Full blood count - Can anyone help advise what to do next?

[VillageFete]

Firstly, i’m so sick of my GP surgery. I’ve never bothered them unless desperate, and now I’m desperate and am being fobbed off, so I had a full blood count done privately. I am wondering how to broach my GP and request further testing as the last few times i’ve been, they just don’t care.

I have intense, sharp pain in lower right groin. Comes and goes, no rhyme or reason to it, but it’s making my life miserable. It floors me at times. I suffer with constipation and bloating too.

This pain is possibly gynae or nerve damage as it started not long after my C section 3 year’s ago, but due to the constipation and bloating, I have worried it could be the bowel.

After visiting my GP 4 times over these issues which are becoming worrying, they agreed to a Calprotectin test. It came back at 47, which is apparently normal, they also suggested a Celiac blood test - again, came back normal. So now they won’t entertain it being a bowel issue. I paid for a private FIT to check for blood in the stool for peace of mind in January and it was negative. I’m going to pay to do another because i’m sick of the bloating/constipation.

Besides the pain and the constipation/bloating, I am so fucking tired. I feel wiped out and get waves of utter exhaustion. I feel like I have what I can only describe as total brain fog, I also occasionally get lighthearted and sometimes it feels like my heart skips a beat.

GP won’t do full blood count, says it isn’t needed so I paid for my bloody own with Medichecks. I will post the results below, but I think it’s unlikely I have iron deficiency anemia (Thankfully) But Googling the MCV and MCH, I’m thinking I could have a B12/Folate deficiency going on? Maybe even Pernicious anaemia?

Haemoglobin - 137 g/l : Normal
Haematocrit - 0.402 L/L : Normal
Red cell count - 4.11 : Normal
MCV - 98.1 : Borderline
MCH - 33.4 pg : Abnormal
MCHC - 341 g/l : Normal

White cell count - 5.4 : Normal
Basophils - 0.12 : Abnormal

There’s others under the white cell count but all saying “normal”

I just feel like shit and often miserable now because of the way I feel.

Can anyone please give their insight and advise me how to approach my GP on this. What can I ask them to do? They don’t believe I need a colonoscopy due to Calprotectin test being normal, plus my bloods don’t show iron deficiency anemia (Any other way to diagnose that? Should I have checked ferritin?) But something just isn’t right with how I feel these days. I get enough sleep, I shouldn’t feel this shattered and weak! It’s really affecting my quality of life and making me so anxious.

Forgot to say, in terms of Gynae, i’ve had about 100 internal ultrasounds and all is absolutely fine. I was undergoing IVF privately not long ago and regular Ultrasounds on endometrium and ovaries are part of it. Had a smear in December, and a hysteroscopy with biopsies taken, again, paid privately. All clear.

I simply cannot afford to keep going private to figure out what’s going on. The cost is crippling me.

I’ve drip fed 🙄 Forgot to add - Thyroid is perfect. Again, paid privately to check!

TSH - 1.1

Thyroid antibodies, T4, T3 all in optimal range.

Why on earth did they not do an iron profile with your symptoms?

@Katya213 I think they were focusing more on the pain and digestion side of things?! Not entirely sure but i’m beyond pissed off with them now.

Just not sure what to do in terms of putting my foot down and asking for next, but I need to get to the bottom of this!

Thriva do good blood tests if you did want to pay again sorry. I know that's not ideal. They check iron, and lots of other things that you can choose

I think you should see a different GP in the practice, or failing that see the practice manager.

Thank you for the replies. I appreciate it.

I have seen a few different GP’s 🫣 But will be going back tomorrow and not leaving until I’m satisfied.

Any idea what particular bloods I should be asking for? I keep reading that low B12 and Folate is somewhat common and can cause the symptoms i’m having, but also reading that many GP’s don’t seem to understand/empathise with the condition!

May I ask how much you pay d for the test? Why does the cost not include interpretation of the results for you, seems odd to leave people in an information vacuum

Ferritin and B12. You can have a normal FBC and a very low ferritin x

(My FBC often stays in the normal range even when my iron stores are so low they need IV replacement)

Could it be due to adhesions following the surgery?

