Blood test results - now even more confused

[Helsbells68]

I have also done the Genova Adrenal Stress Profile test but am still waiting for the results, will post them separately when they arrive.

Currently taking 2.25 grains Nature Throid at bedtime, at least 3 hours after any food. Increased from 2 grains nearly two months ago.

I did the BH Thyroid Plus Ten test more to see if I had hashimoto's more than anything else. I last took my NDT 33 hours previously, here are the very confusing and conflicting results:

CRP 1.00 (<5.0 mg/L)

Ferritin 37.8 (20 - 150 ug/L)

TSH L 0.05 (0.27 - 4.20 IU/L)

T4 Total 71.3 (64.5 - 142.0 nmol/L)

Free T4 L 9.76 (12 - 22 pmol/L)

Free T3 3.94 (3.1 - 6.8 pmol/L)

Anti-Thyroidperoxidase abs 13.0 (<34 kIU/L)

Anti-Thyroglobulin Abs 10.9 (<115 kU/L)

Vitamin B12 347 (Deficient <140 pmol/L, Insufficient 140 – 250, Consider reducing dose >725)

Serum Folate 18.16 (10.4 - 42.4 nmol/L)

In March at 7:40am my GP did the following tests, but I had taken 2 grains NDT that morning before the test (had to change to taking it in the morning as I had started taking amitriptyline at night, though stopped taking that after two weeks of severe dehydration):

Serum TSH level – 0.12mu/L (0.34 – 5.60 mu/L)

Serum free T4 level – 10.3pmol/L (7.9 – 20.0pmol/L)

Serum free T3 level – 7.1pmol/L (3.80 – 6.00pmol/L)

Serum Cortisol - 396nmol/L

Serum Total 25-OH vit D level – 21nmol/L (<50nmol suggestive of insufficiency)

Serum Vitamin B12 – 427ng/L (120.00 - 625.00ng/L)

Serum folate – 8.7ug/L (<3 suggests deficiency)

Previous results were from 9:10am June 2015, when I did take 2 grains NDT the night before (11 hours), GP wanted to reduce dose based on these results (suppressed TSH) but I refused:

Serum TSH level – 0.07mu/L (0.34 – 5.60 mu/L)

Serum free T4 level – 8.0pmol/L (7.9 – 20.0pmol/L)

Serum free T3 level – 5.3pmol/L (3.80 – 6.00pmol/L)

Serum Cortisol - 222nmol/L

Serum cholesterol – 6.3nmol/L

I have several supplements that I have started to take, D3 gel capsules prescribed by GP - 800IU (20 micrograms) 4 per day, vitamin C, B complex, zinc, selenium and magnesium.

Clearly I need to also take B12, K2 and iron but should I also get a reverseT3 test done?

I expected the T4 and T3 levels to drop slightly due to not taking the NDT before the test, just not by this much given that I have increased my NDT by 0.25 grains and the current T4 levels are higher than June 15, though again the ranges are different. Is it worth adding another 0.25 or is something else going on?

In addition to the fatigue, pain and brain fog (which do not help when trying to remember what tablets to take and when), I am the heaviest I have ever been without being pregnant. More history is available on my profile.

Any advice greatly appreciated

[Clutter]

Hellsbells68,

Thyroid antibodies are negative for autoimmune thyroid disease (Hashimoto's).

24 hours between last dose and blood draw is ample. Leaving longer skews results, particularly FT3 which will appear to be low. TSH is low, FT4 is below range which isn't uncommon for patients on NDT, but FT3 is low too, so there is scope to increase dose.

B12 is low, PA Society recommend 1,000 is optimal. Supplement 1,000mcg methylcobalamin and take a B Complex vitamin. Folate is good.

March vitamin D was deficient. I would double the dose your GP has prescribed. D3 softgel capsules 5,000iu can be bought online.

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I am not a medical professional and this information is not intended to be a substitute for medical guidance from your own doctor. Please check with your personal physician before applying any of these suggestions.

[bluebug]

Looking at your vitamin results I've noticed that:

1. Your ferritin is too low.

2. Your B12 is too low

3. Your vitamin D is too low

The pain, brain fog and fatigue are caused by having one of these low on their own let alone in combination and that's ignoring the thyroid issues.

You need to supplement with iron and B12 and increase supplementation of vitamin D.

You should take B12 in the form of Methylcobalamin as we have no idea what your stomach acid is like. You will not get this version on the NHS as your level isn't low enough for injections. Your level should be at around the 1,000 mark.

Iron should be taken 4 hours away from thyroid medication and you need something like one ferrous fumerate (about 65mg of iron ) a day with vitamin C. You should try and take iron on it's own away from taking all other supplements and medication as it can cause bowel problems. (There is more information on what you should avoid taking it with on the package or if there is not ask the pharmacist.) If you have a full blood count and some abnormal red blood cell results you may get your doctor to prescribe the iron. You want your ferritin level around 80. One issue is that it raises slowly and without a haemoglobin result it isn't wise to advise you to take more.

While you are supplementing with 3200IU per day of vitamin D3 it is too low for someone who is at your level of insufficiency. In fact where I am any level under 25nmol/l is severely deficient. As vitamin D rises slowly you should take 10,000IU per day for 3 months and then cut down to the level your doctor is prescribing for 3 months. Ideally you would be tested after 3 months but no NHS area I am aware of allows this for adults. However you can try and ask your doctor to test you after 6 months but s/he may have to refuse due to CCG policies. If they refuse and you can afford it get a test done by City Assays. You need your vitamin D level between 80-100. 100 is better. .The levels your lab is using were increased in my area around 2010 so to be at optimal you need to be at 75nmol/l.

There is an ideal of when to take all vitamins and minerals but to be honest the easiest thing is to make sure you take your thyroid medication as normal, take the iron with vitamin C away from everything else and take the rest together with lunch/dinner. You need to keep taking the magnesium, K2, B complex and other supplements.

[Helsbells68 in reply to bluebug]

I have placed an order for Jarrow Formulas, Methyl B-12, can I get ferrous fumarate over the counter or will I need a prescription?

Many thanks

[bluebug in reply to Helsbells68]

You can buy it from a pharmacist e.g. Boots, independent pharmacy without prescription.

It either comes in a tub or a packet of 84. The tub is about a pound cheaper.