Blood test results

[JAYR]

Hi! Further to my recent post re hair loss, I have now obtained a copy of my recent bloods taken in Sept 2013 (taking 50 mcg levo daily). Please let me know what you think as these mean nothing to me whatsoever, just another language. Thank you J

Full blood count - FBC. Total white cell count - 6.3 10*9/L (3.9 - 11.1). Haemoglobin estimation - 125 g/L (118 - 148). Please note: Hb and MCHC are now reported in g/L. Haematocrit - 37.5% (36.0 - 46.0). Mean corpuscular volume (MCV) 90.1 fL (82.0 - 98.0). Mean corpusc. haemoglobin (MCH) 30.0 pg (27.3 - 32.6). Platelet count 295 10*9/L (140 - 400). Neutrophil count 3.1 10*9/L (1.7 - 7.5). Lymphocyte count 2.1 10*9/L (1.0 - 3.2). Monocyte count 0.7 10*9/L (0.0 - 0.8). Eosinophil count 0.4 10*9/L (0.0 - 0.5). Basophil count 0.0 10*9/L (0.0 - 0.1).

Actions Completed: Normal - File.

Serum ferritin 83.1 ug/L (13.0 - 150.0)

urea and electrolytes

Serum sodium 144 mmol/L (136-145)

serum potassium 4.7 mmol/L (3.5-5.1)

serum urea level 4.4 mmol/L (2.1-7.1)

serum creatinine 58 umol/L (44-80)

serum chloride 107 mmol/L (95-105) "high"

thyroid function test

serum free t4 level 15.1 pmol/L (10.3-24.5)

serum tsh level 3.49 miu/L (0.4-5.5)

will be filed as: 3.49 mIU/L

Glomerular filtration rate

serum creatinine 58 umol/L (44-80)

glomerular filtration rate > 90 mL/min

GFR calctd abbtd MDRD Af Am or"> 90mL/min

Actions completed: satisfactory - file

[Jackie]

Hi Jayr,

FBC ( blood count) is fine. some of those , 2, show no infection. U`s and E`s are kidney function. potassium, chloride and sodium are a little high but fine. However, I would make sure you drink more, water best,as these would be better a little lower..GFR the most important renal test, is not a range, that is brilliant.

Thyroid, T4 is slightly low in range. You definitely need a Free T3 test, pretty sure that is the problem and you need a little T3 with the Levo, but without a blood test for it dangerous and no way of being sure. A lot of NHS Labs no longer do it. If your GP cannot, it is a good idea to have it done on line, with the T4 and TSH, Be sure to use a well known Lab. I use Blue Horizon, there is a finger prick or venous blood. You need to be sure of the Lab ( that is well known to docs) so if low, you can show it for treatment, some not recognised.If you use them quote TUK 10 for a discount.As your TSH is quite high you could tolerate some T3, if test proves you need it. It could make all the difference. If have some, start on 5 mcg., what ever prescribed, it is usually 20 mcg. Gradually build it up until 10 mcg 12 hour apart ( daily), then retest 6 weeks,

I hope this helps, If you do not fel right, the treatment is not enough.It is usual to take along time to get the dose/doses correct and be stable.

Jackie

[JAYR in reply to Jackie]

Hi Jackie. Thank you for your response and pointing out re kidney function which I was not aware of and neither had the GP mentioned to me. I try to drink lots of water and feel if I drink anymore I'll burst. I generally eat quite healthy cannot understand what else could be causing this. The only supplements I'm taking now are evening primrose, fish oil with calcium and also selenium with vits or selenium with zinc. I've noticed on the box this contains magnesium and wonder whether this may be the cause? or could it be the fact that during the last six months I have had two steroids injected due to frozen shoulder? With regard to T3 testing why is it that the GPs do not test for this for thyroid sufferers? If they are to help us to control our condition then surely they should be testing for this as well as party of the thyroid blood test. Thank you for pointing this out to me. How can a patient's thryoid be properly managed if the GP is not carrying out a full blood test. Am I better off being referred to an endo for this? I personally think there is something else going on which is not being picked up. With or without the thyroid medication I feel fine. I'm only taking the medication as the GP diagnosed me as hypo. The only thing that really concerns me is my hair shedding and my scalp becoming visible in various place but other than that I feel fine healthwise. Yes I am sensitive to the cold but no more than anyone else. I expressed my concern again last week to the GP and have had test done for b12 and glucose/folate (awaiting results). In the meantime she has asked me to stay off the levo for a couple of months at which time I am to have another thyroid blood test. Jay

