I received the following results today from a fairly thorough blood test and I would like to see if I can get some advice on interpreting them. The GP said that everything falls under normal range except for Vitamin D. When I asked her about the fact that I was on the lower end on some of these results, she said there wasn't much she could do in terms of offering other types of medication such as T3 or NDT unless we got a second opinion. She was nice enough to refer me to a specialist in Oxford and I'll be visiting them in the not too distant future.
These are my results:
B12: 576
Serum Folate: 5.8
Ferritin: 303
Iron: 19.8
Transferrin: 2.29
Transferrin Saturation: 34
FREE T3: 3.69
FREE T4: 12.03
TSH: 1.48
Vitamin D: 49
She also ran a test which came up positive for Hashimotos.
The below figures were given for the normal ranges for the lab that ran my tests:
B12 Range: 187 - 883
Serum Folate: 3.1 - 20.5
Ferretin: 22 - 275
Iron: 5.5 - 25.8
FREE T3: 2.63 - 5.7
FREE T4: 9.01 - 19.05
Vitamin D: 80 - 150
TSH: 0.35 - 4.94
What are you opinions on these numbers? Would you suggest any particular topic during my follow up with my GP or with the specialist I will be meeting with? Are there any red flags that you can see with these numbers? The reason I ask is because I have been taking 125mgc of Levothyroxine for over a year, but the symptoms are possibly worse than when I started. I have decided to take considerable steps to change my diet moving forward to a gluten free diet, which should help with the Hashimotos and may also eliminate the symptoms. Early days though so not much to report regarding my diet changes.
Cheers,
-A
Written by
anelson411
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Correct. I left the office with no additional treatment, just have levothyroxine. Again, she did refer me to a "thyroid specialist" in Oxford, but I know nothing more than that at this time. She mentioned that she was really unable to give any additional treatment without a second opinion and she also said that she really just a GP who doesn't have the specialised knowledge go properly interpret the test results and give sound advice. Fair enough, at least she was honest and is open to helping me after a second opinion.
Jezebel, antibodies may have been tested when you were first diagnosed hypothyroid. Ask your GP. If your symptoms stabilised on thyroxine any antibodies you may have had may will likely have reduced or gone away. Treatment for Hashimoto's is Levothyroxine so there's no advantage in testing other than knowing gluten free dietary changes can be beneficial and the realisation that ownership of one autoimmune disease predisposes you to others.
Anelson, You need the ref ranges from your own lab as they vary across the country. You can phone the lab at your hospital to get the reference ranges.
Are you on Levothyroxine?
Without the ranges I can see ferritin is high in range which is common if there is inflammation or pain in the body, but it doesn't say where. Your B12 looks fine but your folate is a little low.
Anelson, TSH 1.48 is a little high for someone on thyroxine and an increase of 25mcg should bring it down and improve your FT4 and FT3 which may relieve some of your symptoms.
TSH of people on medication is usually comfortable just above or below 1.0. Scroll down to Guidelines and Treatment Options to read Dr. A. Toft's comments in Pulse Magazine thyroiduk.org.uk/tuk/about_... Email louise.warvill@thyroiduk.org.uk if you want a copy of the article to show your GP.
Has your GP prescribed, vitD? If not, supplement vitD3 5,000iu softgel capsules daily for 4/6 weeks and then cut back to 5,000iu on alternate days until April when the sun may return.
You can improve folate by eating more folate rich foods or by supplementing folic acid or methylfolate for 3/4 months.
Many Hashimoto's sufferers find a gluten-free diet can reduce antibodies, reduce Hashi flare ups and relieve symptoms of bloating, gas, consitipation and diarrhoea.
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Clutter, I'm confused why reference ranges are not standardized. If one lab says that normal FREE T3 range is between 4 - 8 while another lab says it's between 2.6 - 5.5, how can that be? Are there different methodologies used at different labs that give them different results? Would my lab results come up different at a different lab where the normal range was different? I would think that my actual results would be more important to base my decisions moving forward rather than the reference ranges given by the lab, no?
Anelson, There have been mutterings about universalising testing but at the moment methodology varies at different labs and the ref ranges are based on the mean average of population ranges so also vary across the country. I think your results will be pretty much the same wherever they are tested but the ref ranges will vary.
In January I had bloods drawn and tested 2 hours apart at two different phlebotomy depts in two different areas. The ref ranges were slightly different but the TSH results had a tiny variation which will have been due to the time difference in the draws as TSH fluctuates throughout the day and seasonally. The difference in FT4 was also small.
" ref ranges are based on the mean average of population ranges so also vary across the country" - I'm not sure how to interpret my results if I am not sure what to base them on. The example given above is a Free T3 range of 4 - 8 with one lab and 2.6 - 5.5 on another lab. So according to one lab my T3 is normal while at another lab it is low. What's important to me is understanding what I should be aiming for, should I be trying to get my Free T3 above 5? Are my results of 3.6 and Free T4 of 12 acceptable or are they low? According to the lab I used, they are normal, but according to other labs used they are very low. Why should I trust the numbers used by the lab that processed my test over other labs that have drastically different numbers.
I'm also not sure how different normal ranges in different parts of the country should have any influence over what is a "normal range" and what is optimal for people with hypothyroidism or Hashimoto's.
Thanks for you advice, I do appreciate it. I'm just trying to get my head around what my results mean and what to do moving forward in a proactive manner.
Anelson, you base your results on the ref ranges of the lab which tested the bloods because methodology may also differ between labs. How you feel is more important than blood test results. TSH just above or below 1.0 is usually comfortable for most people but some need it lower or even suppressed to feel well. FT4 and FT3 in the top 75% of range is considered 'ideal' but most have FT4 midway or near to 'ideal' and FT3 will be low if there are conversion problems, serious illness or if people are on very restricted calories. Most will feel well even if they fall short of 'ideal'. Good levels of ferritin (70-90) aid absorption of thyroxine and good vitD levels (75-200) aid conversion of T4 to T3.
Could you not up your dose yourself. Say and extra 25 of levo every second day and see how it goes. You will run out of pills before they are due again but if you feel better then go back to your doctor and tell what you have done and that you need more levo. She cannot leave you short.
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