Test results advice

[Vic198]

Hi. I have Hashi's and would be really grateful on your evaluation of my bloods. I am still outstanding a few others:

Tsh - 0.17 (0.3-4.4)

T4 14.7 (9-19)

T3 3.9 (2.5-5.7)

Vitamin D level 39 (44 or more)

B12 - normal

Ferritin - 27.7 (10-200)

Currently on 125 Levo, but not feeling particularly well. I followed advice and skipped my levo the night before the bloods and had the bloods done early. Interestingly my TSH 8 weeks ago was 0.28 and that was without skipping a tablet and in the late afternoon.

Thanks for any advice you can offer

[Clutter]

Vic198, TSH is low, but so are FT4 and FT3. There is plenty of room in your FT4 and FT3 for a dose increase but it will probably suppress your TSH which may cause your GP angst. Read Dr. Toft's comments in Treatment Options thyroiduk.org.uk/tuk/about_... Email [e-mail] for a copy of the full Pulse article f it would be useful to show your GP.

Vitamin D is low. Optimal is 75-200. Supplement 5,000iu daily for 6 weeks to boost levels and then reduce to 5,000iu on alternate days. Good levels of vitD aid T4 to T3 conversion.

Ferritin is also low. Half way through range is optimal. Supplement iron and take 500mg-1,000mg vitamin C with each tablet to aid absorption and minimise constipation. Iron and vitD should be taken 4 hours away from Levothyroxine.

What is B12 normal? Ranges can encompass 140-2,000. B12 <500 can cause neurological symptoms and B12 around 1,000 is generally desirable.

TSH fluctuates considerably throughout the day which is why early morning fasting tests are recommended as TSH is highest then. See the graph in this link healthunlocked.com/thyroidu...

[Vic198 in reply to Clutter]

Thank you so much. Your advice is invaluable. I still feel so rubbish. I have a lot of muscle twitching and blurred vision, amongst other symptoms. I asked the receptionist for my b12 level but she said it didn't have a level and just said satisfactory. I am waiting on folate and TPO results. I really appreciate your advice on supplements and will start those ASAP. I saw my GP a few weeks ago and asked whether I could be prescribed T3 or NDT on a named patient basis but she said no. She was contacting the local endocrine team to see if any of them are open to prescribing anything other than Levo. Doesn't sound hopeful though!

[Vic198 in reply to Vic198]

Is there a particular dose for the iron tablets?

[Clutter in reply to Vic198]

Vic, contact your practice manager about the B12 result. They must have a number otherwise how can it be deemed satisfactory? Under the Data Protection Act ou are entitled to know the result, not just the GP's interpretation or opinion.

Many CCGs are instructing GPs not to prescribe T3 without an endo recommendation. GPs aren't obliged to prescribe NDT as it isn't licensed for UK use. Most members using NDT and some using T3 buy their medication on the internet.

[Vic198 in reply to Clutter]

Thanks clutter. I'm tempted to start the self medication route but it does make me nervous!

[Clutter in reply to Vic198]

Vic, it might be better to wait for your B12, folate results and sort out your minerals and vitamins first . Good levels of ferritin aid absorption of Levothyroxine and low levels can make it difficult to tolerate dose increases. 3 x 210mg Ferrous Fumarate is recommended taken with vitC.

Better absorption of Levothyroxine and good levels of vitD will aid conversion of T4 to T3.

[Vic198]

Fantastic, thank you. It will be good to see if the vitamins and minerals help with my symptoms. Fingers crossed. Really appreciate your help.

[Vic198]

Hi clutter. I got my b12 level and it was 377 with a range of 180-900. How does that sound. Also had my antibody TPO measured and it was 35 with a normal range <60.