Any advice appreciated on blood test - hypothyroid symptoms.

[cc120]

Please see latest blood test results ABOVE.

PREVIOUS BLOOD TEST RESULTS

TSH and FT4 blood test results over 9 year period:

30/10/2013 - TSH: 8.1 H mu/L (0.3 - 4.2); FT4: 15.6 pmol/L (12 - 22)

09/07/2012 - TSH: 2.5 mu/L (0.3 - 4.2); FT4: not given

30/01/2008 - TSH: 7 mu/L (0.3 - 4.2); FT4: 13 pmol/L (12 - 22)

27/07/2007 - TSH: 7.5 mu/L (0.3 - 4.2); FT4: 13.1 pmol/L (12 - 22)

11/06/2004 - TSH: 4 mU/l (0.3 - 4.2); FT4: not given

Blood test results for 6 Jan 2014:

ONLY THE FOLLOWING RESULTS GIVEN:

TPO ANTIBODIES - (KT) – normal – no action

Thyroid peroxidise antibody level: 16 iu/mL (0.00 – 34.00 iu/mL)

B12/FOLATE LEVEL- (KT) - normal – no action

Serum vitamin B12: 260 ng/l (190.00 – 663.00ngl)

Serum folate: 8.1 ug/l (4.60 – 18.70ug/l)

BONE - (SDB) – normal – no action

Serum calcium level: 2.21 mmol/L (2.15-2.55mmol/L)

Corrected serum calcium level: 2.09 mmol/L (2.15-2.55mmol/L)

Serum inorganic phosphate: 0.94 mmol/L (0.87 – 1.45mmol/L)

Serum total protein: 77 g/L (66.00 – 87.00g/L)

Serum albumin: 46 g/L (35.00-50.00g/L)

Serum alkaline phoshatase: 46 iu/L (35-129.00iu/L)

IRON – (SDB) – normal – no action

Serum iron level: 15 umol/L (6.60-26.00umol/L

Serum TIBC: 70 umol/L (40.80-76.60umol/L)

FERRITIN – (SDB) – normal – no action

Serum ferritin: 36ug/l (13.00 – 150.00ug/l)

CHOLESTEROL – (SDB) – normal – no action

Serum cholesterol: 6.1 mmol/L (Targets are total cholesterol <5 mmol/l (LDL cholesterol <3 mmol/L in the general population and total cholesterol <4 mmol/L (LDL cholesterol <2 mmol/L) in high risk groups)

DIFFERENTIAL – (SDB) – normal – no action

Neutrophil count: 3.0 (1.70-7.50)

Lymphocyte count: 2.1 (1.00-4.00)

Monocyte count: 0.3 (0.20-1.00)

Eosinophil count: 0.2 (0.00- 0.40)

Basophil count: 0.0 (0.00-0.10)

COMPLETE BLOOD COUNT – (SDB) – normal – no action

Haemoglobin estimation: 134 g/L (115-165)

Total white cell count: 5.6 (3.50-12.00)

Platelet count: 376 (140-400)

Mean corpuscular volume (MCV): 83.4 fL (78-98)

Red blood cell (RBC): 4.76 (3.80-5.80)

Haematocrit: 0.40 L/L (0.37-0.50)

Mean corpusc haemoglobin (MCH): 28.2 pg (27-32)

MCHC: 338 g/L (310-360)

Red blood cell distribut width: 14.4% (11.50-16.00%)

[Jackie]

Hi Latest Iron separate to ferritin , too low, are you taking iron? Strongest one one NHS , always take with a vit c soluble tablet for absorption.T4 too high. TSH we do not bother too much about so long as not high.You need FT3 blood test.Phosphate keep an eye on as a little high.B12 too high, dangerous. See Endo or if taking it, stop.Calcium too low if on D take some calcium to absorb it ( NICE)

THis is my personal opinion , rest OK.You need FT3 results desperately.

Jackie

[cc120 in reply to Jackie]

Hi Jackie, thank you. I can't understand why iron is low, if ferritin is high. I take with vit c time release? I was wondering if I had RT3 as not feeling as well as TSH / T4 would signify. Stopping B12 for awhile. Is calcium low: Serum calcium level: 2.48 mmol/L (2.15-2.55mmol/L)?