[Jackie in reply to JAYR]

Hi The little magnesium ( see the box) should be Ok, as probably tiny. However, re calcium , have a corrected calcium check, they usually do both. You do not want that over range.The other minerals you are taking are good and safe.Steroids can throw out the Us and E`s, for example I can no longer have any cortisone injections as it can effect the electrolytes, although meant to be localised, not really, totally. I would try and drink a bit more and have U`s and E`s done in 3 months. You can also have a specific test for magnesium, it has a tiny range. I have to have lots of magnesium for my heart, script, so therefore weekly blood tests. GP`s always did the standard 3 tests although then there was no T3 as a separate tablet. Now, it is down to costs, it is the Lab managers, not docs at all. Makes me mad, only biochemists! A few still will., especially some hospitals.If you feel OK then if all your other tests are fine, hair should eventually grow back.Diabetes actually causes the same symptoms of thyroid to start with. I am much colder, more tired etc. when my Diabetes is "out" and in fact, the first obvious symptom ,originally

I would not be happy ,if me, to go off the thyroxine, Does she have a good reason?.

Best wishes,

Jackie

[Jackie]

Jayr, 2 things I forgot to say , too early in the morning!

With high Potassium do not take magnesium supplements ( food OK) unless under a GP with lots of magnesium and U`s and E`s tests. Sodium is salt, I would also try and cut back that a little, ie not use it in cooking, only at the table.

Jackie

[JAYR in reply to Jackie]

Thank you for your message re salt. I'm not much of a cook and generally put things in the oven and serve with veg and salad. When I do cook (which is very rare), I do not tend to use much salt as not a big fan. Jay

[Jackie in reply to JAYR]

Hi All the more reason to suspect too little fluid. I have to have a very high fluid level for my kidneys, or I have acute failure, I have serious kidney disease any way. High fluid is not so good for my heart, but a juggling act. With high Potassium and sodium, I would first suspect that. I do not know your age, but I know, younger people do tend to not have enough fluids, in general.

Jackie

[JAYR in reply to Jackie]

Hi Jackie. Sorry to hear you have kidney disease on top of the thyroid. I will try and up the water even more however do struggle to even drink the amount that I do which is a very large jug prob around 6/7 large glasses on top of one green tea and two milky coffees (some days prob slightly less). I find that as soon as I drink I have to go to the lav not long after. I am 41 years old and must admit that I have only started to drink a lot of water in the last year or so. J

[Jackie in reply to JAYR]

Hi That does not sound to bad, but I used to be told for renal disease to have a half pint, large glass full, every hour or so ,during the day. Now I am only meant to have 2 litres a day, because of my heart. However, had acute renal failure 3 times, very serious, because the lower fluid for my heart has caused the problem with dehydration.I am suspicious of your intake because your sodium is quite high and yet you have little salt and Potassium much higher than you want. When my Potassium near the top of range I am in acute failure. Too low, then I arrest. So, as you can see not easy, but I would give it a try., Have another U`s and E`s in a month or so and see.If they get worse, there is a 24 urine test for Potassium and sodium, which sees what your body is absorbing. These electrolytes and the others are, really Endo but also Nephrology and Cardio, just so important.

best wishes,

Jackie

[JAYR in reply to Jackie]

Thanks Jackie

[galathea]

Hi Jayne,

Looks as though your levothyroxine level is too low. As normal full replacement is nearer 150 than 50. Ideally if you are on meds, you are looking to get your tsh under 1 and your free t4 at the top of, or just over range.

