Blood test results and GP no idea

[Icenii]

Below are my blood test results. All apparently normal. I have been feeling persistently tired, with some days of total exhaustion and brain fog. In addition, some days I am extremely stiff in my joints, and my muscles ache. I have no joint swelling. I assume peri (46). The GP stated there is nothing in my blood to indicate an issue, and it is unlikely to be perimenopausal. He was rather dismissive and finally agreed to see me in a month. They seemed more focused on mental health issues.

Is there anything obvious below?

Rheumatoid factor 8 Range: Below 12.5

Serum ANA level Negative

Tissu transglutaminase IgA lev < 1 Range: Below 6

Urea and electrolytes
Serum sodium 138 Range: 133 to 146
Serum potassium 4.5 Range: 3.5 to 5.3
Serum urea level 3.0 Range: 2.5 to 7.8
Serum creatinine 55 Range: 60 to 120

eGFRcreat (CKD-EPI)/1.73 m2* Range: > 90

Liver function test
Serum ALT level: 11 Range: 10 to 49
Serum bilirubin level: 10 Below 21.0
Plasma C reactive protein < 5 Below 10
Serum urate level 309 Range: 184 to 464
Serum total protein 76 Range: 57 to 8

Serum vitamin D 63
Serum vitamin B12 524 Range: 220 to 700
Serum folate > 20.0
Serum ferritin 11 Range: 10 to 291

Full blood count
Total white cell count: 7.9 Range: 4.0 to 11.0
Red blood cell (RBC) count: 4.89 Range: 3.90 to 5.60
Haemoglobin estimation: 147 Range: 115 to 165
Haematocrit: 0.447 Range: 0.370 to 0.470
Mean corpuscular volume (MCV): 91 Range: 80.0 to 99.0
Mean corpusc. haemoglobin(MCH): 30.1 Range: 27.0 to 32.0
Platelet count: 334 Range: 140 to 400
Neutrophil count: 5.34 Range: 1.50 to 7.50
Monocyte count: 0.42 Range: 0.20 to 0.80
Eosinophil count: 0.04 Range: 0.04 to 0.40
Lymphocyte count: 2.05 Range: 1.00 to 4.00
Nucleated red blood cell count: < 0.20 Range: 0.00 to 0.20

Serum LH level: 12.1
Serum FSH level: 15.8

Haemoglobin A1c level: 4.9 Range: 4.0 to 5.9

HbA1c levl - IFCC standardised 30 Range: 20 to 41

Serum free T4 level: 12.9 Range: 11.5 to 22.7
Serum TSH level: 1.00 Range: 0.55 to 4.78

I discovered that magnesium deficiency is more likely to cause muscle pain. I took HRT because I thought it was due to perimenopause and HRT made no difference. I take lansoprazole for reflux, have done for years ( I take blood pressure medication and reflux is a side effect). Lansoprazole prevents absorption of magnesium so I was chronically low. Vit B 12 is also similarly affected.
After 6mnths of supplements I had a massive improvement.

Other signs of low iron are a chronic metallic taste or burning mouth, enlarged tongue and brittle nails. The fatigue can be severe and also when you climb the stairs you can have heavy legs and palpitations. I had severe anaemia during pregnancy, the result of years of heavy periods. I used to regularly get the “twirly-whirlys” sort of a spaced out feeling/brain fog combined with dizziness.

I struggled with iron supplements because they caused gastritis. Eventually I had ferritin infusions and within a few weeks was bouncing off the walls again.

That's really interesting, I've been following them a lot as my ferritin was 5 and haemoglobin 83, I did wonder if some of it was a bit crackpot ?

Her ferritin is dreadful! That's not 'normal' in the real life sense of the word just some ridiculously low NHS threshold

Yes totally incorrect mine were still very very regular

That is so bizarre about the ranges.
I really hope the iron does the trick for you.

Your five hours too late with that insight 😂 And it may well not explain everything.

I had my bloods done at 44 when I had your symptoms. I also wasn't sleeping. Was told I wasn't in period. Like hell I wasn't! I was just ultra sensitive to the slightest hormonal imbalance, and they weren't enough to show on a blood test. Within 6 months they were and I was allowed HRT.

