(See details.) Can I request a CBC during my annual physical exam?

It is a reasonable request, given your list of symptoms. Drs. will always try to eliminate physical causes and will also be receptive to discussing psychotherapy. You might want to call your insurance company before the visit and find out just how much psychotherapy is covered over a year under your policy.

You might want also to look into some secular guided meditation techniques…you can do it at home…twenty minutes daily is easy and useful. I do it daily myself and have found it has helped me through some very trying situations. If you want details of what I do, PM me.

My insurance covers CBC whenever I need it. I have a slow thyroid, and also had weight loss surgery so those are all things that one would need blood count to monitor. I think you have a valid and legitimate reason for CBC.

Bloodwork is a fairly standard part of any physical exam so there should be no problem with requesting it.

CBC, TSH, vitamin D and B12 with those symptoms.

My physicals always included CBC even without any symptoms. When you think about it, you can have some health issue trending that does not yet cause you any discomfort, but the numbers might be creeping up or down or whatever and the doctor should need to know.

Actually, add a BMP too maybe, so your glucose is measured. You should be fasting for that test.

By the way, if your B12 is below 500 I suggest supplements or foods with B12. Some doctors won’t mention a reading as low as 300.

I’m pretty sure my physician does the BMP automatically. My husband always gets lab results showing sodium, potassium, etc. when he has a physical with the same doctor and I know I’m getting a fasting glucose done because I was told not to eat beforehand.

I suspect anxiety is the root of my problems, probably made worse by the caffeine in my preworkout supplement and coffee in my protein shake. I’m pretty much fine on weekends when I’m not working out or drinking coffee, and I don’t have work to worry about. My symptoms just don’t seem to fit anything else all that well. One symptom of this, two of this, but nothing really concrete is sticking out. Of course, I’ve convinced myself that I have a brain tumor, but logically I know that’s my anxiety talking as well. I find talking to my husband about it and trying to be as realistic as possible seems to temporarily help any weird feelings I’m having, so there’s that…

Thanks for the input. I’ll definitely be asking for the CBC if he doesn’t automatically do it, which I don’t think he will.

I’m on a prescription drug that makes any blood test automatically include CBC, but I hate the idea of having to request healthcare that isn’t covered by insurance because I never even have to consider the insurance question when it comes to my or my family’s healthcare where I live.

I want you to read up on something. Have you ever heard of the vagus nerve? It is incredibly powerful and it is very under appreciated and ignored. Here are a few articles:

https://www.psychologytoday.com/blog/the-athletes-way/201302/the-neurobiology-grace-under-pressure

http://www.newsmax.com/Health/Headline/anxiety-vegus-nerve-stimulation-brainstem/2014/09/15/id/594746/

This is why people think prayer helps them, even though it could be anything they use to slow down and control their breathing. Buddhist chants and meditation create the same conditions. It is helping to stimulate the parasympathetic nervous system in the body which helps break the stress cycle of adrenaline and cortisol your body releases as a result of the thoughts going through your conscious brain.

A physician should order a test only if there is a clinical indication, and you’re trying to answer a specific question. Tests should not be ordered as “fishing expeditions.”

Can you go without the preworkout for two weeks and see if that helps?

A lot of them mix vasoconstrictors (like caffeine and others) with vasodilators (like l-arginine and niacin) and so you’re left with battling ingredients that go through your system at different rates. That would explain a lot of your changing symptoms. Scalp/lips/tongue/fingers would be especially susceptible because they are sensitive extremities.

Depending on which preworkout you use, some also have ingredients meant to improve your mood, although that’s less common since a couple of them have been pulled by the FDA.

Caffeine and creatine usually get you the two biggies in preworkouts without the unknowns if you want to run a test.

@osoraro Wouldn’t you agree a CBC or iron can be easily justified for women yearly. My TN GYN tested iron in her office during an annual visit. I refused it sometimes when my CBC started being done regularly by my endocrinologist.

Same with B12, vitamin D (if the OP has no tan) and thyroid (thyroid especially with her anxiety, but it can be justified to check in women routinely. I had a GP who used to test for it regularly).

@JLeslie I agree. My GP orders a CBC every year, following my regular physical.

