Blood test results - help !

[AliF]

I have had Hashimotos for about 3 years. I take 100 mcg of levothyroxine. Feel rubbish a lot of the time and especially at the moment. I had a blood test at my GP's a few weeks ago for TSH, iron and vit D. All came back normal. I had been taking lots of vitamins and supplements up until that point but stopped, waited a couple of weeks and have now taken the plunge and had another blood test with Blue Horizon. Feeling a bit down as far as the BH Dr is concerned nothing obvious shows up. Here are the results. Blue Horizon Dr's comments below together with the results. I did tell them I had Hashimotos! Any advice gratefully accepted. Thank you !

"The thyroid function is currently normal. The positive thyroid antibody result, however, increases your risk of having, or developing, autoimmune thyroid disease. This represents a situation in which your body manufactures antibodies to the thyroid gland. This may lead to the development of either an underactive thyroid gland (hypothyroidism) or overactive thyroid gland (hyperthyroidism). If you believe you have symptoms of thyroid disease, it would be a good idea to discuss them with your usual doctor. Surveillance of thyroid function would be advisable usually.

The Folate (Folic acid or Vitamin B9) level is elevated. As with high doses of Vitamin B12, this situation is not likely to represent a significant overdose - as a water soluble vitamin, it is usually well tolerated by humans even in high concentrations. Supplementation or following a diet rich in the vitamin (for example fresh green vegetables) is the usual reason behind a high level of folate in the blood. "

Biochemistry

CRP 0.90 <5.0 mg/L

Ferritin 34.1 20 - 150 ug/L

Thyroid Function

TSH 0.61 0.27 - 4.20 IU/L

T4 Total 114.9 64.5 - 142.0 nmol/L

Free T4 15.70 12 - 22 pmol/L

Free T3 4.00 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs H 40.8 <34 kIU/L

Anti-Thyroglobulin Abs 19.7 <115 kU/L

Vitamins

Vitamin B12 334 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate H 43.27 10.4 - 42.4 nmol/L

______________________________________________________________________________________________________________________________

[Clutter]

AliF,

Thyroid peroxidase antibodies are positive for Hashimoto's. 100% Gluten Free diet can help reduce symptoms and antibodies.

chriskresser.com/the-gluten...

thyroiduk.org.uk/tuk/about_...

TSH is low-normal, but FT4 is only half way through range and FT3 is low in range so there is scope to increase dose. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Emaill [e-mail] if you would like a copy of the Pulse article to show your GP.

B12 334 is low but not deficient. PA Society recommend 1,000 is optimal. Supplement 1,000mcg methylcobalamin daily with a B Complex vitamin. As the BH doctor commented high folate is not a problem.

Ferritin 34 is very low and may be why you are feeling rubbish. Halfway through range to 100 is optimal. Supplement iron and take each tablet with 500-1,000mg to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine and retest ferritin in 6 months.

___________________________________________________________________________________________

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.

[AliF in reply to Clutter]

Thank you Clutter. My GP has told me I am o the correct dose of thyroxine so I doubt that she will increase the dose -- I could ask though. Do you think I may not be converting T4 to T3? Just want to check one thing. Is there a word missed out in your answer re Ferritin "Ferritin 34 is very low and may be why you are feeling rubbish. Halfway through range to 100 is optimal. Supplement iron and take each tablet with 500-1,000mg ???? to aid absorption and minimise constipation"

Feeling a bit happier that there may be something I can do to feel better !

[Clutter in reply to AliF]

AliF,

Currently I think you are under medicated even though TSH is low. Poor conversion is indicated by low TSH, high FT4 and low FT3 indicate poor conversion.

Sorry, I meant to say take each iron tablet with 500-1,000mg vitamin C.

[AliF in reply to Clutter]

Thanks Clutter. So you don't think I fall into the non converting group from my results. I have low TSH medium T4 and fairly low T3 haven't I ?? Not really sure what constitutes high or low so glad I have you to ask !

[Clutter in reply to AliF]

AliF,

Low TSH is 1.0 and lower.

High FT4 is > 20.

As I said, if you can get a dose increase it will raise FT4 and FT3. Read the Treatment Options link I posted above. It illustrates how some patients need very low or suppressed TSH with FT4 high in range to feel well.

[AliF]

Thank you. I don't know what I would do without this brilliant forum and your advice. Much appreciated.

[HASHISmom34]

your ferritin is definitely low! B12 is very low even though not insufficient! Just because dr or lab says within range does not mean you are not low. If i were you i would supplement those 2 things immediately plus get your hands on a copy of your iron tests and Vit D. Those probably are the same and need to be improved! Good luck