Help please! Tsh 0.10 and t4 23.0 Also been told need more blod tests to test for b12 and folate. I have no thyroid and am on 125mcg of levo

[megaliz]

I've been feeling so much better, better than I have for years now my blood tests are saying I'm "abnormal" what's going on???

[Hidden]

Do you have the blood test results to post? It might help people to comment. I'm assuming you've got macrocytic anaemia (enlarged red blood cells) if they're testing B12 and folate. Autoimmune conditions like to hang out together so it is not uncommon to develop others. The most common cause of B12 deficiency is autoimmune Pernicious Anaemia, lots more info here:

b12deficiency.info

[shaws Administrator]

Do you think your TSH is abnormal? I don't think it is. If you put the ranges of your blood tests as well as the results it makes it easier for members to comment.

If you are feeling well on 125mcg then I would stay there. Don't allow your GP to lower your meds due to your TSH. Dr Toft ex of the BTA says in an article in Pulse Online that some of us need a very low or suppressed TSH

or the addition of T3 to a reduced T4.

[megaliz]

Blood test results are - serum free t4 23.0 pmol/l (9-19.1) and tsh level 0.10 mu/l ( 0.35-4.94)

I don't know if I have macrocytic anaemia as I don't know what it is to be honest and have never heard of it :/ I'm still trying to get my head round my levels :/

[Hidden in reply to megaliz]

Do you have copies of all your test results? The ones that would be of interest are on the Full Blood Count (FBC).

B12, Folate and Iron are all vital in the correct formation of Red Blood Cells (RBCs). If you don't have enough B12 and/or Folate, your red blood cells become larger than normal, this is called Macrocytic Anaemia. Conversely, Iron deficiency causes RBCs that are too small, called Microcytic Anaemia.

On the full blood count you might have low RBC, low Haemaglobin (Hb) and low Haematocrit (HCT), indicating the presence of Anaemia.

You would then look at Mean Corpuscular Volume (MCV), if this is high then you could have B12/Folate deficiency, if low you could have Iron deficiency. If normal, you could be deficient in all of them as they cancel each other out.

For B12/Folate deficiency you may also have high Mean Corpuscular Haemaglobin (MCH) and high RDW. You may also have low White Blood Cells (WBC) and low Platelets.

And just to confuse matters even further, you can have B12/Folate deficiency with no signs of Anaemia whatsoever, a normal FBC. So if you're showing Macrocytic Anaemia in your blood test results then I'm pretty sure that you'll come back with quite a low B12 and/or Folate. Make sure you get a copy of the results because the range is set way too low, and they'll tell you you're normal when you're not.

If you do end up having treatment for a B12 deficiency bear in mind that you need folate levels up near the top of the range and ferritin of around 80 at least. You may also find that it increases the effectiveness of your thyroid meds (because correcting nutritional deficiencies improve conversion), so you may need to adjust the dose of that further down the line, but not now when you're feeling so well. Just thought I'd flag it in case.

H x

[Stourie in reply to megaliz]

If you feel good now I wouldn't let the doctor alter your meds after the blood test. He will probably want to drop them but just say no. It's how you feel that counts most.

Jo xx

[Hidden]

Hi Liz

Some people would be feeling well with those results. Other people would be having symptoms of being over-replaced - heart palpitations, feeling very hot, feeling a little 'hyper'.

If your GP is happy with the levels and you are feeling well, if it was me, I wouldn't worry.

If, however, you are feeling over-replaced at all - check the Patient Information Leaflet for your levo, it contains a list of symptoms - you may need to discuss a slight decrease with your GP.

L

x

[Jackie]

Hi Make sure you have had your other tests too, especially vit D , hormonal as the others mostly are. Ask for the ranges, results fairly useless with out ranges. Looks like the T4 definitely too high , . Depending on range you may be and a Free T3 test with ranges, again, you may feel better on less T4 and some T3. Although remember hypo symptoms can be identical to Hypo. Did you give the higher dose of T4 long enough to be established, 6 weeks before the tests. It is the only way of being sure if overdosed.?

it does take a while with frequent tests to be right. I was overdosed years ago, went to see my then new Endo and did not believe it, it was horrific, she was so right.

Best wishes,

Jackie

[summer01]

Hi megaliz, glad to hear that you are feeling well. I'm in 125mcg and my a results are similar to yours, tsh 0.01and t4 20.4. My range goes up to 23 so if yours is the same you are just at the top of it. The lab wrote on my tsh low but my GP was happy to keep me on the level. Can you say you feel fine and ask not to have your dose amended until you have the b12 results etc. if they do insist can you ask for a trial reduction? I'm no expert but 125mcg doesn't seem a lot if you have no thyroid? Good luck.