Test results - help plese

[cwill]

My results are in and the first surprise is that I can probably stop supplementing certain items and the second is that my GP appeared to agree to do Vit D, folate, ferratin and Vit B12 but actually omitted the Vit D. I need to really check up on the detail I suppose.

Serum vit B12 (XE2pf) 1694ng/l (211.0 - 911.0) High

Serum C reactice protein level (XaINL) < 4mg/l (0.0 - 6.0)

Serum ferritin level (XE24r) 98.0m ug/l (10.0 - 291.0)

Serum folate level (42U5) >24.00 ug/l (>5.38)

Blue Horizon tests:

TSH 0.05 IU/L(0.27 - 4.20) LOW

T4 Total 110.8 nmol/L (64.5 - 112.0)

Free T4 25.48pmol/L (12.0 - 22.0) HIGH

Free T3 4.12 pmol/L (3.1 - 6.8)

Anti-Thyroidperoxidase abs 131.2 <34 kIU/L

HIGH

Anti-Thyroglobulin Abs 17.6 <115 kU/L

I am grateful for any advice on how to proceed. Do I wait 3 months and then repeat or should I try a dose reduction prior to that? And the antibodies?

Thanks for your help.

[Clutter]

Cwill,

I would only reduce dose if you feel over medicated on your current dose. FT4 is over range but not unduly high and some people need high/over range FT4 to deliver decent FT3. Your FT3 4.12 is low in range and will drop further if you reduce dose. Read Treatment Options in thyroiduk.org.uk/tuk/about_...

Thyroid peroxidase antibodies are positive for autoimmune thyroid disease (Hashimoto's) which causes 90% of hypothyroidism in the UK, Europe, USA and Canada. 100% gluten-free diet may improve symptoms and reduce antibodies.

chriskresser.com/the-gluten...

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

B12 is usually high when supplementing. I would reduce dose to 1,000mcg daily maintenance dose with a B Complex vitamin. Folate is good.

Ferritin is optimal around halfway through range. If you are supplementing I would continue, for a while but if not, 98 is adequate.

VitD can take a 2-3 weeks to return a result if it is sent to a special lab. Check for results with your practice in another couple of weeks.

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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.

[cwill in reply to Clutter]

Thank you Clutter for your help and analysis. Yep gluten and dairy free for over 8 years and on the autoimmune version of paleo at present. Re symptoms I am still fatigued and basically bed-based (have CFS/ME 'diagnosis' as well so my clinical features are always overlooked re hypo and ascribed to the CFS) with no hyper symptoms that I recognize from the list other than those that occur with both. Struggling with hoarse voice, difficulty swallowing and persistent cough as well as most of the other hypo symptoms.

I didn't realise that vit D takes way longer. Will stick at 100mg Levo for the time being as I was keen to know my levels and was inclined to argue for an increase before the bloods were taken. I imagine that the average Gp is not going to be willing to raise the dose with these results if they are prepared to ignore a low basal temp of 36.1 and all my clinical features that keep me resting all day and capable of very little. More reading to do to make sure that I can argue my corner again in 3 - 4 months time.

[Clutter in reply to cwill]

Cwill,

GP is quite likely to reduce dose when TSH is below range and FT4 over range. I don't think there is any chance your dose will be increased. I doubt increasing Levothyroxine would be helpful but adding a little T3 to a reduced dose of Levothyroxine would raise FT3 which might improve symptoms.

If you don't get out of the house vitD is likely to be low so push for the vitD result as you may need to supplement.

[cwill in reply to Clutter]

Thank you. I have been supplementing with Vit D since first diagnosed with CFS. I will read again about T3 and the ways in which to obtain it and how to organise the dose. Thanks again.