Don't think they will test FT3 on NHS but will ask.

[Jackie in reply to cc120]

It is the correct calcium that matters and sorry it was OK. ferritin is different to iron. My iron is very low and have to take masses, even so my Endo wanted me to have some iV in hospital but Haematologist said no because of my other illnesses. My ferritin is high.

The treatment is the same if FT3 is low so does not matter really about reverse, new idea, same treatment.It can be tested but a lot of Labs refuse.You also need it done with TSh and T4.Doctor can make a special request.

Otherwise oK.

I hope that helps.

Jackie

[cc120 in reply to Jackie]

Thank you Jackie.

[cc120 in reply to Jackie]

GP said point-blank laboratory will not test T3!!!

[cc120 in reply to Jackie]

How I miss the lovely and helpful Jackie, rest in peace and joy up there xxx

[Clutter]

CC, Sept TSH is suppressed but FT4 is within range so you don't look to be overmedicated. VitD is good but will drop unless you supplement Oct-Apr when light levels are too low to stimulate vitD. 1-2,000iu softgel caps daily should suffice.

[cc120 in reply to Clutter]

Thank you Clutter, I don't understand why supplementing with iron accompanied by vit c (time release has caused increased (overloaded) ferritin but lower iron.

Oct 2013

IRON – (SDB) – normal – no action

Serum iron level: 15 umol/L (6.60-26.00umol/L

Serum TIBC: 70 umol/L (40.80-76.60umol/L)

FERRITIN – (SDB) – normal – no action

Serum ferritin: 36ug/l (13.00 – 150.00ug/l)

Sept 2014

IRON – (SDB) –

Serum iron level: 12 umol/L (6.60-26.00umol/L

Serum TIBC: 58 umol/L (40.80-76.60umol/L)

FERRITIN – (SDB) –

Serum ferritin: 251 ug/l (13.00 – 150.00ug/l)

[Clutter in reply to cc120]

CC, I know ferritin is a storehouse/dump for iron and levels fluctuate hour to hour as the body extracts and dumps according to requirements. I don't understand either how supplementing iron can increase ferritin but decrease iron. Hopefully someone else will be able to.

[cc120 in reply to Clutter]

Thank you Clutter.

[cc120]

As I have explained though my serum iron level had decreased from (Oct 2013): Serum iron level: 15 umol/L (6.60-26.00umol/L to (Sept 2014): 12, my ferritin had (after supplementation) risen from Serum ferritin: 36 ug/l (13.00 – 150.00ug/l) to 251 in Sept 2014. She told me I had to stop iron supplements, but I had to push for a reason why I was storing so much iron but less had become available in the active form. She said other proteins binding iron, asked why, she said possible inflammation in body and mumbled something about she would ask the laboratory about it?

I forgot to ask about a full blood count test as she wasn't being very helpful overall, though finally agreed to refer me to an endocrinologist on Louise's list, but she's awaiting my full symptoms list that I suggested emailing her rather than sit there and have her type each one up on her PC.

Could I ask for a copy of the referral letter?

[Clutter in reply to cc120]

CC, certainly request a copy of the referral letter when you email her your symptoms list.

[cc120 in reply to Clutter]

Thank you Clutter. I will certainly do that. She did say that the referral could take months. I asked could it be over 3 months, and she said it could be and to call the hospital that the endocrinologist worked at to ask how long his waiting list is.

[cc120 in reply to cc120]

Also, she wanted me to decrease the amount of NDT I was taking as TSH 0.03 (suppressed) below lower range. I explained that I was only on 180mg and despite my T4 doubling, I don’t feel the expected effects of that and could she test for T3 to see if I’m converting T4 to T3. She assured me the lab would not. I said I would probably start taking T3 if energy levels did not increase.

When I asked I asked for referral to an endocrinologist (specialist on Louise's list) and she said she would refer me but would I listen to him. I said as he is a specialist and would test me fully of course I would. She began to list my symptoms for the referral letter, but as there would be so many I offered to email them to her.