GP refusing iron and B12 testing

[Lemonthyme]

I'm so fed up with my GP. Looking back through my test results, My iron and B12 levels were on the low end of the normal range 2 years ago. I'm struggling with energy, weight loss and feeling cold. Recently had some blood tests and the GP didn't bother to repeat them.

He's saying because they were in spec it's fine despite there being loads of evidence out there that people who exercise a lot need more than scraping the bottom of the range.

I have a GP appointment soon and he's refusing to repeat these tests before I see him. After my last appointment he referred me to the county "weight loss service" who aren't accepting patients anyway but helpfully sent me advice on diet and exercise (I exercise 5-7 days a week already and already eat healthily and drink no alcohol).

To say I'm p---ed off with this idiot is understating it. We have poor provision where we live for GPs so I can't even move practice (I'm outside the catchment of other practices).

I'm perimenopausal but utterly f-ked off by being gaslit by male GPs who think "eating less and moving more" is a magic wand for all weight loss despite the fact that most people find that advice really hard to follow but I'm one of the unusual cases where I AM ACTUALLY DOING IT ALREADY!

Since my last consultation, no thanks to him, I read up on B12, ferritin and how that can elevate HbA1c results (mine were 5.8% despite my lifestyle) but in any case am trying 1 x 24 hour fast per week which so far DOES seem to be helping, albeit I'm pretty knackered. Possibly glycogen depletion but if my HbA1c is high genuinely, what is the alternative? I just want some f-king advice that isn't bloody patronising. Is that too much to ask?!

The point in asking for the tests is because you can often have absorption issues so supplementation may not work.

Why does it feel that as a middle aged woman in the UK you're on your own when it comes to health? Drives me potty.

All I can say is UANBU. And I agree, it really does feel that as a middle aged woman (and let's face it, a woman of any age), they just fob you off.

Change doctors or practices. There are also private tests you can do where you attend a clinic or order a test and take the blood yourself. It's really easy, I did it recently for a female hormone test because of my anxiety, fatigue, low mood symptoms, I'm 44 and my female GP said I could not be perimenopausal at 44 even though my friend had anxiety as a peri menopause symptom and let's face it some women start perimenopause in their 30s! My iron is also bottom of normal range, it was 41 which is the exact bottom of the range and has been 19 before when I was younger but she signed it off as normal. My HBA1C was 43 which is prediabetic officially but it was signed off as normal by my previous GP which is why I moved to my current one. Not sure why yours is as a %, is that blood sugar rather than HBA1C? My fasting blood glucose was 5.9 so top of normal range.

Im the same, some of my results are right on the border of too low but its 'normal no action' as the comment on the results.

I would use medi checks or Thrive or something like that if you can, they sometimes have offers. Remember to not take your supplements for a periods prior to the test (I stay off them for a month but I dont think it needs to be that long)

So they didn’t do B12 or iron on your recent test? I don’t think I’ve ever had a blood test that didn’t have them as standard

If you can afford it, or have access to a private health check via your employer, I would look to get some bloods done elsewhere. If these are out of range then your GP will treat the problems.

I’m not saying you should have to do this, just that I know several people who have with success.

Unfortunately access to tests are driven by policies and budgets rather than optimising individual patient health.

I had B12 and magnesium deficiency symptoms and with a history of long term PPI use it was obviously something to check. They tested B12 serum once, told me I didn’t need to stop supplements prior to testing as it was better to see levels with supplements 🤦🏻‍♀️ and as results were in NHS range, and I was also on HRT, my female GP told me all was ok and “we all get niggles as we get older”. She wouldn’t listen to my request for an active B12 test.

Everything pointed to B12:deficiency and so I started self injecting and 3 months in my peripheral neuropathy symptoms were gone. I am trying to reduce frequency of injections now but find after 4 weeks symptoms start to return so injecting monthly for now.

I have read recently on Facebook groups GP have had new guidelines issued and they are being encouraged to challenge those currently receiving B12 injections, retesting B12 (which shouldn’t be done after treatment initiated as results will always be high) and removing prescriptions. Lots of patients upset that they are no longer receiving them when they have absorption issues.

Yep, try another GP.

I went to see mine as my annual monitoring is due, mentioned I'm feeling tired and think my meds are off and I've got an entire battery of tests lined up...

He did ask me if I eat too much tho!