@funkdaddy I go without preworkout on my deload week, which is one week every month. I wasn’t having these symptoms before my last deload, so I’m not sure if going without preworkout had much of an effect. My next deload week is the week after my exam, but I will be using a different preworkout (almost half the caffeine) next week, so I’ll see if I feel different that week and then the following preworkout-free week. I’m going to get the CBC done regardless, but if it’s clean, then I’ll still need to figure out if it’s my caffeine intake. I actually plan to cut the coffee out of my protein shake and decrease my preworkout to 1 scoop instead of 1.5 scoops as of tomorrow. That’ll make about a 130 mg difference in my caffeine intake each day.

I use Cellucor C4 Extreme usually. Next week I’ll be using ProSupps Dr. Jekyll.

@livelaughlove21 Here’s where I am going to agree sort of with @osoraro…why a CBC? It isn’t testing really for anxiety related things. I just support your desire to do it because I think it’s justified for women to have their iron checked or the CBC done, which if your iron is low the CBC will have whacky red blood cell numbers. If you already get iron done, CBC is probably overkill and a waste of money for you and everyone paying for healthcare in your group. What specifically in the CBC are you interested in?

@JLeslie Because I don’t want to brush it off as being caused by anxiety if it’s not. I’m certainly not under the impression that a CBC will test for anxiety. I’m just concerned that these symptoms might be caused by a physical problem instead of a mental one. If the CBC comes back fine, it’ll be even more likely that this is anxiety-driven. Once I know that, the anxiety will probably dissipate. If I knew it was anxiety causing this with certainty, then I wouldn’t care about a CBC. I also just want to know I’m healthy before I try to have a baby. If any of my numbers are off, I want to know why and address the issue.

If the CBC has low or high numbers it won’t answer anything regarding your desire to figure out your anxious feeling. Not that I know of. @osoraro can correct me if I’m wrong.

CBC is only an indicator if infection. I don’t know what your obsession with it is. If you had an infection you would normally be running a fever or showing signs of an infection.

@JLeslie Once again, I’m not under the assumption that the CBC will show anything related to my anxiety. I’m not sure how to make myself clearer on that. When I said that my anxiety will probably dissipate once I get normal results is because that’s how it always happens with me. I freak out that I have some illness, I see a doctor about my symptoms, they tell me I don’t have this illness, and then the symptoms go away because they were most likely caused my anxiety in the first place.

@cazzie Obsession? Seriously? I have health-related anxiety. Be glad if you don’t know what that’s like.

“A complete blood count may be done to:

Find the cause of symptoms such as fatigue, weakness, fever, bruising, or weight loss.
Check for anemia.
See how much blood has been lost if there is bleeding.
Diagnose polycythemia.
Check for an infection.
Diagnose diseases of the blood, such as leukemia.
Check how the body is dealing with some types of drug or radiation treatment.
Check how abnormal bleeding is affecting the blood cells and counts.
Screen for high and low values before a surgery.
See if there are too many or too few of certain types of cells. This may help find other conditions, such as too many eosinophils may mean an allergy or asthma is present.

A complete blood count may be done as part of a regular physical examination. A blood count can give valuable information about the general state of your health.”

It’s more than just for infections. It’s not as if I’m requesting a full-body scan or something.

Not getting involved with this any more than I already have. Sorry.

Well that escalated quickly. Surprise surprise. Heaven forbid someone want a blood test when they’re experiencing physical symptoms that are scaring them. I must be some crazy freak to think that might be okay.

I thought I’d answer @jleslie’s direct question about routine annual CBC. The answer is categorically no.

http://www.aafp.org/afp/2007/0801/p351.html
http://www.acpinternist.org/archives/2010/01/annual.htm

And for the record, I didn’t say the CBC was not indicated, so nobody should try to say that that’s what I said. In fact, I’m not commenting on the clinical situation of the OP at all. A CBC very well might be indicated, but I would only know that after taking a complete history and physical exam.

@cazzie Untrue. It’s not only to indicate infection. It looks at RBC’s too and that can be off in the absence of infection. Mine are because of anemia. My husband’s because of thallessemia.

@osoraro Sorry if it seemed like is was putting words in your mouth. Not my intent. What about testing iron in women? My GYN in TN did it, other GYN’s didn’t. I used to refuse a urine test at my GYN most years also.

I found out about my lowish B12 without having any complaints.

@cazzie Another interesting thing I noticed one time was my platelets were normal, but very close to being out of range on the high side. This is when I was a teen and on the pill. I did not routinely have blood tests. I’ve noticed my platelets are never towards high now. I don’t know if that was a fluke reading or if it had to do with being on the pill. It would be an interesting “test” when I took the pill again, but I never checked it.

