Bloods - need advice

[jobey30]

I had a thyroidectomy Oct 2014 - I am on Levothyroxine which was constantly being adjusted due to levels, I am now on 125mcg per day ( for last 8 months) and my aches and pains seem to have settled, my hair started to re-grow ( though was also taking Iron 200mg of iron tablets ) The GP stopped prescribing Iron tablets and advised to purchase over the counter ones. I am also on calcium tablets and have 10 weekly B12 injection which I do supplement with B12 tablets x 2 daily. I am on Statin and BP tablets ( Was put on them when I was 3-4 stone heavier , bad diet and smoked. I lost weight changed diet took exercise and stopped smoking and for the last five years both BP and Cholesterol have been perfect.

I am also Diabetic and started on insulin 29/04/2015 and levels are stabalising and dropping. I have been extra careful about diet no increase in fat - but my cholesterol has risen quite significantly. I am waiting for my HBA1C results. Since being on the Insulin I have put on 6kgs despite being extra vigilant with diet and portion controls, i am hoping this will settle.

Results below from 29/06/2016 & 25/05/2016 - Any comments/thoughts would be appreciated:

Test Range 29/06/2016 25/05/2016

Calcium 2.20 -2.60 2.31 2.21

Phosphate 0.7 - 1.4 1.95 1.68

LDL Cholesterol 0.0 - 2.0 1.86 1.83

Total Chol/HDL Ratio 2.74 2.44

Adjusted Calcium 2.20 - 2.60 2.35 2.25

C-Reactive Protein 0.3 - 5.0 4 3

TSH 0.2 - 5.0 0.13 n/a

Free T4 9.0-24.0 29.2 n/a

Cholesterol 0.00- 4.0 4.5 3.8

High Density Cholesterol 1.64 1.56

Triglyceride 0.0 -1.7 2.2 0.9

Sodium 133-146 140 139

Potassium 3.5 - 5.5 4.4 4.2

Urea 3.5 -7.4 6.1 4.1

Creatinine 45 - 84 70 52

Estimated GFR 79 >90

Acute Kidney Injury 0 0

Alkaline Phosphatase 30 -130 71 66

Albumin 34 - 48 37 38

Alanine Transaminase5 - 40 18 17

Total Protein 60 - 80 73 72

Bilirubin 0 - 22 6 9

ESR 0 - 7 18 16

Serum Ferritin Assay7 - 90 n/a 26.8

Serum Ferritin B12 Assay150 - 900 >1000.0 >1000.0

White Blood Cells 4.0 - 11.0 9.9 7.6

Red Blood Cells 3.80 - 5.50 4.36 4.46

Haemoglobin 115 - 165 132 136

Haematocrit 0.370 - 0.470 0.363 0.372

Mean cell volume 80 - 98 83 83

Mean cell Haemoglobin 27.0 - 33.0 30.3 30.5

Mean Cell Haemoglobin conc.320 - 365 364 366

Platelets150 - 400 334 308

Neutrophils1.80 - 7.50 5.78 4.06

Lymphocytes1.00 - 4.00 3.32 2.94

Monocytes0.20 - 1.00 0.6 0.47

Easinophils0.00 - 0.40 0.17 0.09

Basophils0.00 - 0.10 0.05 0.05

[greygoose]

Oh so many thoughts! Where to begin...

Well, let's start with the statins. You shouldn't be on them. End of. No, seriously, you were hypo, that's why your cholesterol was elevated. And treating your hypo brought the cholesterol down, not the wretched statins!

And, even if it didn't, doesn't matter. Highish cholesterol is not a problem. You don't want to lower it. You're more likely to have a heart attack from taking statins and/or low cholesterol than you are from high cholesterol.

Cholesterol has little to do with what you eat. It's made in the liver, and it's made in the liver because it's an essential nutrient! The brain needs it, the adrenals need it to make hormone. The liver adjusts it's output to the amount you consume. If you eat less, it makes more. If you eat more it makes less. But the reason it's high when you're hypo is because with low thyroid hormones, your body cannot use the cholesterol as it should, so it builds up in the blood. Which is ok. It won't harm you.

Nobody should be taking statins, but especially not women, because they don't do anything for women, but have a load of side-effects. And hypos shouldn't be taking them, either, for other special reasons. It is pure insanity to keep trying to reduce cholesterol lower and lower, because those with the highest cholesterol live the longest. However, your doctor gets more funding points for prescribing it, than he does for treating your hypo!

And, talking about side-effects, did you know that diabetes is one of them? Yup, statins cause diabetes. And so very much more. I think you ought to do some research for yourself, and find out if you really want to keep taking them. Look out for Dr Malcolm Kendrick.