Isn’t there a new law that if you go with the same symptoms 3 times they have to investigate - so if you go with tiredness over 3 separate appointments then they have to be seen to investigate that by necessary means

You self diagnosing and deciding your own treatment may not be right. Go to a private doctor if you don't believe your NHS doctor? Don't think this is anything to do with women being treated differently.

I can't. I live in an area where there are no other GPs who claim we are in the catchment area for their practice. I've already changed GPs within the practice several times. Honestly the relationship broke down when they refused to follow NICE guidance on HRT till I raised an official complaint about it.

44 is a prime age for perimenopause.

HbA1c can be expressed as a percentage or mmol / mol. I think it equates to 41.

But that high when I'm really active, eat healthily etc is really weird.

I'm sure well meant but when they have been very difficult about anything relating to HRT, it's hard not to conclude that.

I can't afford a private doctor. I work for myself. My B12 and iron results were both reported as abnormal previously but over 2 years ago but now with symptoms they're refusing to retest. When those blood tests for the NHS are actually relatively cheap and treatment if I need it is too, also preventing other worse issues which could potentially happen with my health.

GP's do seem to be pretty rubbish on following up on blood test results..... luckily I have found a brilliant homeopath who also supplies supplements to help with these like low iron/ferritin levels. Have CFS ME, so need all the help I can get to improve my health!

Sorry, but I think you have convinced yourself of a health issue based on internet and possibly AI.
if you are struggling to lose weight, iron and b12 might not be to blame.
Test it. Buy supplements that melt in mouth and are absorbed by oral mucosa. If your issues go away, you were right, if not, at least you know it is not that.

Im interesting what you say here about neuropathy, Ive got this in my feet (the doctor isnt describing this as such) toes and hands but am on very very high B12 supplements due to a previous surgery

Recent bloods (which werent for this) came back ok but I realised I was taking my supplements. Im a bit worried that its not being measured properly

I just want to rule it out. Especially as it was previously low and I've changed my diet.

It's more the cold intolerance and tiredness which are odd symptoms.

But also I'm SO F-KING SICK of the "eat less and move more" advice that you're given without actually asking any questions.

I think it must be a nightmare to be a GP and have a percentage of patients who ship up demanding treatments, based on their latest internet reading.

The op is asking for fairly standard blood tests for her age! Don’t make out she’s being unreasonable. I’m waiting for an iron infusion (ferritin level 6, saturation 7%) but imagine if my gp refused to test, I’d be left feeling crap with no answers.

The alternative to ‘eat less, move more’ is the weight loss drugs. Worth considering?

You are NBU. Yet again I have had a hemorraghic bleed and I knew I was anemic (again) after 10 days of this.

i was told to book bloods. I could get any for 10 days (after the day I stopped bleeding) - this was a week ago.

The results still weren’t showing on my app today. I phoned to chase and was told my Gp was off today. Miraculously, 20 minutes later - they were on the app, and I had a text go book an appt.

my Hemaglobin is 91 (would have been lower as I’d been on 2x 210mg ferrous fumerate a day for 3 weeks). My MCH and platelets are also too high.

i phoned to book an appointment. They have none. I had to try again tomorrow.

my HG was 85 after a similar incident a year ago… they did nothing then either !

41 is prediabetic so they should be addressing that. I've lost 4st 4lbs since so my HBA1C has dropped to 37 but that's while on medication to reduce blood sugar so it could be a false negative.
Yes I'm 44 but according to my hormone results, carried out privately, I'm optimal for my 8 female hormones, they are all middle of normal range. But the oestrogen was middle of normal and progesterone was low (as expected) on day two of my cycl, so I believe I'm oestrogen dominant, which my symptoms have led me to believe for years. GP won't test further. I've since started taking pregnenolone for hormone balance and it's working a treat for the anxiety and mood swings and anger I was experiencing. I'm very chilled now and my insomnia has been cured. It's a shame we have to self diagnose and self treat.

Same here, they recently changed the reference range of normal as well for iron and B12 🙃 I've had to push so hard for blood tests and as usual it's men ignoring women's symptoms and just telling us to get on with it 😔

@TeenLifeMumYou call it “making out”, I call it a different opinion.

Have you had your thyroid checked?

But the op is the right age with the right symptoms so I’m struggling to comprehend why you would have the opinion she’s wrong to ask for a test the Nice guidance suggests is appropriate?

You can buy iron tablets and oral B12 and see if you feel better