Given that I have heart disease and DVT in my family, and known genetic bad stuff for clotting, plus other bad cardiac numbers it probably isn’t a bad thing to check my platelets when I took the pill.

And NOW I’m leaving this thread. I just needed to correct some inaccuracies and misrepresentation in what I said.

Bye bye.

I have CBC with every physical since getting my full time employment with benefits almost 20 years ago. I had a slow thyroid which I had no symptoms for but the numbers were trending upward. Even at my worst, I had no symptoms except weight gain, which could have (and was) due to a variety of factors, slow thyroid being one of them.

The only other thing I had which could be attributed to slow thyroid is dry skin, which I had been treated for at the dermatologist, who incidentally never mentioned that I should have my thyroid checked.

Depression could be a symptom of slow thyroid, and anxiety is the “cousin” of depression. Do you see where I am going with this?

To be clear a CBC does not test your thyroid. I’m pretty sure everyone in this Q knows that, but just in case I’m stating it.

Anxiety is extremely common with overactive thyroid, but that does not mean most anxious people have overactive thyroids.

More about my CBC. My hemoglobin and hematocrit (the red blood cell stuff) has been low pretty much since I can remember and doctors never says anything. When I had an ectopic pregnancy my RE said I was very anemic and I took a lot of iron. I realized after taking all that iron and then stopping again that the iron really really helped me. I’m a big believer that lowish iron levels might be healthyish, I think maybe it helps with heart (this is my no medical opinion) but not healthy to be below normal levels.

I think I spent many years more exhausted than necessary, because doctors never told me to take a little iron considering my blood tests. To this day doctors don’t mention my low numbers when they occur, except the hematologist I went to one time out of curiosity and she felt it warranted to take iron. I know I feel much better when I do get my levels up into normal ranges. I stay low normal. So, even having the test did nothing for me, because of how the doctors interpreted it.

I constantly don’t test things written for me. Meaning I refuse the test. If I know it was just done I’m not going to repeat some basic test without reason. My doctor writes a standing every three months thyroid panel, CMP, D, CBC. Thyroid I tend to do every three months, because I have a thyroid problem, and difficult to stabilize, although my new combo of meds has been good so it’s actually 4 months since the last time. The others I do once every six months, and a cholesterol and B12 once a year unless I have changed something significant like med or supplement dosage or am having symptoms.

@livelaughlove21 It’s likely your CBC has been run before, I would just say I can’t see running it often if it is always normal. My husband’s is abnormal and I don’t feel the need for him to do it at all as part of his check up.

I hate doing unnecessary tests, it feels like a money grab to me.

If I were you I’d focus more on dealing with your anxiety and get to a therapist. If you think every little symptom you have is worst case senario I can imagine that will only get worse once you are pregnant.

@jonsblond that is the angle I was trying to take, but feeding her anxiety is only detrimental. Seems @JLeslie only wants to feed the problem.

I’m telling her the CBC won’t show anything regarding anxiety. The thyroid test is justified in anxious patients. I would hope it has been run on her previously. The photo I have seen if the OP I think testing her vitamin D is a very good idea, unless she is more tan than what have seen.

Hyperthyroid is seen in more young women than you might guess, although not extremely common. The test is justified.

One in eight women have some sort of problem with their thyroid during their lifetime. That’s the same as breast cancer. Should we stop testing for that? It’s said that half the people with thyroid disorders are unaware. It is not tested by doctors enough. Simple test. I don’t know if the OP has other symptoms. Except that she is thin, but she works at staying thin so it could easily just be diet and exercise.

You project far too much, @JLeslie

Not “feeding my anxiety” is one thing, @cazzie, but being rude and attempting to make me feel stupid for asking this question isn’t helpful either. @jonsblond somehow managed to get your point across without being insulting, so I’m not sure why you couldn’t. I’m very aware my fears aren’t based on logic, but that doesn’t make them feel less real. Telling me I’m obsessive and implying I’m being ridiculous is hardly going to make the anxiety go away. You’d think I was asking for MRIs and CT scans with no symptoms present. Not the case.

@JLeslie hasn’t made me more worried about it. My weight loss was the result of hard work and definitely not accidental, so I’d be surprised if my thyroid is the problem. I could quite easily be chubby again. Also, I am pretty pale, but I get a sufficient amount of sunlight and I’m not concerned about a vitamin D deficiency. I’m out in the sun a lot in the summer, but it takes a lot for my skin to tan and I lose it quickly. It’s also winter, and most people are pretty pale. Being tan certainly does not indicate health these days – it indicates skin damage. Finally, any picture of me I’ve posted here has a filter on it, so my actual skin tone is likely a mystery to anyone on Fluther.