85% of people on levothyroxine, do well with it, so long as they are on enough. The remaining 15% end up on forums seeking an answer. Don't rush into demanding t3, But insist you have enough meds to bring down the tsh to less than 1.

X

[marram in reply to galathea]

Galathea, I agree that the levels would be low for some people, but the crucial thing is how JAYR is feeling. If her only problem is hair loss and she feels OK otherwise, then she would not need to worry.

We all must not forget that we are individuals. This 'Less than 1' is suggested by Dr Toft but ONLY for people who still do not feel well if their TSH is higher. This is the crucial point.

[Hidden in reply to marram]

... and Dr Toft is also looking at a range of tests including T3 and aware of complications, implications and medical history.

[JAYR in reply to marram]

Hi Marram. Yes I do feel fine. My concern is my hair loss but am generally o.k other than forgot to mention had an op to my shoulder recently due to frozen shoulder (stemed from a fracture to shoulder back in December last year).

[JAYR in reply to galathea]

Hi Galanthea. Thanks for message. As I said to Jackie I'm not taking levo at the moment and to be honest with or without it I feel fine. My main concern is my hair loss which I didn't suffer with prior to taking levo. I have been taking levo as the GP had suggested I start taking it due to being diagnosed as hypo couple of years ago. Thank you

[Hidden]

Hi there,

I know many people feel better with low TSH and FT4 at top of range. However, when I am down even to 0.2 TSH and high FT4 I tend to get hyper (over-medication) symptoms. I find that TSH between 1 and 1.5 and FT4 around 20 works for me (JAYR's ranges look the same as my lab's). It's a long haul but we need to find out what is best for us individually.

Optimum replacement depends on age and size and probably other things too. I had TT but, recently, on 100 mcg tended to over-medication. Agree however that 50 mcg seems low. When my bloods are at JAYR's levels I show hypo-symptoms - admittedly this has only happened once!

Fortunately, I have a GP that supports regular blood tests and says if I am not feeling OK to come back and get them done. He is always keen to listen to symptoms and not just go by the blood results. I feel privileged compared to many people who share their problems. JAYR, hope you have supportive GP.

[JAYR in reply to Hidden]

Thanks Lizzy. Jay

[Hidden]

Hi JAYR

I'm a little concerned about some of the advice being given here.

We're ALL different and for me, my TSH level of around 2.11 is optimal. I know this is optimal for me as I track my symptoms and watch out for them like a woman possessed!

If my TSH went any lower I would become hyper. So when I see a response where advice is to go below 1 this MAY NOT be right for you!

I hope you find the answer to your hair loss.

Best wishes

Liza

[JAYR in reply to Hidden]

Thanks Liza. It's been approx 15 days since I last took levo and I feel fine. My hair shedding (loads) is my main concern. Thank you

[galathea]

The suggestion to get the tsh below 1 and the free t4 at the top of the range comes from dr Toft's book, understanding thyroid problems. I'm assuming that Jayr does not feel optimally medicated,or she would to have bothered to seek out this forum. So far it has been suggested she leaps in with t3, / stays as is / or ups the t4 level. Dr toft is a well known endocrinologist, not all of his theories are 100% right, (he has already apologised for relying on tsh testing only,) But his seems like a reasonable starting point, before rushing in to t3, or doing nothing.

Liza, a tsh of 2.11 if you are on meds doesn't sound optimal .... Not when a Normal tsh is classed as 1. It may be that adrenals are propping you up, they can do this for years and increasing meds can make you feel worse.... Have you had yours tested to make sure this isnT happening to you?

[marram in reply to galathea]

You are absolutely right, Galathea, but his actual words are:

"Judging the correct dose of thyroxine:

Your GPor thyroid specialist will usually prescribe a

dose of thyroxine that raises the fT4 and TI4 to the

upper part of the normal range and reduces the TSH level in the blood to the lower part of the normal range.

Typical results would be a fT4 of 24 pmol/l or TI4 of

140 nmol/l, and a TSHof 0.2 mUll.

