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

Optifer is the brand I used when I tried heme. Im glad it worked well for you

My quickest raising of ferritin was taking feroglobin capsules from Vitabiotics. These only have 17mg of iron, and are slow release and combined with other minerals/vits. NHS advice says to not to take slow-release or combined formulas, which I’m guessing is based on clinical evidence but it is interesting how people respond to things differently. I imagine we also respond differently at different stages in our life. Our bodies are always changing, and causes of aneamia and state of gut health probably has a role to play too.

Just re-reading back through thread and this stood out to me. My most recent aneamia happened after I had been taking ibuprofen regularly to cope with joint pain. I’m post menopause but had to stop HRT last year after breast cancer. The joint pain has been awful and I had got into the habit of taking ibuprofen when waking just to try to get out of bed. So on an empty stomach. I stopped after a month or so cause I had just awful stomach pain and I do wonder whether the ibuprofen contributed to my drop in iron.

Cricket; that's dreadful. You just feel awful!

GP's inist that central hypothyroidism is rare but I suspects it's just wildly undiagnosed.

Please get yourself on the health unlocked thyroid forum. I can't overstate how helpful they are. 🧡

Any other autoimmune disease in the family? Coeliac blood test might be worth doing, undiagnosed it can leave you exhausted and unable to get proper nutrition from food you are eating, often resulting in anaemia.

I was told by my gp that my ferritin levels were ‘normal’ for our area, but where she had worked before the parameters were different. Based on the results and my symptoms I was prescribed a supplement. Lo and behold, my hair started to grow back and I was less tired!

I think this looks for markers for coeliac Tissu transglutaminase IgA lev < 1 Range: Below 6.

We have rheumatoid arthritis, lupus and fibro.

Interesting about ibuprofen. Will read up about that.

Hypothyroidism is also an autoimmune disease... This is your problem. Everything else is a red herring. Doesn't matter how much iron you take, you'll still feel shit with T4 that low...

What on earth am I meant to do about that?

You need to speak with your GP about central hypothyroidism. As I mentioned before I'd suggest you go over to the health unlocked forum to find out more about it.

Hypothyroidism is quite manageable/treatable.

It also causes low ferritin.

Ah right I missed that was the coeliac test! Could ask for antibodies test for Hashimoto's? (Autoimmune hypothroidism)

Arh. There is a correlation between thyroid disorders and melasma. I have had large patches on my face for years and nothing from Dermaticia fades it.

I'm going to go back and talk with someone face to face if they let me.

I haven't gained weight though.

I've found ferrous sulphate to be the best option for me. It raises my levels quite slowly but minimises gut symptoms (though there are still slight issues). Fumerate gives me awful diarrhoea and bisglycinate the opposite. With iron preparations I think finding what works for you is key. The pharmacist at our local pharmacy won't sell fumerate or sulphate over the counter. You need a prescription or a letter from the GP recommending you take them. This is since the dosage was reduced from 3 a day to 1. It seems like the general feeling in the NHS is that people are overdoing it with iron. Yet so many people appear to be deficient.

I never gained weight either. Not everyone presents that way. Still have all my eyebrows too.

You will likely face push back as GPs think central hypothyroidism is mega rare when in fact, it's just under diagnosed.

Best of luck. 🧡

Thanks for the correction about it not being available over the counter. I am always wary of getting involved in online discussions about health - I get annoyed at the misinformation and so it’s really useful (and embarrassing!) when it turns out I’m contributing to it.

I bought mine online June 2022. I wonder if the guidelines have changed since then, or if I just mid-remembered the process. Anyway, thank you 😊

With regard to the changes in dosing from 3 x 210/320mg to 1 x 210/320mg a day, guidelines were changed fairly recently because research showed that less frequent dosing was more effective. Further research has shown that every other day 210/320mg is as effective as daily. So yes, less is now more.

I also found that I struggled to take it on empty stomach, avoiding tea etc for a while after, remembering the vit c. So I’m a bit more relaxed nowadays and figure it’s better to just take it rather than wait for the perfect environment for maximum absorption!

I've just bought it from an online pharmacy. I added my blood test results into the request. I plan to take take it every other day and then a general supplement in-between that I need to finish off.

Started to feel like I want to vomit and not eat. Been taking them for just over a week, every other day, and was fine.

Hi @Icenii

I know this is an old thread but just wondering how you're feeling now?

Sorry didn't realise it was an old thread... skulks off

Hi

Sorry - old thread i know
But i currently have high urate

Wondering what happened re your urate reading please ?