Hello,

I'm confused about what my Doctor has tested me for and what vitimins I should be taking supplements for. Apparently all my bloodwork comes out looking good, but I don't think I'm being tested for some vitimins I should be checked for. I'm still very fatigued all the time and think this is the reason. All the numbers below are within range so I didn't bother posting everything, but this is what I have been tested for. Please help with suggestions. I'm making an appointment tomorrow and need some answers. I should be feeling better by now, but am still really tired. Thanks!

WBC
RBC
Hemoglobin
Hematocrit
MCV
MCH
MCHC
RDW
Platelets
Neutrophils
Lymphs
Monocytes
Eos
Baso
Glucose Serum
GLom Filt Rate
Vun/Creatinine Ratioj
Sodium,Serum
Potassium, Serum
Chloride, Serum
Carbon Dioxide, Total
Calcium, Serum
Protein Total, Serum
Globulin, Total
A/G Ratio
Bilirubin, Total
Alkaline Phosphatase, S
AST
ALT

On my own, I've been taking a multivitimin, extra C, Calcium, Magnesium, Zinc, D, B12 and B6. I have not taken any probiotics or enzymes yet. Are these necessary?

Hi Joni,

I am by far an expert!!! Have you been tested for Thyroid? I believe that low thyroid could cause fatigue. Here are the tests I had:

TSH
Thyroxine (T-4)
T3 Uptake
Free Thyroxine Index

The only thyroid test I've ever had was TSH. It was 1.817, in the normal range. They never tested me for any other thyroid numbers. I will talk to her about that, too. Thanks!

How about a...

Sed rate
C-reactive protein
B-12
D (or ADEK if he feels adventurous
That should cover some possible immune and vitamin sources of fatigue-very broadly, there are a lot more specific tests.
Have you had and ANA before?

You need to make sure your vitamins etc. have no trace gluten in them. And yes enzymes really do help.

I second testing for B12. You can be in the low normal range and still have some nasty symptoms. It happened to me. I am on B12 weekly self injections and it helps so much.

I also agree with the B 12. I had low normal as well, but my doctor decided to try the B 12 injections. My fatigue improved greatly with the first injection and has continued to improve. My tremor went away along with the caffine sensitivity I had been having.

Fatigue was the only complaint I had left after a year gluten free.

I am not 100% yet, but getting so much better.

I'll just add I tend to be B 1 deficient, not B 12. They don't make B 1 injections. So I take co-enzyme multiple vitamins to get 100 mg. of the B 1 each day -- balanced with the other B's (B 12 is in there however). The co-enzyme quality makes the B's go directly into the blood stream rather than having to be digested in the gut. As such one has to take it at least 2 hours after and 1 hour before eating--though in actuality I just take it either late at night or early in the morning. I avoid the sublinguals since they often have sorbitol which can have gluten. B 1 deficiency makes making use of basic protein and carbohydrates dicey as well as undermines the nervous system in general.

You may also want to have an iron panel run. It usually includes your ferritin, total iron binding capacity (TIBC or IBC), iron saturation and it has a couple other things.

It is either called an iron/anemia panel or hematology panel. Even though your hemoglobin may be within normal range, these other numbers can be low which makes you iron deficient, not anemic.

That will cause lots of fatigue.

I went back to my older bloodwork and found that I had been tested for the Iron and TIBC and also B12 and folate. This was taken 1 month after I went gluten free (the end of August)

Iron Bind. Cap. TIBC 338 250-450
UIBC 230 150-375
Iron, Serum 107 35-155
Iron Saturation 32 15 - 55

B12 659 211-911
Folate, Serum >24 >5.4 normal

I've never seen a iron panel ordered as a hematology panel. The hematology panel is the Hgb, Wbc, Differential, Hct etc... this is usually done by a machine and if any of the tests done in a panel are abnormal then a technologist makes a slide and does the differential manually. The full iron studies has to be ordered as a full iron studies (at least in the labs I worked in).

Yolo! You will hopefully be pleased to learn that they do make thiamine injections. Just search on "Thiamine Hydrochloride Injection, USP"
Here is a PDF file with lots of info
http://www.appdrugs.com/PIs/Thiamine_45819C.pdf
Your doc should be able to get these for you, if you are interested
This vitamin has become very popular for injection in the past few years because large numbers of people who have had gastric bypass surgery are deficent in it.