Blood results normal... Any thoughts?

[LocoCocoa]

Hi all,

I originally went to my GP a year ago with a long list of symptoms such as, all over joint and muscle pain, loss of strength, tiredness, feeling cold, panic attacks, itchy skin etc. Blood results came back normal. The GP couldn't find a reason and diagnosed 'stress' and prescribed citalopram.
Since then things have only got worse, I had to give up work as I no longer had the energy. I've developed awful palpitations, muscle spasms, keep forgetting things and find it really hard to concentrate. I went back to my GP last week and he done another round of blood tests, again normal. This time I asked for my results but all seem to be in normal range. I can't go on like this but I know if I go back the GP will just say, well your results are normal :(

TSH (0.23 - 5.6 mU/L) - 0.83
FREE T4 (9-28 pmol/L) - 17
HAEMOGLOBIN (115-165 g/L - 126
HAEMATOCRIT (0.36-0.47 RATIO) - 0.377
RED CELL COUNT (3.8 - 5.8) - 3.99
FERRITIN (15-200 ug/L) - 112
VITAMIN B12 (18-2000 ng/L) 275

Your blood results all look really good. My thyroid and ferritin levels are a lot worse than yours and still considered fine.

There are plenty of things you could have that don't show on bloods. Have you looked into chronic fatigue syndrome or fibromyalgia? Could you see a different GP and ask if things like that could be explored?

Your B12 is low. B12 deficiency is not well understood by GP as they have never been trained it it. B12 basic tests are not reliable is the issue is poor absorption. Even says so on the NHS.net website! You need an active B12 test.

Look up Pernicious Anemia. The UK website is full of good info.

Another vote for investigating that low B12.

Yes, they are in within the specified ranges, but I've read before that some people have symptoms despite this. I was convinced it was my thyroid but clearly not. I was recently diagnosed hypermobile but GP said that wouldn't cause all these symptoms.
I've just realised after looking at the form again that I've noted the B12 result from my LAST blood test a year ago. The B12 result was March 2022, it was not tested in last weeks bloods so I don't know what it currently is 🙄
The rest of the results are current.

Have they considered or discussed the possibility of MS? I don't wish to cause alarm and am in no way medical but your symptoms are exactly the same as a friend of mine who was recently diagnosed. She also had unexplained vision problems despite optician giving her the all clear.

Did you go to GP due to "sudden on-set" or had it been building for years? My first thought was Lyme tick disease in addition to MS or the new "long Covid" all of which match the symptoms so far described.

I was diagnosed with Pernicious Anemia (positive for IF antibodies) when my B12 was 285. Your B12 is 275.

I'm not saying you have PA, but a level of 275 doesn't rule it out by any means. I'm in the US and most MDs will flag anything under 400 for further investigation (unless the low level can be explained by insufficient dietary intake).

Apologies OP, I've just read the other replies to your post. I didn't know b12 could still cause issues if it's in the 200s. However in my experience, GPs are very reluctant to do anything if your results are technically "in range". My thyroid is apparently "satisfactory" even though my results are actually outside the acceptable range 🤔 they're just not far enough outside. So I'm expected to just put up with my abnormal periods, thin hair, and needing 12 hours sleep a night...

Very frustrating, I know. Could you try seeing a different GP at your surgery and ask for a second opinion?

How old are you op? I just ask because a lot of those symptoms can be linked to peri menopause. Such as chronic fatigue, joint pain & brain fog/forgetfulness.

If that B12 result is over a year old, can you ask them to repeat B12 and also do Folate?

Low B12 does cause neurological symptoms in some people

I wont quote reply as there is a few different questions, I'll just reply to all here.

I'd say it had been building for years, I used to have some joint and back pain in my teens, this worsened after pregnancy (16 years ago) Throughout my 20's I would have flare ups of crushing tiredness, pain, urticaria that would then go away for months. Last year it flared up again and just didn't go away, then all the other symptoms have added on, I don't know if both things are related though.

I did actually request to see another doctor, who was lovely and referred me to physio for the pain (where I found out i'm hypermobile) but when physio couldn't help and I was referred back, the GP had left the practice so I'm back with my usual GP who said the hypermobility wouldn't cause my symptoms.

I'm 37. I have considered Fibro, a family member has this and I could tick all the boxes but it feels like something more specific to me. My joints lock and pop and the pain when active feels specific to certain areas. My muscles have become so weak, for example, If I have to step up onto a small wall or something around a foot high, I cant do it as there is just no strength in my leg / hip. If I step down the equivalent, my leg will give way. A 30 min walk will leave my whole body literally throbbing in pain. When I do lie down to rest, my legs and sometimes my whole body, will randomly tense and jerk outwards for hours, There must be something going on.

If you are hypermobile, look up dysautonomia and see if this fits your symptoms. Often very closely linked.

I feel really ill when b12 is under about 500 and have injections to stay above that level.

Please ask for a vitamin D test too - my husband had severe tiredness, muscle aches, headaches, aching all over etc and his vitamin D was very low! Doctors don’t normally test this as standard I have found….

If you are hypermobile have you looked at Ehlers Danlos syndrome?

Has the GP checked inflammatory markers and ANA for auto immune disorders?

I did ask my GP about this as when I googled hypermobile it came up. He said he didn’t think it was that as I don’t have dislocations and I only scored 8/9 in the beighton test.
I did tear ligaments in my arm after falling out of bed 2 years ago though and broke my foot after falling last year which still causes me pain. Physio said hypermobility could be why these happened, GP disagrees…

8/9 on the beighton scale is high and your other symptoms can absolutely be EDS related. I have Pots and urticaria and it’s all linked to my hyper mobile EDS diagnosis.

I’d see another GP if you can.

8/9 is high. There are other markers for EDS and you need to be referred to a specialist. I would absolutely see another GP and ask for a referral.

Did you have a BG test? I had tiredness itchy skin that wouldnt heal and they discovered I had diabetes via a blood test, just wondering if they tested that

See another GP re the EDS possibility and a specialist referral.

Also your B12 is low end normal. And did they check your vitamin D and folate?

I agree, hEDS. Dysautonomia, fibromyalgia, me/cfs or autoimmune disorder. Ask for your rheumatoid factor, anti CCP, ana, ESR and CRP to be tested for starters. MS would need an MRI. Also coeliac ttg/gliadin. Your B12 is not optimal either. Good luck.

Is your B12 result ng/l?
Mine was 213 and was told was fine.