In some patients, a sense of well-being is achieved only when fT4 or TI4 is raised, for example 30 pmol/l or 170 nmol/l, and TSH low or undetectable.

In this circumstance, it is essential

that the T3 level in the blood is unequivocally normal in order to avoid hyperthyroidism.

Failure to take thyroxine regularly is very obvious from blood test results."

You will notice, he says "in SOME patients" - this is not universal advice but is addressing the issue of patients who still feel unwell with what the GP considers a 'normal' TSH.

It is true he speaks of 'typical' results but even that statement does leave room for variations.

[JAYR in reply to galathea]

Hi Galathea. I'm looking for answers really as I've read hair loss is a symptom of hypo however I feel o.k. My GP tells me she has never come across hair loss in hypo but only in someone who is hyper. I have read about hair loss in Mary Shomon's book. Even though I do not have patches of baldness my hair has shed so much that you can see my scalp. It's mainly from the crown and the sides of my head since starting levo. Even though I feel fine I don't know if I do need to be medicated more or if there is something else going on or maybe as suggested check T3? Should I get referred to an endo? If so, can anyone recommend someone in London please?

[Hidden in reply to JAYR]

Your GP is sadly mistaken!

Hair has a long life-cycle and sometimes what appears to be hairloss caused by levo, it is a left over symptom.

There is a very interesting article on this here:

btf-thyroid.org/index.php/t...

We have a list of NHS Endos in the office - email me for it - [e-mail] - Mon-Fri only.

Louise

x

[JAYR in reply to Hidden]

Thanks Louise. Interesting article. J

[Hidden in reply to galathea]

Galathea

there can also be other issues going on - such as vitamin deficiencies which need investigating. If I have a vitamin deficiency, any amount of T4 being thrown down my neck isn't going to improve things. If I have a heart problem, advising me to take more T4 and bring my TSH below 1 is downright irresponsible and could be dangerous.

Do you know the people you're giving your advice to do not have vitamin deficiencies... do you know that they do not have heart problems... are you insured to give your advice?

[galathea]

Actually Liza, if you have a heart problem then one of the likely causes is too little thyroid hormone. Suggest you read the very excellent book by dr Mark Starr, - Hypothyroidism Type 11. He delves a long way into why low thyroid levels affect the heart.

I do not give advice, I offer an opinion and find your comments rather rude. The whole point of a forum is to exchange views and ideas. None of us is professing to be right.

[Hidden in reply to galathea]

My comment was no more 'rude' than yours to me! To reply to a comment, try clicking on the 'reply to this button'.

[Hidden]

Hi Jayr, hairloss can be caused by other things, as LizaSahara says vitamin and mineral deficiencies spring to mind. Your ferritin looks OK, have you had B12 and folate tested? Other B vitamins can also be implicated, such as biotin. Vitamin D has also been implicated in hairloss. See if you can get these things tested - B12, folate, vitamin D (+ calcium) - just to rule out any severe deficiencies that might need medical treatment, and to establish what your levels are before you try any supplements. I am hyper and vitamin deficient and was losing handfuls of hair, this has stopped now I am euthyroid and on B12 injections and other supplements. Obviously no way of knowing which measure helped, probably a combination.

Hampster

[JAYR in reply to Hidden]

Thanks Hampster. Yes, awaiting results now for B12 and glucose/folate which were tested last week. I was lacking in vit d before the summer and was on medication however o.k now. I have lost count of the amount of money spent on products/supps to help with hair loss i.e Regain, Aveda shampoo, scalp lotion and conditioner. I brought biotin from Holland & Barret which did not work and even tried evening primrose capsules three times daily. I appreciate everyone's responses, thank you all. It's shocking how one professional at the practice says one thing to me yet another professional says something else or at the hospital. I will see what my results are from last week's blood test and then go back in December for another blood test as suggested by the gp as by then I will have been off the levo for 2 months. As I said healthwise I feel fine except the hair loss which is bothering me enormously more than the sensitivity to cold. If Gp comes back with nothing then I will ask to be referred to an endo again privately if necessary. Not sure what else I can do really. Thank you all.