Can anyone help me work out my blood test results?

[edgeoffreedom]

I went to my GP a couple of weeks ago as i've been feeling incresingly exhausted. like bone tired and waking up after have a full nights sleep feeling like i havn't slept. I asked to be tested for Hypothyrodism, I have family history of it and after looking into it i seem to have an awful lot of the symptoms!

I got the results on the patient app today and the comments from the GP are "normal". I feel far from normal! Im just hoping somone can perhaps give me some pointers on what i need to highlight with her and as im going to insist on a follow up... thanks

Haemantinic
serum vit b12 322ng/l (189-883)
serum folate 5.7ug/l (3.1-20.0)

liver function
albumin 44 (35-50)
bilirubin level 10 (<22)
alkaline phosphatase 80 (30-130)
ALT level 14 (<50)

Urea and elcetrolytes
sodium 138 133-146
potasium 4.4 3.5-5.3
creatinine 57 49-90
eGFRcreat(CKD-EPI) 116 units n/a

Thyroid function
TSH level 3 (0.4-5)
free T4 11 (9 to19)

Full blood count
heamoglobin estimation 146 (110-150)
total white cell count 9 (4to11)
platelet count 309 (150-400)
RBC 4.81 (3.8-4.8)
Haematocrit 0.442 (0.36-0.460)
MCV 91.9 (80-100)
MCH 30.4 (27-32)
MCHC 330 (320-360)
Neutrophil count 6.4 (2-7.5)
Lymphocyte 1.6 (1.5-4)
monocyte count 0.5 (0.2-1)
eosinophil 0.4 (0.02-0.5)
basophil 0 (<0.1)
nucleated red cells 0 (n/a)

Bloods are all normal. Most tiredness is lifestyle related and bloods have a very low pickup rate. Sleep apnoea won't be see in bloods, do you wake at night gasping for breath?

Your folate is quite low. When this happens your body can't utilise B12 so it just floats around in the blood, hence your normal result. If you take 5 mg of folic acid for three months and then retest your B12 you might find it much lower as it will be able to be utilised by your body.

Join Vitamin B12 Wake Up Facebook group for all you need to know about B12. All your symptoms can be put down to B12deficiency

GPs are notoriously bad at diagnosing this or even being proactive about helping you so a lot of people on this group follow their protocol and ignore their GP!

Yes, bloodwork looks fine. Do you have a sport/health watch that analyses your sleep? It will tell you if you're getting sufficient deep sleep, REM sleep, if you're waking up often during the night, etc.

no never, i dont think its sleep apnea. i also dont think its sleep quallity related but i dont know.... when i say tiredness i suppose what i really mean is exhaustion, so things like brain fog, muscle and joint aches, limb heavyness, i also get migranes which have also been getting worse and lasting longer.

Long covid? Chronic fatigue syndrome? Menopause? Depression?

I don't beleive it sleep related but i will try my watch this week to see what it says , i don't usually wear it as i find it uncomfortable to sleep in

Thanks i'll look into that, i was concerned that the folate and b12 were on the lower side of "normal", i did also find out that hypothyroid can cause deficientcy in both of these too and "hashmitos"(?) dosn't show up in the TSH and FRee T4 tests i have had and can present as "normal" thyroid function.

Im 34 so im hoping its not menopause just yet, could be some of the others, defenitly worth mentioning to the gp, thanks!

Following as I've also just had a full suite of blood tests for similar symptoms. GP also said all normal, but like OP my folate and b12 are also towards the lower end of range. I am approaching peri-menopause so that has been on my mind...not that GP suggested it as a reason.

I have all those symptoms too, as well as lightheaded / dizziness - doc told me it was long Covid and, well tough basically 😫😏

@TheTerribleMaster GP also thinking long covid for me, but I think that's because I had previously had this in 2020, but symptoms abated in 2021. Seems an easy choice to suggest it again rather than exploring further.

I'm working at the moment but struggling, and can't decide whether to go with the long Covid diagnosis and take time to rest, or keep pushing the GP to consider alternatives.

Where is the vitamin D level?

The only thing that stands out is your TSH of 3. Whilst in the normal range that GPs go by (the magic “it’s below 5” 🙄) that level would be higher than optimum for me. I’ve been underactive for years and ideally my level needs to be below 1.8 ish otherwise I notice the symptoms coming back. I see a thyroid specialist (privately unfortunately so have to pay) and she would put you on Levothyroxine with that number

oh no that sucks! to be honest i dont know much about long covid, have you had the symptoms for long?

l looks like GP didnt order that one, or ferritn? as i don't have results for either😣

@usernamedifferent this is what i was thinking, as they are "within normal range" but there are studies which read that the upper reference should be more like 2.5! im trying to find out what my parents 'normal' readings are so i can see if i can find out what is normal for me, im probably overthinking all of this though 😆

Many areas don’t test for vitamin D now as studies have shown the majority of people have low Vit D and it’s an expensive test, take some high strength vitamin D and see how you feel after 3 months. You could do with knowing ferritin numbers though as many women feel awful below 50.

These are good for an energy boost, worth a try

https://www.hollandandbarrett.com/shop/product/nature-s-way-alive-women-s-energy-multi-vitamin-tablets-60027956?skuid=027956&utm_campaign=shopping&utm_medium=cpc&utm_source=google&&gad_source=1&gclid=CjwKCAjwouexBhAuEiwAtW_Zx4dVPAqV-Obhvm3HSP4-fzqG97_9CVBAGQ6IfTWzpp3WsTRx0LFimxoCu0wQAvD_BwE&gclsrc=aw.ds

I believe the NICE guidelines are to treat the symptoms rather than go by hard and fast numbers. As there is a family history I would ask for a retest in 6 weeks. Diarise your symptoms and explain your family history.

I'm Hypothyroid and would really struggle at 3, I take 100microg of levothyroxine after starting on 25.

Definitely get your ferritin checked. My gp allows me to go about my day, every day for 2 years with ferritin levels of 3 because my iron levels were only just below ‘normal’. I was bone tired and just walking up my stairs would leave me breathless. I ended up needing iron infusions.

So slept in my watch last night and it was the first time in about 3 months my 5 year old has woken up! 😅 so although i had a broken night my watch has said that i managed a total of 7hr 40mins sleep, 59 mins deep, 4h21m light, 2h20m REM, which dosnt look too bad considering...