Help with lab interpretation?

I finally got at least some lab results today. I'm most disappointed that there is no free T3/t4 info but I'm seeing an endo in January and hope to get it then. Here's what seems off:
TPOab - 71 (range 0-34)
Serum ferritin - 4 (range 13-150) on ferrex
Hemoglobin - 9 (range 11.1-15.9) down from 9.4
Hematocrit - 30.5 (range 34-46.6) down from 31.3
MCV - 65 (range 79-97)
MCH - 19.2 (range 26.6-33)
MCHC - 29.5 (range 31.5-35.7)
RDW - 17 (range 12.3-15.4)
Platelets - 470 (range 140-415)
Serum glucose - 101 (range 65-99) down from 167
A/G ratio - 1.4 (range 1.1-2.5)
HDL Cholesterol - 39 (range >39)
LDL Cholesterol Calc - 127 (range 0-99)
Vitamin B12 - 1602 (range 211-946)
Sonogram showed only mild diffuse enlargement of right gland

Cortisol - 12.9 (range 2.3-19.4)
DHEA - 285 (range 31-701)
TSH - 2.57 (range .45-4.5) down since 50 mc. Levothyroxine
T4 - 9.1 (range 4.5-12)

PCP doubled my ferrex from this report.
Any thoughts?  Things I should watch for?  I don't know what all of this means.  All other things were in normal ranges. I have at least 2-3 other autoimmune conditions and I at least suspect Cushings, possibly cyclical, and even MEN as my mother died in April from a rare neuroendocrine carcinoma.

[Squishyleo]

I gather the CBC problems are associated with the low iron and anemia. Does the antibody result mean it's definitely Hashimoto's?  What is the danger of the B12 being so high?  I was taking supplements but this looks like I should stop them or cut back.

[panda2526]

Hi there, took a quick look at your results...your blood work looks a little anaemic, but there are cautions here to consider...anaemia does not always mean you are also iron deficient. In fact there are many disorders where there is anaemia with iron loading...and thyroid issues are common with people with iron overload..ie, hypothyroidism and Hashimoto's are co-diagnosed with disorders having to do with damage to thyroid by excess iron in the body.

Iron deficient anaemia can be misdiagnosed and mistreated...a person is deemed anaemic and thus it is suspected that they have low iron due to low hemoglobin, hematocrit, RBC's...however for the true iron picture to be known they need to go beyond the ferritin test and also check the transferrin saturation, serum iron and TIBC. Then you will know if you are actually storing excess iron, while having a condition that prevents your body from making adequate blood cells.

Research... iron deficient anaemia as well as... anaemia with iron loading disorders (some examples sickle cell anaemia, and thalassemia...which affects the amount of blood cells your body has the ability to make and also the size of blood cells in your body, which are the MCV, MCH, MCHC, which are all low and below the range along with LOW ferritin, HgB and Hct. ) That way you will know for sure the reason for your anaemia. If you are anaemic there are reasons (inherited OR acquired...as in heavy internal bleeding or heavy menstruation or gastrointestinal disorders like ulcerative colitis...to name a few reasons.) One does not have to be iron deficient to be anaemic.

Take care...best wishes

[Barb135]

Since ferritin is the iron storage hormone, the fact that yours is low, would indicate that you are iron deficient.  

The fact that your RDW is higher than normal,  indicates that you might have pernicious anemia, which is another autoimmune that prevents the body from absorbing B12.  Pernicious Anemia is characterized by low B12.  I would request to have the test taken again, as there's a chance there might have been an issue with the testing process.

Most excess B12 is eliminated from the body via urine; however, there are some other conditions that can cause elevated B12, as well.  

I see your serum glucose was "101 (range 65-99) down from 167"  Are you diabetic?  

I might suggest that you stop supplementing (if you're not deficient, additional B12 will not make you feel better) and get retested in a few weeks.  Be sure to have your doctor follow up on this.

[panda2526]

A really helpful explanation as well I had saved as a link is for why ferritin could be abnormally low, as in your case, but it also explains the other low numbers in your profile, as well as in addition, also info on how the thyroid can affect these numbers...you might find it helpful, as a supplement to what also Barb has suggested...

http://www.ehow.com/info_8182878_reasons-ferritin-would-abnormally-low.html

This mystery we call "health"...

Take care...

[Squishyleo]

Thank you both!  I am not diabetic, but I've been told I am at times 'borderline diabetic'. Diabetes runs in my family so I won't be surprised if that happens too. I also understand hypothyroid can cause elevated blood sugar. I'm most concerned with the anemia right now because it's affecting me so and I was alarmed that even though I was on iron I got worse.

[Barb135]

I don't know your age - do you have extra heavy periods or anything like that, that might cause a lot of blood loss?  

[Squishyleo]

I am 44. My periods are long (~10 days) but only heavy for 1-2 days. I had to go back to the dr today because I discovered I had pinworms, which is totally mortifying, but I suppose they might be contributing somehow?  I'm on Prilosec and understand I'm more susceptible to things like that because the lowered acid levels in the stomach aren't able to destroy invaders as well as other people's. If there is any internal bleeding I can't tell. But my blood pressure had gone up again. Probably from worm horror. I'm feeling pretty defeated right now because I can't keep up with new problems constantly popping up.