Funnily enough I get fluttering heart when Tsh creeping up. But beta blockers are v helpful.

I'm in France so tests are much easier to have. I feel as exhausted when I wake up as when I go to bed when vit D is low normal. Difficult to describe but exhausted in the back of my head. Vitamin D drops are over the counter here and prescribed to pretty much everyone at the beginning of winter.

Thanks for all your replies. Quick update: I saw the GP and must have been with her about half an hour (she had booked a double appointment). I felt she really listened to me and we explored the idea that I'm suffering from anxiety. In the end I agreed that I am very anxious about my children, but had never really considered it before - especially as people see the mum that's coping, rather than the panic about everything that's really hidden away. She prescribed 20mg citalopram, took my first tablet last night. Don't know if it was the tablet, sunburn or the large bowl of raspberries I ate right before I went to bed but I was really sick in the night. I'm not looking forward to a repeat tonight if the tablets were to blame.

In the meantime, I'm going to get a good multivitamin. Any recommendations to help boost me up a bit. I've also got some ferrous fumerate tablets which will help get my ferritin levels up.

Thanks again for your posts.

blimey this could be me!!! I have just had lots of bloods and all 'normal' however GP has prescribed ferrous sulphate tablets due to low ferratin levels (19). My symptoms have been fatigue, memory failure, confusion, irritable, emotional, racing heart. She initially thought it was depression/anxiety....end Aug til end Jan I was anti depressants.... 20mg of citalopram but I felt that I have dealt with lots of home type issues that didn't help with the help of some counselling so stopped taking them. Starting them can be as tricky as stopping them...try taking 10mg for a week or two and then increase to the full dose. My GP has suggested anti depressants again but I don't feel that I am depressed, anxious maybe but lots going on at home with GCSEs and ASs, hubby away a lot and possible redundancy hanging over my head!!!
will watch this thread.....very interesting! I have also started (today) to be mindful of iron rich foods....kale, brocolli, oranges, etc plus taking the supplement. GP has recommended 200mg three times a day which seems quite a high dose. I don't have periods since am on my third consecutive MIrena coil so no bleed. I am 45, 46 but she says hormone level is 'normal' at 6.1...? Am also open to anyone's thoughts/comments.
Thanks OP hope you are feeling better soon xx

It's not the "hormone" level just at the point you have the blood test. The problem with peri-menopause is that you are producing estrogen erratically so one day it might be enough, then a few days later too little and then a few days later too much. Your body can't compensate for all the erratic production. Taking hormones puts the estrogen level above a minimum so the erratic production doesn't have as much of an impact. Also, you haven't mentioned Vitamin D. You must have it checked....it can have an enormous effect on mood and the only way to get vitamin d in the necessary amounts is from sunshine (you don't have a lot of that in the UK) or pills (super cheap).