I've now had my vitamin and mineral test results back. I'm due to see a GP to discuss them on 4 September, but thought I'd ask what you kind people thought first. (Reference ranges are in brackets.)
Ferritin 170 (15-200)
%Transferrin Saturation 24 (15-65)
Iron 16.8 (9.0-30.4)
Transferrin 2.7 (2.0-3.4)
Serum Folate 2.1 (2.8-12.4)
Serum Vitamin B12 493 (179-1162)
Vitamin D 28 (50-150 - <25 = significant deficiency)
TSH 3.73 (0.3-5.0 – result up slightly from 3.71 in March)
Free T4 13.0 (8.8-18.8 – result up from 9.78 in March)
Ferritin seems to be on the high side of normal.
Folate is lower than "normal" range.
B12 is also at the lower end of normal – I'm thinking of asking for a referral for an Active B12 test. The doctor appears to have written "No action" as a comment on the B12 and folate result (though it's a bit scrawled so I may have misread it!) Should I dispute this?
Vitamin D seems ludicrously low – possibly not a shock given that I'm a sun-phobic pasty Celt, though!
Previous TSH and Free T4 tests were done by Genova, these ones were done by Lewisham Hospital, so I'm not sure how significant the 0.02 bump in TSH is, but there seems to have been a fairly big change in my Free T4. The doctor I saw said a Free T3 test wasn't an option, which is unfortunate, as I appeared to have high (probably pooling) T3 when I had the Genova tests done, so I'd like to see what that is now.
The only other comment would be that I'm borderline for diabetes, but I'm assuming that's a knock-on effect of my thyroid/adrenal situation.
I'm not on any thyroid meds at the moment, but I have been taking adrenal supplements prescribed by Dr Peatfield.
Thanks in advance for your help! x
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Taffhamster
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Thanks, Tegz – I didn't want to go too much into symptoms in my question as it's fairly long-winded anyway! I tick quite a lot of boxes on Dr Peatfield's symptoms questionnaire, though my main problems are obesity and recently extreme fatigue, brain fog and aching muscles. I work from home which is both good and bad – on the one hand it's meant I can roll with my symptoms to a certain extent (lunchtime naps if I'm tired). On the other it's meant I HAVE rolled with my symptoms, possibly too much, which has meant they've gone unaddressed for too long. I've had the feeling that something's not right for years (decades, even!) and first investigated the possibility of a thyroid problem over ten years ago. But that was just the standard TSH test with an NHS GP so of course I was told I was "normal".
Doesn't sound as if Adrenal supps. were enough- but excellent you have seen Dr D-P, he's a mine of info. I have his book. You are in a good place to go forward.
There's a lot of NHS resistance to dealing with marginal cases of UAT and the reasons for this must be as varied as the patients histories.It certainly seems intstitutional.
Is that a clue- difficult to treat, easier to put off 'till later'?
Even the preferred T4 use, once established, has a varied outcome.
You can get a FT3 test done privately.
A local health check private clinic should be able to draw blood and get Labs done.[abt £70]
It's fairly early days with the Adrenals – I know it can take a good few months or even up to a couple of years to put them right, but I shall persevere! In Dr P I trust! I'm trying to get NHS tests done where possible, just to save money, but I'll probably get another thyroid profile done by Genova or similar just before or after I see Dr P for a follow-up. And yep, you're absolutely right about marginal UAT – the irony is, the GP who first tested me was approachable and sympathetic and would probably have been open to a discussion had I known then what I know now – sadly she left the practice and the current ones aren't so great.
That low vitamin D could be part of the cause of your back pain - look up osteomalacia or in other words, adult rickets.
As you say folate is low but supplementing with folic acid is not a good idea if there is any hint of B12 deficiency as it masks the B12 deficiency in test results so that should be checked before starting folic acid. You already know about the active B12 test which would be a more reliable check.
If memory serves me correctly someone posted on her that their thyroid levels improved significantly once their Vitamin D deficiency was sorted. However, it is really important that Vitamin D treatement is managed properly (and I don't GPs are any better for that either).
Please try to persuade your doctor to test your calcium levels and parathyroid levels before supplementing with vitamin D. It is important to rule out hyperparathyroidism and hypoparathyroidism as the reason for your low vitamin D levels. I know you have said you don't get much sun and this could be the reason but I would want to rule this out.
Thanks, Editfrmt – I did wonder if the aches might be VitD-related. I'm due to check in with Dr P within the next few weeks, so I'll mention it to him. I'd guess that it's a lack of sun – again I can possibly trace this back to working from home as it means that over the past few years I've spent less time outdoors during the day – no commuting or nipping out at lunchtime, for instance. Also, as I'm large I tend to cover up, and anything that's exposed tends to get slathered in sunscreen! Thanks for the tip on calcium and the parathyroids – I'll definitely mention those.
Hi again, editfmrt – do you have any more details regarding calcium? Just so I can explain to the doctor why I'm asking for that to be tested. (Hopefully, they'll know but if not, I'd liked to be clued up!) Hope you don't mind me asking.
First of all you have low vitamin D levels. This can be due to diet, lack of sunlight, poor absorption, or problems breaking down vitamin D due to certain drugs.
Sometimes it can be more complex than that. Vitamin D is involved in regulating Calcium levels in the blood. The levels of calcium and Parathyroid Hormone (PTH) and phosphorous should be tested to rule out parathyroid conditions.
I have researched this quite extensively in the quest to help my sister who has Hashimoto's and the often associated vitamin and mineral deficiencies. Like you (looking at your history of posts) she had bad back pain as well as the usual symptoms of hypothyroidism, so this pointed me in the direction of B12 and Vitamin D deficiency.
