Can someone please help with some test results?

[Shushione]

I'm hypothyroid and I've never been able to digest how to read test results, I just think it's part of the disease and the inability to concentrate. No matter how many times I read the instructions re understanding the test results I just can't retain it.

I would really, really appreciate if someone could help me with my latest test results which I had taken after feeling quite ill over Xmas. Ive felt very, very tired with no energy for sometime, everything is such an effort. I also feel very low. I had a chest infection and was on antibiotics. I haVe the usual hypo problems such as digestive problems ie peptic ulcers and a hernia and am having to take Omeprazole again.

I take 75 micrograms of Levothyroxine and 20mcg of T3

My results are:

Free T4. 16.4. Pmol/L 9 - 22.7

TSH. <0.05. Mu/L 0.35 - 5.5

(Says that 0.05 mu/L with high FT4 and FT3 is consistent with hyperthyroidism but if the patient is on thyroxine then over replacement

Ferritin. 109. Ug/L 10 - 291

Vitamin B12. 1075. Ng/L. 211 - 911

(Says: interpret with FBC and clinical picture)

Folate (serum)

Serum Folate. 15.3. Ug/L. 2.8 - 19

(Says: if serum folate <2.8ug/L and FBC abnormal, this is likely to represent folate deficiency

Free T3

Free T3. 6.1. Pmol/L. 3.5 - 6.5

Total 25 (OH) vitamin D. 113. Nmol/L

(Says: less than 25 nmol/L indicates deficiency

Sufficiency range >75 nmol/L

Vitamin D concentrations >250 nmol/L in the presence of hypercalcaemia are consistent with Vitamin D toxicity

Would so appreciate someone having a look at t he above

Shushione

[Angel_of_the_North]

How do you feel now? Your results look fine. You don't have high T4 or high T3 (that would be above the top number of the range). Taking T3 makes your TSH low (shouldn't really be used for assessing meds of someone on T3) and your T4 lower than that of someone on Levo only.

Taking Omeprazole will make your thyroid meds less effective, so you might feel worse, and will prevent you absorbing some essential vitamins and minerals (eg B12). It wasn't designed to be taken for longer than a couple of months. Apparently cabbage juice (fermented as in sauerkraut juice might be better for hypos) and mastic gum are good for ulcers, plus soil-based probiotics (esp useful after a course of anti-biotics).

Some of your symptoms could be Omeprazole side effects:

nhs.uk/medicine-guides/page...

[Clutter]

Sushione, TSH 0.05 is below range but isn't suppressed. Taking 20mcg oral T3 lowers TSH because the pituitary senses sufficient circulating hormone and switches off TSH. It doesn't mean you are overmedicated, that's just a bossy note to your GP from the lab. Even if you were on Levothyroxine only you wouldn't be overmedicated as some people need TSH below range or even suppressed to feel well.

Your FT4 is good and your FT3 is in the 'ideal' top 75% of range so you look to be optimally medicated.

Ferritin, vitD and folate are optimal. B12 is over range but it is a low range, most go up to 1,100 and some 2,000. Excess B12 is water soluble and is excreted in urine. Omeprazole is likely to make it difficult to produce B12 from nutrients so its good that you are starting from a good place. Ask for B12 to be retested every 6 months while you're on PPIs in case you need to supplement.

There's nothing in your bloods to account for you feeling low and fatigued. It can take several weeks to recover from a chest infection at this time of year and I expect the ulcers and hernia take a toll too. I hope you'll feel better soon.

[Shushione in reply to Clutter]

Thank you so much for the responses to my post. Try as I do, I just have a complete mental block when it comes to understanding it, it's so frustrating. I have to depend on my doctor's interpretation and he thinks everything should be within range. I was a patient of the lovely Dr Skinner and haven't found a replacement since he died :(.

I think the flu bug then chest infection took its toll. I'm feeling a little bit better, still a bit tired but I thought maybe this was the Omeprazole and it's no coincidence that I've put on some weight/bloated too :(.

Thank you so much once again.

Best regards

Shushione

[Clutter]

Shushione, It's handy to keep a note of results, doses and how you feel. Then if some 'must be within range' doctor tries to change things you can say "but I feel dreadful when my TSH is 2 and my FT3 at the bottom of the range which is what happened when you reduced my dose last time". The lab ref range is based on a general population range. While it may be a used as a guide, GPs need to take notice of how individual patients feel and stuff the range

Omeprazole reduces stomach acid which is usually already low in hypothyroid patients and can screw up your digestion which is why you are probably bloating and gaining weight. The peptic ulcer means you have to keep stomach acid low though. You might try and see whether a gluten-free diet helps with the bloating.

[Shushione]

Thank you so much for the advice, you are so right, It is a problem when your doctor doesn't or won't think outside the box! I was dreadfully ill for the first two/three years after being diagnosed, legs that wouldn't work, exhaustion just getting dressed, dependent on inhalers and four dress sizes larger than the size I had been all my life. I slept on and off all day and my life just went into limbo. My doctor could not give me any answers other than that the medication WAS working! I went to see Dr Skinner and started taking T3 and i will always be so grateful because my life changed for the better.. I don't think I'll ever be completely the same as prior to being diagnosed but I am certainly so much, much better physically. Having been so bad before, when there is glitch, it's never far from my mind that it's only a volatile medication that keeps me well.

I'll definitely have a look at a gluten free diet as I think they would want me to stay on Omeprazole long term.

Thank you all so much for all your help today.

Regards,

Shushione

[acunatang in reply to Shushione]

Omeprazol causes all kinds of problems, Apple Cider Vinegar (with the mother) is far better for helping digestion and far safer, I would definitely look at gluten free diet and dairy free!!