Odd blood results

So I've been back at work for 5 weeks after having 7 months off following diagnosis of Hashimotos. I am now back up to doing 13hr shifts. So far so good but it did take a while to get used to them and I've found I have to be ultra organised to get everything done. Also noticed that I get brain fog kicking in around 1pm (shifts start at 7am) so making sure I get a break is essential and at the end of the day all I'm good for is sleeping and everything aches dreadfully. I finally had my b12 checked which was 145.03 (155.87 - 1355.4) my ferritin levels were 26 (20 - 300) however my monocytes, plasma viscosity, total white blood count and platelet count were all well over their high reference range, this is the same as 6 months ago. The lab results state that as these are high then although my ferritin levels are with range they are low enough to indicate iron deficiency. My TSH has now dropped to 0.1 (0.35 - 4.7) and t4 is 13 (7.8 - 21). I'm still waiting for advice from my GP about these results.

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  • ferritin and b12 should be HALFWAY in their ranges yours need massive supplementing

    free t4 at 13 is still too low don't care what TSH says

    Free t4 should be nearer 19 (upper quadrant of its range )

    As for working 13 hr shifts that's tough on fit people and not good at all for Hashimotos patients

  • IWNBB, you are B12 deficient and should have intrinsic factor and gastric parietal cell antibodies tested to rule out pernicious anaemia. You will need B12 loading injections until any neurological symptoms resolve and to restore B12 levels, and if positive for PA, will need lifelong quarterly injections after the loading shots. Pernicious Anaemia Society on HU will be able to advise better on B12 deficiency.

    b12d.org/b12-signs-symptoms...

    TSH 0.1 is fine as long as FT4 is within range. Your FT4 is less than half way through range and ideally dose will be increased until it is >18, even though it will suppress TSH. Resist any attempt to reduce your dose to force TSH into range as it will lower FT4. Read Treatment Options in thyroiduk.org.uk/tuk/about_...

    Ferritin is optimal half way through range but hold off supplementing in case your GP needs to do an iron panel to investigate iron anaemia.

  • Thanks for the advice. I spoke to my GP today. She wants to hold off supplementing B12 until she does a repeat test in 8weeks as per new NICE guidelines it seems. Doesn't want to do anything about the iron levels at all but I've persuaded her to prescribe me supplements. She has also dropped my dose of thyroxine by 25mcg. Aaarrgghhhh!

  • IWNBB, B12 is deficient and isn't going to magic itself replete in 8 weeks and FT4 will drop with the 25mcg dose reduction. I'm sorry your GP wasn't at all helpful.

  • Hello IWN,

    It's good to get back to work but 13 hour shifts sound quite difficult to manage.

    B12 & iron are very low but once deficiencies are addressed you might feel better as this should also help with thyroíd med synthesis.

    Your T4 is less than halfway through range so I would say .... this allows room for a small med increase. However this will suppress TSH so your GP might be reluctant.

    I think supplementing selenium will assist with conversion of T4 - T3 and help with symptoms.

    Monocytes and leukocytes are probably raised due to increased antibodies as both respond to inflammation within the body. If so antibodies need to be reduced and many have found a gluten free diet to be beneficial. I supplement Curcumin to help reduce imflammation.

    I hope you feel better soon,

    Flower

    Link for Curcumin

    ncbi.nlm.nih.gov/pubmed/126...

    Link for selenium

    thyroiduk.org.uk/tuk/treatm...

  • I have had a TT and should also work 13 hour shifts. I managed for a short while then got shingles and had to have more time off sick. Do you have an occupational health department where you work? If so I would recommend going to see them and try to organise shorter shifts. I know that this may be very difficult but it may well help your long term health and extend your working life. If you don't have an occupational health department it can be worth trying to discuss this with your endocrinologist, some are supportive about work even if unsympathetic re t3 replacement. According to my occupational health doctor hypothyroidism and the tiredness fall within the disability at work act so employers have a statutory responsibility to try and support you at work. If work are unsupportive I would think of contacting a union. A colleague of mine was able to sue for constructive dismissal on this basis. Good luck.

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