*wasn't in peri, not period!

Also have restless legs. Definitely think the ferritin. I'll check what strength my iron is this morning. Will over the counter be fine?

Here I am in bed after going to bed at 10pm, and I have no energy to get up. I have a million things I really want to do today (flexi day). He seemed so heavily focused on it must be my mood and would not listen to me.

Should I speak with someone else? Wait 3 months and go back?

@Icenii Just in case you missed it, how long have you been taking the iron? If it's been a while then it might not be being absorbed properly and so you might need a different form. If it's recent I would take it for 3 months and then go back. Hopefully that should do the trick and you should start to feel better.

Same here at 52. Definitely peri

My current ones are from Boots and are purely 14mg of iron. Taken for a month so far. Had to wait to get a month to get a follow on phone call from the GP.

Before that it was the liquid feroglobin on and off this year; so not consistent. I am a vegetarian but my diet is rich in foods with iron.

Some months my periods are heavy, some months they are not.

Iron what? There are various types: ferrous fumarate, ferrous sulphate, ferrous gluconate etc. They’re all absorbed slightly differently, and ferrous fumarate in particular can be very hard on the tummy. I would also suggest that 14mg is no where near enough, depending on the exact form. Also, are you avoiding tea and coffee, especially around meal times? The tannin content can inhibit iron absorption, while vitamin c, such as in orange juice, can help. Plus if you’re having heavy periods then ibuprofen can help slow blood loss; ibuprofen reduces prostaglandin production and so leads to fewer cramps/ less bleeding.

Its 'Active Iron' and it says iron sulphate.

I take ibuprofen for PMT and joint aches.

Im going to have to read up and find out what to take. Really, I would have hoped a GP would have helped rather than tell me all my bloods were fine.

I don't drink caffiene with food but do have a lot of tea.

Thanks for all the replies BTW.

https://www.hollandandbarrett.com/shop/product/active-iron-30-capsules-60063456

As a first step I would suggest tripling your iron tablets. That’s still less than the recommended daily dose for iron deficiency, which is more like 200mg a day/every other day, but should give your ferritin a bit of a jump start while limiting potential gastric issues. As you can see from the thread, GPs are notoriously terrible for iron issues, especially in women. I would aim to get your ferritin to around 100; that’s the level many women need to feel well in themselves. Oh, and try and cut down the tea! I hope you feel better soon 🙂

In the short term get some floradix from H&B liquid iron with all the stuff in to help you absorb it.

A tip given to me by a pharmasist- When you take your iron tablet drink a small glass of orange juice with it. The vit C in the juice means a lot more iron is absorbed and means you won’t suffer from an upset stomach, which can happen when taking iron supplements.

Hope you’re feeling better soon.

OP i take ferrous sulphate from boots (210mg) with 1000mg of vitamin C tablet (orange juice is grim and the tablets do the same job!)

As above, every second morning at 5am when I get up. No coffee, tea or herbal drinks or food for 2hrs afterwards.

My ferritin went from 13 to 71 in three months.

14mcg is the kind of thing Holland and barrett sell.

You need to get proper strength ones for the pharmacy counter at boots. I've had them from asda pharmacy before too.

I have been feeling exhaustion for over a year and it’s getting worse, I can’t leave the house some days. Hair shedding, bones aching, sensitive eyes, brain fog, heavy periods. My GP is so unhelpful, I’ve had blood tests and eventually I was told to take vit D. I’ve just had another look at my test results on the back of this thread and ferritin is 18. Perhaps low iron is my problem. I was dismissed several times when I mentioned perimenopause and I was offered anti depressants instead, I’m now having the marina coil as I’ve been told this will help with symptoms and heavy periods and then if I need it HRT for estrogen.

Worth upping your iron @dutysuite . They are so dismissive. I've just asked ChatGPT about it and it says they are low and I should consult with the professional to understand why.

I don't see why they can't use a carefully designed AI to examine medical history and blood test results. I'm sure it would produce better correlations and outputs. We use it in IT all the time.

I've bought some 200mg ferrous sulphate tablets and added orange juice to the food order. Let's see if these work.