Blood Result

[Boltie]

Please, I will appreciate it if members could look into my recent blood result eight weeks after my Total Thyroidectomy surgery.

Thanks

TSH: 0.14 mu/L. (0.30 - 5.00)

T4: 18.2 pmol/L. (8.89 - 18.80)

T3: 3.0 pmol/L. (2.60 - 5.70)

Vit D3: 54 pmol/L. (>50)

Ferritin: 1959 ug/L. (15 - 200) will repeat test in 3 month.

Transferrin: 1.9 g/L. (2.0 - 3.4)

Iron: 22.8 umol/L. (9.0 - 30.4)

Vit B12: 524 ng/L. (179.0 - 1162.0)

Folate: 10.3 ug/L. (2.8 - 12.4)

[humanbean]

Hi,

It would appear from your thyroid results that you aren't converting T4 into T3. Your T4 is very high in range but your T3 is very low in range. If you were converting well your T4 would be a bit lower and your T3 would be higher, which is what you would want to happen. I imagine you feel awful with such a low T3 reading.

Please tell us what thyroid meds you are taking, and what dose.

Assuming you are being given levothyroxine only, you need the addition of some T3 to your meds, and possibly a small reduction in your levo. The other alternative is that you take NDT - natural desiccated thyroid - which is made out of pig thyroid and contains all the hormones that a normal thyroid would produce.

I'm a bit confused by the units of measurement for your vitamin D3. Usually it is measured in nmol/L not pmol/L. Can you double check please. Assuming it should really be nmol/L then your vitamin D is too low. Most people feel well with it being around 100 nmol/L - some feel best a bit lower, some feel best when it is a bit higher. If I'm right about the units of measurement, then you should supplement with 5000 iU vitamin D3 per day for a couple of months then re-test to see whether your level has risen sufficiently. If it has, then you should lower your dose to about 2000 iU to maintain your levels rather than allow them to drop again.

Your B12 is not brilliant but nor is it outrageously bad. It should be top of the range or even a little over to feel at your best - please note that B12 is not poisonous and having a test result over the top of the range (if you have been supplementing) is not a problem. If you decide to supplement use methylcobalamin 5000mcg for a couple of months then re-test. Assuming your level is okay then you could reduce to 1000mcg per day to keep your levels healthy. Jarrow Formulas and Solgar both do a popular product which is available on Amazon.

Folate - the reference range you've given is not one I'm used to seeing - it looks a bit low to me. But assuming it is a sensible range then your folate looks fine.

Your ferritin (iron stores) is very high, your transferrin is low, but your iron is actually a good level. This suggests to me that you are unlikely to have haemochromatosis (iron overload). Instead you are likely to have a chronic inflammation going on somewhere and your body is protecting itself by shoving your iron into storage and so your ferritin is very high. You need to look into Anaemia of Chronic Disease.

Look at the table at the bottom of this page :

irondisorders.org/Websites/...

Ask your doctor to test for inflammation. This would be a CRP test and/or an ESR test :

labtestsonline.org.uk/under...

labtestsonline.org.uk/under...

The problem with the above tests is that they may confirm that you have inflammation but they won't tell you where it is. You'll really need to discuss it with your doctor.

[Clutter]

Boltie, can't really add anything to Humanbean's post except ferritin may be high due to inflammation caused by the thyroidectomy. The major healing occurs in the first few weeks although it continues for up to 18 months.

[Boltie in reply to Clutter]

Hi humanbean & clutter,

I'm currently on 150mg levothyroxine.

Dr did confirm high ferritin is due to inflammation and it's cause by the surgery, will do a retest in 3month.

I did asked for a trial T3 medication, I was told my Endocrinologist have to write-up the first script and my schedule appointment is not until mid July.

Vit D3 was nmol/p. I do take 1000iu vitD3, b-12 methylcol 1000 mg lozenge, b- complex, methyl folate, vitC, ferrous sulphate and omega3 for joints.

I take medication for my high blood, since been on Levo, my blood has greatly improve, instead of taken three different tablets it was reduce to two tablets.

I'm very poorly, tire, fatigue, shortness of breath. It is a big struggle going out, walking my dog etc.

I did have the CRP and ESR test done. Most of the result came back below range. I'm seeing a Dr at my local Haematology clinic and she is monitoring my blood work.

[humanbean in reply to Boltie]

I would think that a lot of your symptoms are due to having lots of T4 in the bloodstream which your body is unable to convert to T3. It is T3 that gives us energy for living. Improving your levels would probably improve your breathlessness and your fatigue a lot. I am not a good converter, and T4 only made me feel poisoned.

If you can't get a prescription for T3 from the endocrinologist then you may have to self-medicate. The choices are

1) Add T3 to a slightly lowered dose of T4.

2) Natural desiccated thyroid (NDT)

3) T3 only

If it does become necessary to take control of your own thyroid meds, write a new post asking for advice, rather than adding on to this one. Lots of people ignore old posts.

You need to take a higher dose of vitamin D3. 1000 iU isn't enough. There are loads of brands to choose from on Amazon and other shopping sites. It is not terribly expensive.

I also think you should raise your B12 dose, but obviously the choice is yours.

I hope your ferritin drops back to more normal levels soon.

Good luck!