Exhausted all the time but normal blood results, what now?

[GenericName123]

I’m hoping for some advice on what to do about feeling so exhausted and run down all the time. I’m usually in bed and asleep by 9-9.30pm, up around 6.30am so around 9 hours of sleep despite which I am constantly knackered. I don’t sleep particularly soundly and wake regularly but I’ve always been like that and have managed fine. My DD is 3 so life is pretty full on and she/we do pick up a lot of bugs from nursery but other people with young kids still have enough energy to watch TV until 10pm or later which just seems impossible for me right now!

I saw my GP who tested me for a variety of things - thyroid, diabetes, celiac, hormone levels (I’m 40 so may be peri menopausal) along with FBC and electrolyte levels. All came back normal. She didn’t check vitamin levels so I did a private test through Superdrug which was 47 so not too bad. I’m assuming any anaemia issues would have shown up in the FBC.

So I guess that’s all very reassuring but I don’t know where to go now. Is it worth going back to the GP? I take a general multivitamin but should I try other supplements? Any advice appreciated!

I;m exhausted all the time and got my blood tested. Turned out I had a major B12 deficiency and what is called Pernicious Anaemia. In my case it is due to a lack of an enzyme called intrinsic factor and is an autoimmune disease.

But it kept getting missed because while i was previously tested for iron deficiency i was not being tested for B12.

A bunch of injections later and then pills i am more or less stable, but need regular monitoring.

So you might want to look into vitamin issues generally.

Definitely get your actual numbers! My counts were all normal but my ferritin was really low in the normal range- 6 weeks of iron tablets and I cannot believe the difference! Mine was 24.

I haven’t had it rechecked but my hair is no longer falling out and I just feel so much more energetic, no breathlessness either.

Also, my surgery gets given the breakdown by the labs, so the lab will stamp your results as ‘normal’ and the receptionist gives the result. A doctor doesn’t even look at them unless you force them to look at your recent results. I only found out about my iron count and how much it had dropped because a nurse practitioner was reviewing my HRT because I couldn’t get a dr appointment. She then referred me for a proper count. My actual dr still hasn’t seen me or looked at them

being tired doesn’t seem to pique anyone’s interest unfortunately so even though you feel dreadful you won’t really get help unless you keep at them. Keep going back and follow everything up.

I agree that being tired is just dismissed. But in my case- pernicious anaemia if untreated is fatal.

Looking back I can see how I was deteriorating. But it was incremental and I was just being fobbed off for literally years.

I felt the same a few years ago and am much, much better now after taking vitamin D, all the Bs, and iron.

It can't hurt to do that, so might as well see if helps.

Quite annoyed that doctors didn't say this to me tbh.

You absolutely need to ask your surgery for a copy of the test results. "Normal" can mean a lot of things. I was fobbed off with being told my thyroid was "normal" for a long time, but it was actually causing all my symptoms as my results were actually outside the reference range, but not enough for the GP to do anything about it. I kept pushing, and eventually they did a full thyroid panel - discovered I have Hashimoto's disease (autoimmune thyroid disease)

I've had the same happen with ferritin. Told me it was "normal" because it was 11, and only 10 or below was deficient 🙄 the GP then told me that a healthy level is actually 60+!

A full blood count will include haemoglobin.

We're not allowed to request Vit D levels in primary care, it may be the same where the OP is. So her GP may not be shit at all.. mind you I'd have checked haematinics (B12, folate and ferritin).

IME 90% of tired all the time patients have normal bloods and their fatigue is lifestyle related.

Or their bloods are "normal" but not actually healthy - such as my post above where my ferretin was 1 point above deficient but I was told normal?

I kept getting told I had depression and antidepressants shoved on me. Or I needed to exercise more. Turns out I have thyroid disease, cortisol issues, high prolactin and vitamin deficiencies. Many of these only discovered once I saw a private doctor who was willing to dig a little deeper.

I had full blood test done with GP. Was told it was normal. Accessed the results via the NHS app and then cross checked with info online (some via NICE) guidelines. My iron, folic acid and a couple of others were normal according to NHS standards but not health guidelines. Some were either borderline or below the guidelines.