To cut a long story short, after pushing the issue and getting calcium levels checked, it was established she had secondary hyperparathyroidism which is identified by Low vitamin D, Low calcium and high PTH.
She also has B12 deficiency but her GP has refused to acknowledge Pernicious Anaemia even though she tested positive for parietal cell anti bodies.
High calcium and low vitamin D is another issue altogether. Whatever, parathyroid issues are little understood and neglected just like B12 and thyroid conditions by GPs and endocrinologists.
I agree, you folate is on the floor and it is worth checking active B12, if you can, first. Your doc should prescribe you 5mg folic acid to correct the folate deficiency. If you have the active B12 test and it's normal, it's still a good idea to take some B12 alongside the folate as they work together. Iron as well, as Carolyn says all your iron results are low apart from ferritin, suggestive of inflammation somewhere in the body. Your doc should be asking the question: why are all these vits and minerals low? I don't know your other symptoms, but if gastric, it would be worth seeing a gastro to rule out things like coeliac disease, atrophic gastritis, H pylori etc. H x
Thanks, Hampster! Gastro-wise I don't have as much grief as a lot of people on the board, but I do have problems with my digestion. I did a home blood test for coeliac that came up negative, but I'm not sure how sensitive that was. x
Your ferritin is on the high side. That could suggest inflammation. It may be worth asking your doctor to test for possible indicators of inflammation, such as thyroid antibodies, ESR and an arthritis screen to name but a few.
Thanks as ever, Carolyn – my thyroid antibodies were OK when I got tested in March but I'll definitely ask about inflammation. This may be by the by, but I have a faint recollection of my mother saying her blood iron was too high. (I think they treated it by drawing the proverbial armful!) Just wondering if there's anything hereditary going on there? x
Ah, yes. Haemochromatosis is where there is too much iron stored in the body. I think that can be hereditary.
Often with haemochromatosis, serum iron and transferrin are also high. That's why I wondered about inflammation but, as you have a family history, it would definitely be worth looking into the haemochromatosis.
Candida could be another "suspect" – I am prone to flare-ups of that and had quite high levels when I tested for it a few years back. I'll add that one to my list! xx
This article points out the changes in the gut due to hypothyroidism which of course has an impact with regard to deficiencies.
My doctor never felt the need to test calcium before high dosing with vitamin D but you certainly need enough K2 to help with calcium distribution. It also seems better to take high doses of D3 (not D2) separated by a few days rather than a daily pill. Its value can't be overstated.
I just want to say thanks very much once again to everyone who's replied to this query and to others – this forum is amazing. I'm still muddling my way through the whys and wherefores of all things thyroid, but I hope I'll be able to return the favour where possible. xxx
Saw GP earlier today – not particularly productive. As far as I could tell, if something was within the "normal" range, even borderline, that was that. No problem, no discussion.
As far as she's concerned, my thyroid is "normal" (TSH 3.7), and not even subclinical hypo. I explained that in other countries 2.5 or 3 is the upper end of the normal range, and that my level is above the optimal level, but for starters, she didn't seem able to discern the difference between "within normal range" and "optimal".
She agreed that folate was low so I have a prescription for 5mg
She didn't view my Vitamin D as problematic at all. She's agreed to a calcium test but won't test parathyroid until the results for calcium come back.
Ferritin was dismissed as being "normal" even though it's near the top end of the range. I asked if it might signify inflammation, and was told, "It's normal."
She says my B12 is "normal" and while she's not opposed to my having an Active B12 test, she'll only write me a referral if whoever recommended it can't do so. (I'm assuming Dr Peatfield is no longer able to make referrals – is it possible to get one via Thyroid UK or does it need to be via a GP?)
The biggest problem was that she got fixated on my cholesterol and treating me like a naughty kid when I disagreed with the "received wisdom". The main thing that had her knickers in a twist was that it's apparently risen by one point (from about 6 to about 7) over several years. Cholesterol per se isn't something that concerns me (see research by Zoë Harcombe, Malcolm Kendrick, etc) but I got the usual guff about diet, exercise and ditching red meat (it occurred to me after I'd left that she hadn't even asked me what my current diet is before telling me what I'm doing wrong!) Unfortunately, I didn't have the details of what can cause an apparent rise but when I investigated on returning home, the possible explanations include… stress, low Vitamin D and borderline hypothyroidism!
Wonder what effect hitting my head against a brick wall is having on my levels!
I'm sure you have the sympathy of all sufferers finding the same reactions!
On the plus side she is still listening to you and further tests lined up.
For tests that are needed and can't be done through GP - go private and offer to send bill to NHS- if & when you find something wrong!
Quite likely your D status has gone up through these last sunny months- but a low level supplement may help D3+K2 sublingual / -but should be tested for sometime.
PS: Adrenals can take years to correct, in my experience.
Thanks, Tegz – I actually think a lack of sun may be a factor, odd though it sounds. I work from home at present so I don't even get the sun exposure of a commute or even to nip out at lunchtime if things are particularly busy. (I'm trying to be stricter with myself on that count.) Also I've tended to slap on the sunscreen when I'm out for longer periods, as I'm prone to sunburn but the truth is, I don't get out much right now. I agree with you about the adrenals – Dr P is working on them at the moment but it's a slow process. I felt quite stressed at the GP's today. Like you say, she listened to an extent, which was a good thing, but I didn't feel it was anything like a two-way conversation. It doesn't help that I'm not naturally confrontational (in the sticking up for yourself sense!) I tend to get nervous and over-apologetic, and probably don't put my case over very well as a result.
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