Can anyone tell me what I should get tested for? Extreme tiredness, low blood pressure, prone to anaemia, etc etc

[AnnieBeeBee]

I’m pregnant, and finding it much, MUCH harder than I did last time, so I wanted to speak to the doctor about testing me for something meaningfully.

Before I got pregnant, I felt pretty crappy and was convinced there was something up with me - I was just utterly exhausted all the time. I even paid a fortune for a 360 health check (which actually was the waste of money people warned me it would be - they didn’t test for anything my GP didn’t test for).

I am pretty sure my GP thought I was a hypochondriac, I was actually getting embarrassed to go so I stopped. But I know that what I was feeling - and am now - isn't how I feel when I'm my normal self.

In hindsight, I probably should have figured it out before getting pregnant, but really wanted another DC sooner rather than later because of mine and other DC's age (I'm 35, DC1 is 2) and DH and I always planned for 3 DCs (not sure my body can take another pregnancy after this one now though!).

I really want to try and find out what’s up before the baby comes so I’ve the energy to be a good mum! And for breastfeeding, etc.

I’d like to get more specific with my requests to test for stuff. I wondered if anyone had any advice on what I should ask to get tested for?

My symptoms:

Utter exhaustion. Low blood pressure. Anaemia and Vit b12 v low (previously deficient, borderline now). Low mood to the point of depression/anxiety. Heart palpitations. Constant "tight" feeling in my body, especially around my chest. Tired when walking for longer than 15/20mins - I have to lie down! Weight gain (more so than last pregnancy despite my lifestyle and diet being basically the same - exercise being less because of my tiredness though). Waking with a swollen face sometimes. Hair greying faster than ever (though I am 35! And quite happy to believe this one would actually happen anyway!! Thought I'd chuck it in there anyway). Bleeding gums/gum disease despite good dental care.

DESPITE: religiously taking vitamins (and ones recommended by a nutrionist). Eating incredibly well (lots of balance: protein, fresh fruit and veg, hardly any processed food, homemade stuff, etc etc). Exercising 2-3 times a week (yoga and a personal trainer, both appropriate for pregnancy. But not able to do all I used to and am utterly wiped for the rest of the day when I do the exercise - but am determined to keep it up, it must help??). Getting at least 8hrs a sleep a night, unbroken, plus a nap when DC naps.

I don't have: a thyroid problem. Coeliac disease. Pernicious anemia. (These have been tested for already.)

If your B12 supplements are for dissolving sub lingually, then that bypasses the stomach/ intestine absorption route IFYSWIM.
However, if you have pernicious anaemia (quite possible with such a low level) then you need on-going life-long B12 injections. No amount of sub-lingual B12 will ever cut the mustard.
Go back to your GP or go/change to another GP even, and ask them to do all the following bloods:

1. Full blood count, for Haemoglobin level.
2. Iron stores (this is for ferritin-a low level also needs a course of Iron).
3. B12 and folate
4. Vitamin D levels
5. Thyroid Function Test to include TSH and Free T4 not just TSH.
6. Coeliac testing, but you probably won't get a reliable result on a GF diet. Not to worry, the other bloods are much more important currently, as you can just continue with a GF diet indefinitely.

I'm not sure about POTs but know about the above bloods. And they are standard for TATT "tired all the time".

Get a print out with ranges, of all the above. Post them back on here or "thyroid uk health unlocked" for further advice. A lot of the autoimmune disorders above are interlinked with thyroid problems.
You may have to pay a photocopying fee but you're entitled to a copy. If there's a hoo-ha about giving you them, write them all down in a notebook with ranges. Shouldn't have to justify but if so, say it's for my records. Good luck.
PS ask the midwife to arrange if GP refuses. Emphasize the strong Family history of thyroid disorders.

Pescatarians (and even vegetarians) shouldn't have low b12 because it's present in eggs, milk, dairy etc. Coeliacs can struggle to absorb it (I was sent straight for a gastroscopy to check when my low b12 was discovered).
You should feel some improvement in certain symptoms straight away - I don't get palpitations at all any more. Tiredness takes longer. The main issue being that most gps go straight to 3-monthly jabs regardless of symptoms and refuse to believe anyone needs it any more often. My jabs were lasting a max of 1 week, and it's only after a few months of daily injections that I'm feeling ok, and I still have good days and bad days. There are quite a few support groups on Facebook who can give you loads of information to support arguing with your GP for treatment (sadly most people do have to argue!).
With a level of 114, you definitely need treatment ASAP and then you can take longer to find out what the cause is.

Low iron and low B12 can make you feel beyond shit. I slept for hours and woke up feeling tired, couldn't walk up a flight of stairs without getting breathless, heart was constantly racing, I had an extra beat in my heart, was ghostly pale, grumpy, low in mood, dry and peeling skin, dry and thinning hair and brittle nails...probably more that I am forgetting. On these threads, people always suggest things like thyroid and coeliac but you actually do have an answer for you symptoms, so it needs addressing first. I don't think many people realise how unwell anaemia can make you. If you're still ill, then of course, you need further investigation. I'd focus on rectificying your deficiencies and then waiting at least 3 months. Within 6 months, I was back to my baseline of normal.

Take care.

AveEldon - That's good to know about injections in pg and bf. I always had a gut (haha) feeling that it's something to do with my gut. I would totally welcome that sort of exploration!

OhMyWord16 - I've copied and pasted your list into my notes to take with me to the GP on Wednesday! I've requested another GP I haven't met before, hopefully they will be nice! My midwife (who I see at the hospital in about two weeks) is so lovely, and I know she'd order these tests if I can't persuade my GP. Hopefully I can.

VertiginousOust - That's really useful to know about the 3-monthly injections vs the weekly. Do you just get them at your local surgery? How long did it take for your tiredness to mainly go, even though you still have bad days? Did you have an underlying cause?

Doggity - yes that's how I feel!! I'm so glad you are better now!! And 6 months - I'd take it. I've been feeling like this for so long and it's just frustrating and, frankly, depressing. I'm sure that's why I've suffered from prenatal depression and anxiety this time. I just feel - physically - so shit!

I get monthly jabs at my surgery and do daily jabs in between at home.
I'm only just having more good days in the last few weeks and have been getting monthly jabs since January and daily since April? 3-4 months of daily or every other day jabs seems pretty standard to get back to 'normal'. Do have a look at the pernicious anaemia society website and the Facebook support groups. I have PA.
(Sorry have name changed, it's vertiginous!)