Help please to interpret test results

[arty123]

Comments please on the supplements I need from the test results below. I already take a good Univite brand multi vitamin and minerals daily and also: Calcium and Vitamin D3 3000mg/800IU tablets per day; 1 Solgar Ginko 60 ; 1 Beta Glucans and Beta Sitosterol to boost immune system (is this good idea as I have autoimmune thyroid disease?)

Past story is that I've been unwell for over 20 years supposedly with ME and had to give up my job; thyroid treated with doses up and down between 25 and 125 mcg for last 6 years; last 8 months I've been extremely unwell unable to work, socialise or do household things most of the time and twice I've been taken to A&E with chest pains. Extensive tests have been done by specialists to exclude as much as possible. Outcome is that I have autonomic dysfunction and that my hypothyroid medication has not been working. I'm onto a third endocrinologist who HAS recognised this and I'm now taking 50mcg levothyroxine and split dose of 10mcg T3 - which is most I've been able to tolerate in first 4 weeks.

My blood test results just back are as below and all thoughts and advice would be extremely welcome as I'm finding it very hard to cope with feeling so unwell and the long time it is taking to get any better and I do want to reach optimal micronutrient levels as soon as I possibly can.

Serum ferritin 40 (11-336) Should this be higher?

B12 516 (180-914) Should this be in top quartile?

Serum folate 21.3 (3.1-19.9) Above range - what causes for this?

Serum Vit D 64 (51-75) Should this optimally be above 70?

Total white blood count 7.1 (4-11)

Red blood cell count 4.38 (3.8-5.8)

Haemoglobin concentration 130 (115-165)

Haematocrit 0.37 (0.37-0.47) Was low last June also when already v. unwell

Mean cell volume 84 (80-98)

Red blood cell distribution width 13.7% (11-15)

Mean cell haemoglobin level 29.7 (27-33)

Mean cell concentration 350 (315-359)

Platelet count 208 (140-400)

Neutrophil count 4.1 (1.8-7.7)

Lymphocyte count 2.2 (1-4.8)

Monocyte count 0.6 (0.2-1.5)

Eosinophil count 0.2 (0-0.5)

Basophil count 0 (0-0.2)

Huge thanks for any guidance on iron and Vitamin D and anything else re T4/T3 replacement. I think I'm anaemic and have often been in past but have not taken iron for some years.

October thyroid results were FT4 17.9 (9-25); FT3 3.4 (3.5-7.8); TSH 17.9 (9-25)

Antibodies not tested since 2011.

[Clutter]

Arty123,

Your TSH is far too high and your FT3 below range so you will need to try and increase your thyroid medication until TSH is just above/below 1.0. Increasing dose will improve your FT3.

There is no iron blood test other than ferritin. Low ferritin can be an early indicator of iron anaemia so it may be worth requesting an iron panel.

Ferritin is optimal 70-90 so supplement ferrous fumarate. Take each iron tablet with 500mg-1,000mg vitamin C to aid absorption and mitigate constipation. Take iron 4 hours away from thyroid medication.

B12deficiency is unlikely >500 but high in range is good. Take 1,000mcg methylcobalamin sublingual lozenges, spray or patches daily.

Folate is good. High isn't a problem as it is water soluble and excess is excreted in urine.

VitD should be in optimal range 75-200. You could increase to 5,000iu for 6/8 few weeks to boost it.

Your other results are within range. You can find out more about the tests on Labtestsonline.org and Patient.co.uk

[arty123]

This is very helpful as I was having great problems identifying exactly what I should take. Sorry, though, I put wrong result for TSH. It is, of course, TSH 2.52 and I have been told in the past to aim for 2. These were tests done before I started on any T3 and at the time I'd been extremely unwell while taking 75mcg of levo for 5 months. Does that result indicate anything significant about for instance whether I was converting T4 to T3? I'm seeing my Endo on Monday and on his instructions have been taking 50mcg of levo and 10mcg split in two of T3. As I have autoimmune thyroid problem and T4 has not relieved any symptoms over last year I believe I should be aiming to gradually transfer to T3 to see if that is best treatment for me. My Endo has prescribed T3 and my GP says she has one other patient taking T3 so I think I will get agreement to try me on higher dose of that and 'wean' me off levo to see if I can begin to return to normal life. Do you have any further thoughts on the T4/T3 issue now I've corrected the test result?

[arty123]

Also I wanted to ask which tests are included in the full iron panel? If my GP won't do these as I've just had the other tests can I have them done privately at Blue Horizon perhaps?

[Clutter]

Arty, when you reply to a post click on the orange Reply button under the post you are responding to and an email alert will be sent to the poster you are responding to.

TSH 2.52 is still high and indicates under medication. TSH of people on medication is usually comfortable just above or below 1.0 although some need it lower or even suppressed to feel well. Scroll down to Guidelines and Treatment Options to read Dr. A. Toft's comments in Pulse Magazine thyroiduk.org.uk/tuk/about_... If you want a copy of the article to show your endo email [e-mail]

It's a pity your T4 was reduced from 75mcg when 10mcg T3 was added as I think you were undermedicated and would have felt more benefit from 75mcg T4 + 10mcg T3. If your FT3 is still low then an increase to 20mcg T3 is justified. FT4 high in range and FT3 low/below range usually indicates a conversion issue so adding T3 to T4 is usually beneficial.

I personally prefer T4+T3 combination to T3 only as I like the security of having T4 in my system should I be unable to take T4 or T3 for a few days.

This link suggests ferritin is more commonly used to determine iron anaemia than a full iron panel but it explains what the full panel is and when it is necessary.

labtestsonline.org.uk/under...