And, calcium? Why are you taking calcium? That's really not a very good thing to take unless you absolutely have to.

So, from what I can gather from your post, your doctor is changing your dose according to the TSH. That is not a good thing to do, because so many things can affect the TSH reading. It's a good way to keep your patients sick! Have you ever had your FT3 tested? From your FT4 result, I have a suspicion that you're not converting very well.

Have you had your vit d tested? From the fact that you are taking calcium, I deduce that you have problems with your bones? Osteoporosis? Osteopenia? If so, your vit d reading is extremely important, because vit D3 is more important to bones, than calcium, actually, but it's a whole heap of vitamins and minerals that need to be optimal for healthy bones. Plus good levels of T3. So, do get vit D tested, if you haven't already.

And I take it you have Pernicious Anemia if you are getting weekly B12 shots. But are you taking a B complex with them and your B12 tablets? All the Bs work together, so need to be kept balanced - you don't want one much higher than the others. So, it's important to take the B complex every day. Especially if your folate was low. Have you had your folate tested?

I don't know that much about diabetes as such, but all these things are interconnected. So, you need to get it all right - starting with the statins, I would think!

[jobey30 in reply to greygoose]

I have been talking to GP about stopping statins, but not had a positive response. Will research more and maybe just decide to stop, though I am worried that my cholesterol has risen, maybe that because we are conditioned too worry?

B12 shots are every ten weeks - but I need to supplement with tablets I purchase otherwise levels drop as does ability to function! What do you mean by B Complex? is this other B vitamins? I also take B6 tablets.

I have to take the calcium because my parathyroid glands were damaged during my thyroidectomy.

I am taking the following supplements:

1,000mg vitamin C - Take in the evening

Folic acid - 400mg x 2 AM

Iron ( over the counter)

B6

Evening Primrose x1

B12 x 2 am

Sea Kelp x 2 - was recommenced for hair and nails by a friend.

Will request blood test, need to look into everything more but i find it all confusing so many different opinions and because I have different conditions they overlap symtoms -Dont know which is what!

Thanks for your information and reply

[Clutter]

Jobey30,

TSH 0.2 is suppressed and FT4 29.2 is over range so in theory you are more than adequately medicated. Unfortunately, low TSH and high FT4 doesn't guarantee good T4 to T3 conversion which can be difficult for thyroidectomised patients on Levothyroxine only. I would ask your GP to test FT3 and if he is unable to do so I recommend you order a home finger prick test from Blue Horizon or Genova via thyroiduk.org.uk/tuk/testin...

Was there loss or damage to parathyroid glands during your thyroidectomy? Phosphate can be high when calcium is low and vice versa. Phosphate and calcium are regulated by parathyroid hormone (PTH) so you may need PTH, phosphate, calcium and vitamin D tested at the same time. I believe PTH is time sensitive so blood draw should be done at the hospital.

Ferritin is optimal >70. You could supplement iron with 1,000mg vitamin C to raise iron but make sure to take it 4 hours away from Levothyroxine.

B12 1,000 is optimal according to PA Society.

Estimated GFR 79 indicates mild loss of kidney function. My understanding is that >60 is fine.

ESR is high which indicates inflammation somewhere in the body.

The other results (exc cholesterol) are normal as they are within range. I can't interpret cholesterol.

___________________________________________________________________________________________

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.

[jobey30 in reply to Clutter]

Hi

Thanks for reply

There was damage to parathyroid glands during my thyroidectomy.

ESR - I have inflammation/bursuitis in the ball of my foot, going to treat with orthotics for the next few months then re-asses, also prescribed Naproxen

I am taking the following supplements:

1,000mg vitamin C - Take in the evening

Folic acid - 400mg x 2 AM

Iron ( over the counter)

B6

Evening Primrose x1

B12 x 2 am

Sea Kelp x 2 - was recommenced for hair and nails by a friend.

Will request blood test, need to look into everything more but i finf it all confusing so many different opinions and because I have different conditions they overlap symtoms -Dont know which is what!

Thanks again

[Clutter in reply to jobey30]

Jobey30,

If parathyroids didn't recover and you have hypoparathyroidism calcium and vitamin D need to be balanced so PTH, calcium, phosphate and vitD should be tested together.

parathyroid.com./hypoparath...

Kelp is high in iodine. You shouldn't need to supplement iodine unless you have tested low. You should be getting the iodine you require from Levothyroxine and diet. Improving your ferritin level will improve hair and nails.

_______________________________________________________________________________

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.