Advice re blood results

Hiya, I'd appreciate some advice re blood results as I'm continuing to experience ongoing symptoms including weight gain, tiredness, constipation and no periods. GP saying results are all normal apart from low Vit D.

I'm currently taking 75mg Levothyroxine.

TSH - 0.37 (0.34 - 5.60)

Free T4 - 11.6 (8.0-18.0)

Free T3 - 5.2 (3.8-6.0)

Vit B - 215 (>140)

Folate - 13.5 (>4.0)

Ferritin - 29 (11-200)

Vit D - 37.6 (>50.0)

Thanks very much, feel like I need some extra advice before I go back to GP.

9 Replies

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  • T3 is the active thyroid hormone which controls the metabolism and therefore the symptoms. Your Free T3 is above the midpoint of the normal range so the hypothyroid symptoms should be significantly reduced.

    As you are still having severe symptoms

    one possible cause is Impaired Sensitivity to Thyroid Hormone (more often known as Thyroid Hormone Resistance). It is genetic and requires very high T3 levels in the body to overcome the resistance.

    If there are other family members with fibromyalgia, CFS, ME, Coeliac Disease, MS, Heart Disease, thyroid or depression this would further support this.

  • Shezabell Your vitamins and minerals may well be in the normal range but they certainly aren't optimal.

    B12 - I've not seen a range like that before. Is it pmol/L and is that a Blue Horizon test? Their ranges say <140 is deficient, 140-250 is insufficient, and >725 then consider reducing dose. If that's the case then yours at 215 is very low. The Pernicious Anaemia Society recommends 1000 in which case you should supplement with Jarrows or Solgar sublingual methylcobalamin lozenges 5000mcg to start and when level rises to optimal level then drop down to 1000mcg as a maintenance dose. When supplementing with B12 you should take a B Complex to balance the B vitamins.

    Vit D is low, if it's nmol/L then it really needs to be 100+. Supplement with D3, at least 5000iu daily if not more to start with (5000iu x 5 days a week is my maintenance dose) and take K2 alongside it. Vit D aids absorption of calcium and K2 directs the calcium to bones and teeth rather than arteries and soft tissues.

    Ferritin is very low, it needs to be at least 70, preferably 100+ for thyroid hormone to work properly. Ferrous fumerate can help, but if you find that upsets your tummy or gives you constipation you can get iron bisglycinate which is more gentle and supposedly non-constipating. Solgar Gentle Iron is one brand. Always take iron 4 hours away from thyroid meds and take 1000mg Vit C with it to aid absorption and help prevent constipation.

    I can understand your GP saying your thyroid results are normal. TSH is below 1, which is were most treated hypo patients feel best, your FT4 is actually a bit low, just under mid-range (which is 13) and usually hypo patients feel better with FT4 in the upper third of range. FT3 is just above mid-range (which is 4.9) and it's generally thought the FT3 should be in the upper quarter. That, of course, is a generalisation and individually we may feel best at different points in the ranges. Your FT4:FT3 ratio is good at 2.2 and shows you are converting well, conversion is not so good when the ratio is 4:1 or higher.

    Getting your vitamins and minerals at optimal levels should help to a degree, especially getting ferritin up as at the level it is then it is probably contributing to your tiredness

  • Thanks very much for your replies. The B12 result is a blood test by the GP & unit is ng/L. Would I be OK to start the vitamins ASAP or do I need 2 discuss with my GP first?

  • Shezabell B12 - 215ng/L converts to 158pmol/L so that is still very low and near the bottom of the insufficient range if it was Blue Horizon. Supplement advice given still stands :)

    My GP wouldn't give much credence to vitamins and minerals unless they were excessively out of range, I don't think many GPs do. I just did private tests, found my deficiencies and started supplementing, totally bypassed my GP.

    If you start supplementing, introduce one at a time, see how you go for a week or two, if everything OK then introduce the next one, and so on. That way, if there are any reactions you will know what caused them, so much easier than starting all together and not knowing what's caused it if there is a reaction.

  • Thank you so much, I've been worrying that the GP thinks I'm a hypochondriac but have genuinely been feeling rubbish. Have gained over a stone since February despite loosing 1 1/2 stone last year, no periods since March & v poor short term memory. In May T4 dropped to 10.4 from 13.6 last August & TSH - 1.37 in May so have only recently increased to 75mg Levothyroxine, fingers crossed T4 continues to increase again & can loose my weight again 😊

  • generally low B12 (unless you are eating very little meat/fish/dairy) is going to be down to an absorption problem - you will need to be taking very high doses to get enough if that is the case.

    There are a couple of tests that can help clarify a B12 deficiency and would need to be done before you started supplementing - MMA and homocysteine - but getting them done can be difficult. Many GPs are totally unaware of the range of symptoms - the fact that left untreated an absorption problem will kill you - and think it is all to do with anaemia - anaemia (macrocytosis) is a symptom not the cause of the problems caused by a B12 deficiency.

    This alert by UKNEQAS may be useful in getting your GP to investigate further as makes it clear that test results don't tell the whole story.

    ukneqas-haematinics.org.uk/...

    Also if you have neurological issues then you should be treated as a matter of urgency - though I guess there is a risk that they will be dismissed as down to thyroid because there is a huge overlap of symptoms.

  • Start them asap.

    Unless you are very lucky you are likely to find your GP thinks your results are normal because you are within the lab range. There are a few GPs who will treat you if your ferritin level is under 30 but the majority won't.

  • Do you know if you also have high thyroid antibodies? There are two sorts TPO and TG - if high in either or both this means you have autoimmune thyroid disease - called Hashimoto's. NHS rarely test for TPO and almost never got TG antibodies. But worth asking GP to do them

    If not then can get done privately

    Vitamin d is very important for body being able to use thyroid hormones

    chriskresser.com/the-role-o...

    Many Hashimoto's patients find going 100% gluten free can help reduce symptoms.

    thyroidpharmacist.com

  • Vit B - 215 (>140)

    Ferritin - 29 (11-200)

    Vit D - 37.6 (>50.0)

    Assuming B is B12, all much too low and could be causing your symptoms. Try 5000iu per day methylcobalamin (sublingual) until B12 is over 900, ferrous fumarate at 140 or so elemental iron per day until your ferritin is over 70, at least 2000iu per day vit D3 plus K2 until your D3 is around 100.

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