Blood results

[Granny56]

Hi,

Can someone please have a look at my results and give me some opinions? I had just completed a 20 day reducing course of oral prednisolone 5 days prior to blood being drawn, commencing with 80 mgs for 5 days and ending with 10 mgs for 5 days.

TSH basal 1.590 ul/UL (0.3-2.5)

Free T3 pmol/l 4.40 (3.1-6.8)

Free T 4 pmol/l 20.7 (12-22)

Thyroglobulin ng/mg 0.3 (3.5-77)

TAK IU/ml 14.5 (0-115)

ACTH pg/ml 1.0 (5-50)

Cortisol ug/dl 2.6 (6.2-19.4)

Vit D ng/ml 34 (30-120)

Folic acid ng/ml 4.1 (4.8-37.3)

Vit B12 pg/ml 477.4 (191-663)

[Clutter]

Granny56, TSH is euthyroid (normal), FT4 excellent and FT3 good.

Folate 4.1 is deficient. Your GP should prescribe 5mg folic acid.

B12 477 is suboptimal. PA Society recommend 1,000. Supplement 1,000mcg methylcobalamin sublingual lozenges, spray or patches and a B Complex vitamin. There's no urgency. It may be best to wait until folate deficiency is corrected.

VitD 34ng/ml is insufficent, 50ng/ml is optimal. There is a guide to dosing in this link grassrootshealth.net/

I suggest you discuss the low ACTH and low cortisol with your GP or endocrinologist, I'm not competent to comment.

endocrinology.org/policy/do...

I don't know what the TAK test is, or what it's for.

[Granny56 in reply to Clutter]

Thank you Clutter. I few more questions if I may.

The blood was drawn a few days before my 3 monthly inj B12 for PA (diagnosed 1987), do you still think I still need supplements?

My TSH seems to swing. Two weeks prior to the endocrinologist appointment, the cardiologist included the TSH on routine bloods. At this point TSH was 0.22, it seems such a large variation in values. I take 50/75mcg L-Thyroxine on alternate days, is this enough?

Vit D was only 9 three months ago so 34 is good although quite a way to go yet. I take 20,000 Dekristol weekly. When my level reaches 50 do I stop supplements or do you think I will need an ongoing maintenance dose?

Many thanks

[Clutter in reply to Granny56]

Granny56, no the B12 will be fine with the injection. If you feel a 'wearing off' in between injections you can top up with supplements.

TSH fluctuates according to time of day. An early morning test could give 1.59 whereas mid afternoon it could be 0.22. Your FT4 is almost top of range so 50/75mcg is enough but if you are symptomatic you can increase to 75mcg daily.

A maintenance dose, particularly Oct-Apr in northern hemisphere, will be necessary to maintain levels.

[Granny56 in reply to Clutter]

Many thanks