I've since started taking iron tablets, vit d, vit c and magnesium daily and I'm feeling much better. I sleep better and I'm not as tired every day. Definitely do your own research on the results. GP just marks them as normal and then nothing is done even if you are borderline.

Perhaps yours is different. my full iron - ferritin, serum all the rest are routinely checked. Similarly, I've been tested, and found seriously lacking, in vitamin d. So it might not be standard where you are but I consider that pretty slack - certainly, my overall fatigue was definitely alleviated by both vitamin D and iron and I know plenty of people in a similar situation.

Thanks everyone. I’ve accessed my full results now and nothing stands out as being particularly close to the stated reference numbers. The haemoglobin is 145 (should be 115 to 160). The MCH is 32.2 and should be 27-32 but that’s only anomaly at all and it’s so minor. I definitely didn’t have ferritin or B12 tested so I might see about getting those levels done privately.

In the meantime I’ve had really good advice. I’ll add some extra vitamin D supplements and will make an effort to try and get a brisk walk in first thing. I’ve also just added some healthy high protein snacks to my grocery order (Greek yoghurt, flax seeds etc) and will make a real effort with my diet. If I’m still feeling awful and a month of all that then I guess it’s back to the GP. I did feel like she was being thorough when I spoke to her - she did things like take my blood oxygen levels that I wasn’t expecting so I was a bit surprised she didn’t test for various vitamin deficiencies. But as a PP said maybe that’s the guidance in our area? One way or another I’m glad I’ve got some things to try.

I'm in the same position. I am 40 and have been feeling exhausted and having palpitations. I got my blood results today and everything is within the normal range. My iron is on the low side so I've got to have it checked in 3 months but nothing abnormal. I actually have nodules on my thyroid and thought I might have an overactive thyroid but apparently not.

I don't really know what to do next either - am so sick of feeling exhausted all the time.

If your iron is on the low side then I'd recommend taking iron tablets and see how you feel. I feel much better having introduced them on a daily basis. My iron count was borderline.

It could definitely be low ferritin. Your GP should be able to arrange that blood test for you.

Came on to say have your ferritin levels checked. If low you'll feel dreadful. Conversely if they're too high, you'll feel dreadful as well! Quite often high ferritin levels is a sign of haemochromatosis. Can be treated but is very debilitating until it's under control

Can anyone read blood tests? Professionally. Doctor says it’s fine- even tho it’s abnormal range.

I was feeling really exhausted. My vit d levels were normal on the nhs range but a dr a while ago had said it should be higher. My ferritin was normal but at the lower end. I also take medication that affects b12 absorption. So now I use a vit d spray and vit b12 spray (from boots) I had to up the vit d spray as although my levels increased they still weren’t high enough. My gp prescribed iron tablets which I now take every other day. I now don’t feel exhausted during the day. I now also have liver disease but feel much better with the vitamins I’m taking. Wish I’d sorted this earlier.

Was vitamin B12 tested? It’s a vital one to know.

Thank you! I have just checked mine on my app and my ferritin is just above normal range! Probably why I'm so exhausted!

There you go! Mine was at 5...up to 30 on iron tablets, eventually had an iron infusion and it has shot up. I feel like a different person. Good luck, I know it's hard to find the energy to pursue these things so it becomes a vicious circle x

My vit b12 is normal but the lower end too 38.9 so I'm going to add an iron tablet in to. They had said my vit D was low so I've been taking that for a couple of months now 👍

I'm absolutely not a Dr but they can obviously advise the amount of iron to take daily. I was on 630mg a day for a few months, for reference, OTC iron tablets contain a fraction of that usually so worth checking you're taking an appropriate amount or it will take forever to get it raised. Take a Vitamin C tablet or/and a glass of orange juice with each iron tablet and don't take them within 2 hours of caffeine or dairy as it's impacts absorption, on an empty stomach is ideal x

B12 is not iron. It's B12- because it is a type of anaemia it's often confused with iron. But if you are deficient it can be quite serious so I'd definitely go to the GP for further tests (if you can get in).

https://www.nhs.uk/conditions/vitamin-b12-or-folate-deficiency-anaemia/symptoms/

I'm going to add these in 👍