Help with results please 🙏: Hi, been Hashimotos... - Thyroid UK

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Help with results please 🙏

Julesb02 profile image
Julesb02
•12 Replies

Hi, been Hashimotos/hypothyroid about 10 years. Was always on 225mg. Since perimenopause they've dropped me to 150 which I was reluctant but had to do. Stayed like this for 3 years but new Dr, new results - she wants to drop me again. Trying to balance HRT to help all pain and symptoms. Scared of how I'll feel and if pain/tiredness worsen again. (I'm already very tired). Do these mean I'm not converting T4-3? They won't test my tpo so don't know what antibodies are.

Tsh 0.07 [0.3-4.5], previously 0.03, 2023) 0.01 (2022)

FT3 4.5 [3.1-6.8] precision 4.7, 4

T4 [10-22] previously 22.7, 20.4

Ferritin 63 [12-250] (I'm only constant daily ferrous fumarate)

B12 245 [150-1000]

Thank you so much.

Finally managed to get surgery reception to arrange a call to speak to Dr tomorrow. Would like to be armed with what to ask. Thank you

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Julesb02
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Jaydee1507 profile image
Jaydee1507Administrator

I can't work out which is the correct FT4 result currently but your FT3 is standing at 33% of its range which is too low. You should be aiming for 70%.

Suggest you send for the Thyroid UK list of Endo's and doctors and think about getting some T3 added but only once you've sorted out your low B12 level and the others too.

To tolerate T3 we need optimal vitamin levels.

Your B12 level is dire. On a serum B12 test it should be 500+. That alone will be making you tired and a host of other symptoms.

You need to get D3 and folate tested. Many members buy private tests to get the results they need to see to feel well.

See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/testing/priva...

There is also a new company offering walk in& mail order blood tests in London, Kent, Sussex & Surrey areas. Check to see if there is a blood test company near you. onedaytests.com/products/ul...

Only do private tests on a Monday or Tuesday to avoid postal delays.

Are you supplementing other than iron?

Are you vegan or vegetarian?

B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

cytoplan.co.uk/vitamin-b12-...

amazon.co.uk/Better-You-Boo...

Julesb02 profile image
Julesb02• in reply toJaydee1507

Thank you so much for this. This is really helpful. My ft4 is 23 now. Sorry I missed that. I looked at the b12 symptoms - I have a lot, but the gp put them down to my hypermobility and perimenopause. Thank you, I really appreciate your help

Jaydee1507 profile image
Jaydee1507Administrator• in reply toJulesb02

Just checking if you always leave 24 hours between last dose of Levo & bloo dtest as per the protocol recommended?

If you do then its not good to have an FT4 above range.

If you dont then you need to and retest.

Julesb02 profile image
Julesb02• in reply toJaydee1507

Thank you, it was about 26 hours between doses as bloods were taken first thing in the morning.

Julesb02 profile image
Julesb02• in reply toJaydee1507

Just checked and they did my folate in December. It was 3.3 [2-18,8]. Not sure what that means?

Jaydee1507 profile image
Jaydee1507Administrator• in reply toJulesb02

So folate is very low indeed. Usual recommendation would be to start a good methyl/active type B complex which contains both B12 & folate.

Don't do that though until you've exhausted the GP option of B12 injections as beginning supplements now for B12 will scew any further blood tests.

B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

NHS easy postal kit vitamin D test ÂŁ31 via

vitamindtest.org.uk

SlowDragon profile image
SlowDragonAdministrator

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Do you always get same brand of levothyroxine at each prescription

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

Also both TPO and TG thyroid antibodies tested at least once to see if your hypothyroidism is autoimmune

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

and especially after dose reduction in levothyroxine

B12 far too low

You must test folate and vitamin D too

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Post all about what time of day to test

healthunlocked.com/thyroidu...

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Suggest you refuse to reduce dose levothyroxine at moment

Instead request GP test vitamin D and folate now

Work on increasing iron rich foods to improve ferritin

Julesb02 profile image
Julesb02• in reply toSlowDragon

Thank you so much. I tested before 9 but had eaten. I had also recently changed brand. I only get what the chemist gives. Mu folate was last tested in December and was 3.3 [2-18.8] but not sure what this means?

SlowDragon profile image
SlowDragonAdministrator• in reply toJulesb02

Means it’s also too low…..but not low enough for GP to prescribe

Taking daily vitamin B complex will improve low folate (as detailed in my other reply)

SlowDragon profile image
SlowDragonAdministrator

Low B12 symptoms

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

NICE guidelines on B12 and testing

healthunlocked.com/redirect...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

Once you have had folate levels tested

Start a separate vitamin B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid supplements

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus B complex popular option. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

Post discussing different B complex

healthunlocked.com/thyroidu...

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) Thorne can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Julesb02 profile image
Julesb02• in reply toSlowDragon

Thank you so much for this. I'll check the multivit I was taking for biotin

SlowDragon profile image
SlowDragonAdministrator• in reply toJulesb02

Multivitamins never recommended on here

Get yourself started on vitamin D

Then add daily B12, then a good quality vitamin B complex

Lastly a magnesium supplement

Also consider testing zinc and selenium

Or just start a zinc supplement and a selenium supplement once a week in about a month’s time

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