Just because I’m not discounting all of her ideas doesn’t mean she’s feeding my anxiety and I’m sitting here convinced I have all the ailments she has mentioned.

Now your weightloss is from hard work? You listed it as a symptom earlier.

@cazzie Uh, and where did I say that? I never claimed weight loss was a symptom.

It is listed as one reason a CBC might be done. It was copied and pasted (hence the quotes) and I never claimed to have all of those symptoms. I even bolded the parts that applied to me. Weight loss was not one of them.

Yes, my weight loss was from working my ass off in the gym and meticulously tracking macronutrients. It wasn’t the least bit “unexplained.”

Way to focus on only one part of my response. You clearly think I’m an idiot, so why continue posting?

I’m not recommending tanning, I’m saying lack of tan can indicate possible D deficiency. I don’t know anyone pale like me through most of the year who isn’t deficient when they finally get tested if they don’t take D supplements.

@cazzie I would link all the medical Q’s I can find where I was right, but the search doesn’t work well now to go back over the years. It is bazaar to me too how many women have thyroid problems, low B12, and low D and don’t feel well. Of course, it isn’t like every jelly I suggest the testing too has the problems, I’m not saying that. Enough do that I don’t feel bad for a second that I bring up those simple blood tests.

I don’t project as much as I am disappointed with doctors who have missed and ignored things during my medical care, and I admit the questions can trigger my feelings about it.

I, like @JLeslie, had medical issue ignored for about 5 years by the physician, when I had blood work and thyroid was slowly trending to 5.5 (which was “high normal” at the time I had it done first, with today’s standards that’s considered “high”). Then it was 8 which was when she finally mentioned it to me. It’s for that reason that now, when I get my blood work done, which is annually at minimum, I request a copy of the results be sent to me so I can look at them myself.

Just one example where I was right. I can’t resist. http://i.fluther.com/77504/what-is-happening-to-my-mother/#quip1221763 I’m so tired of being told to shut up on
Medical Q’s and that I am projecting or not a doctor. I readily admit I am not a doctor. Here I am right and the doctors seem to be wrong. They don’t believe the patient is having hypothyroid symptoms and she was. None of us are there in the medical exam room looking at the patient if the test results so obviously none of us on the internet doctor or not can be substituted for the doctors actually treating the patient.

There was another where a girl described all sorts of problems and I told her she sounded hyperthyroid and she said she already had been diagnosed with it! Failed to mention it in her Q. I could go on and on.

Considering the obesity rate in the US, you will probably be right most of the time with that guess. I guess we should just start calling you the ‘Thyroid whisperer’.

I prefer not to be overly obsessive about medical issues myself and trust good communication with my doctors.

@cazzie Go right ahead. I recommended tests, not for anyone to start popping any pills. I don’t see any major harm.

I am the voice of reason on many Q’s. Asking jellies who want a test done what will happen if the test is positive? Any change in treatment? If not they shouldn’t be so panicked they can’t get the test right away while other jellies are freaking out the test has not been done. I’m not a hypochondriac and I don’t think everyone is a thyroid patient or deficient in D, B12, and iron. What I do think is it is missed all too often by doctors or ignored when numbers are near the edges of normal. If nothing is mentioned to the patient they might be moving out of normal without being tested for months and years. Many people, especially young people, don’t go to the doctor every year. If they know they are teetering on a borderline they are more likely to get the retest within 6 months or a year or whatever the doctor thinks is prudent.

I think CBC is run too often personally, that is my experience and why I refuse it sometimes. I have had bad infections and my CBC is perfectly normal except for the red blood cell stuff that is unrelated anyway. Not that I am saying it shouldn’t be run when infection is suspected, I think it definitely should be.

What I find is some doctors run certain tests because they have come to realize a lot of their patients are abnormal and see positive results treating it. The doctors who never run those tests don’t know a lot of their patients would turn up abnormal.

(will this thread ever end?)

@janbb I’m done.

I have seen a lot more of the medical profession in the past three months than I had expected to. Docs are courteous, informative, and good listeners. For the occasional glitch, which has not been medical, but procedural or bureaucratic that I have caught, everyone was responsive.