I have pernicious anaemia and it was first spotted through my mch/mcv levels. If your gp won't do a blood test, can you pay for another private one to check your b12 and folate levels (don't supplement with either until you have a diagnosis)?

@Gassylady Hi, I think about £50 from memory. I did try and leave more info but it wouldn’t save. I’ve spoken to Medichecks who have taken my info over the phone and waiting for a GP to leave some comments.

@Innocenta Excuse my ignorance but if Ferritin is low, what does that mean?! Could it mean that there’s some digestive blood loss? Not meaning to be dramatic, but the constipation and bloating does worry me! Although I very likely have IBS. I have read B12 can be within “Normal” NHS guidelines but actually still too low and a problem for some?

Do you do regular exercise. Yoga or something like that long term does seem to help with constipation.
How stressed are you with life.

@QuebecBagnet I think the pain is very likely related to that, well, I hope so! Or maybe nerve damage.

@Akite Thank you, although i’m reading that even if B12 is within NHS guidelines it can still be too low? Something about active and inactive? I’m new to all this!

@Ferngreen I spin and do circuit training and absolutely love both. Very stressed at times, but in general things are great. I think my stress is often due to how i’m feeling with these issues!

Ferritin is your stored iron. Here's a page on the test:

www.healthline.com/health/ferritin#_noHeaderPrefixedContent

If you were bleeding a lot you'd probably have a more abnormal FBC. I am not a medic and cannot give any form of advice like that, and I do think you should pursue this. But if you were actively bleeding there would be signs in the testing you've done x

A lot of NHS ranges are pretty blunt and when you see more specialist doctors they try to put you in a more optimised range, so yes I would agree with that about B12, in a general sense. If it comes back okay then you're not dangerously deficient at all but maybe could be more 'optimal for you'.

Yes the levels for b12 are low and vary through the country. In my area the bottom end of the range is 120 but a level of at least 500 is considered optimal. Mine was 100 when it was first tested and with the macrocytic anaemia found from the mch/MCV levels, I started on b12 injections immediately.
if you pay for a private test you can opt for the active b12 test which is more accurate

Your FBC blood results themselves are not particularly abnormal. The MCV/MCH are only trivially raised. Remember a normal range is based around standard deviations, so 5% normal population will show slightly abnormal results, that are completely normal (2.5% will be below, 2.5% above the range). So it’s better to follow symptoms rather than borderline results.

Your symptoms, which sound quite Irritable bowel like but you could discuss having ‘an MoT’ in view of tiredness and abdo symptoms and ask if they could check ferritin/B12/folate/thyroid/liver as per PP

You are all incredibly helpful. I can’t thank you enough. I’ve felt like I was going out of my mind.

The brain fog is awful and the tiredness is off the scale. I can feel ok and then suddenly get this crashing exhaustion that utterly drains me. It’s really weird!

Your symptoms including dodgy digestion are screaming under active thyroid to me. I am not a doctor, just someone who sounds a bit like you whose life was transformed by finding a private doctor who diagnosed the under active thyroid I knew I had that the GP told me was all in my head and that there was nothing wrong with me. I am a transformed person now I take the medication I needed.

I mentioned to a chiropodist that I couldt drop my right leg out (froggy leg) - he pushed something around the symphisis pubis and magically it was much better. So perhaps speak to a recommended sports physio, chiro or osteopath.

@CrotchetyQuaver I have had a thyroid panel done, apparently (according to Medichecks) It was optimal range. I will attach a picture.

I did worry about this too, but in January, my IVF clinic (Abroad) also ran a full panel and again said it was perfect?

Your symptoms sound very similar to mine Except I have diarrhoea not constipation.
the lower right side pain though I have and the horrendous exhaustion.
I too have had blood tests and stool tests and got diagnosed with IBS in the end.
still not sure that is what is going on but that’s where things got to and I gave up going back and forth to GP.
sorry to not be of more help - I’m not medical so can’t comment on the blood results .
did they scan your appendix? This is on the lower right side - and it would be good to rule out a grumbling appendix perhaps.
also how old are you ? I’m peri menopausal and it causes my ovaries (esp my right ovary) to really hurt during ovulation.