Help with test results please...

[Kiwidel]

Hi All, Can anyone assist with interpreting some blood tests please...(these are from a Canadian lab)

Background -I have been surprised by a dr ordering a FT3 test where I had taken my daily 150 of Levo (Synthroid) - a bit annoying as it's the first time I've had it tested! I think the TSH results indicate over medication and I am concerned that my meds will be reduced when I'm not sure that's the right answer.

Symptoms - tired / lack of energy, insomnia (I fall asleep on the couch in the evening but when I go to bed I wake up at 1am and can't go back to sleep), lack of libido, craving sugar, weight gain (before the sugar cravings), hot flushes, itchy skin vulva, vagnial dryness, sore / stiff ankle joints which is worse when I first get up but go away after I move about a bit, generally don't feel "well".

I had been on HRT, but had been told to stop for a month prior to the second lot of tests (and because the dr doesn't seem to like HRT) since the hot flushes, itchy skin and sleep issues have returned / got worse. The sore ankles is new, although I had similar issues before being diagnosed with hypothyroidism, and which went when I started treatment.

I've known about the neutropenia for a couple of years, they don't know what's causing it despite lots of tests. I think I'm, menopausal (I'm 43, had symptoms since before I was 40), low on iron and B12, but also have a niggling thought that something else is out of balance which is causing a lot (all) of my symptoms / odd test results.

After 2 visits the dr agrees re iron so I'm now on a supplement. Can anyone add anything to the puzzle based on my test results? Any thoughts on whether trying to get a little T3 added might help or do these results confirm T4 to T3 conversion probably isn't a problem?

Thanks in advance

15 June - hadn't taken Levo.

Hemglobin 135g/L (120-160)

Hemacrit 0.400 L/L (0.350-0.450)

White blood cell count 1.6 xE9/L (4.0-11.0) Neutropenia

Red blood cell count 4.22 xE12/L (4.00-5.10) Few elliptocytes/ovalocytes

MCV 95 fL (80-100)

MCH 32.0 pg (27.5-33.0)

MCHC 338 g/L (305-360)

RDW 13.7 % (11.5-14.5)

Platelet count 269 xE9/L (150-400) Normal

Neuts 0.7 xE9/L (2.0-7.5)

Lymp 0.6 xE9/L (1.0-3.5)

Mono 0.2 xE9/L (0.2-1.0)

EOS 0.0 xE9/L (0.0-0.5)

BASO 0.0 xE9/L (0.0-0.2)

Vit B12 327 pmol/L (198-615)

TSH 1.64 mIU/L (0.30-4.00) - hadn't taken Levo before test

Ferritin 41 ug/L (10-291

4 Aug - (image) had been off HRT for a month

17Aug - had taken 150mg Levo about 12 hours earlier...

TSH 0.36 mlU/L (0.60-4.00)

Free T4 18 pmol/L (9-19)

Free T3 4.7 pmol/L (3.1-6.2)

[puncturedbicycle]

Nah, you're good, no reduction necessary. Unless you have any hyper symptoms - ? If you took your meds 12hrs before your test I think that seems fine. If they try to reduce it just say you forgot and took your tablet that morning and ask if you can have another test in six weeks.

Hard to say if t3 would help since your only t3 is the one taken after you'd taken your meds. I think you can expect the t4 to be a little high after meds (maybe someone else can weigh in on that) but what you really want to see if what it looks like maybe 24hrs after meds, then if you still have a higher t4 and a lower t3 you'd know conversion isn't brilliant. I personally think anyone w unresolved symptoms could benefit from a trial of t3 to see how you feel, no matter how well you seem to be converting. On paper I was converting brilliantly but I felt as hypo as all get out. Voila - a little t3 sorted it.

Have you had your d, folate, iron and ferritin done? Your b12 looks low. Do you supplement? Would be better up near (even above) the top of the range.

[Kiwidel in reply to puncturedbicycle]

Hi, thanks for responding.

I haven't had iron tested, ferritin was 41 which the first dr said was a little low, but not a problem. After feeling breathless with a constant headache for a couple of days I went back and this dr (I am stuck with a drop in clinic over here) said that they normally start treating at 70 so she's given me 6 months of 150mg ferrous polysaccharide - early days but I feel less breathless and the headaches gone. I've ordered some high strength B12 so will start that soon hopefully.

I'm not sure about the hyper symptoms as the ones I have are also hypo ones. I haven't hard heart palps or anything and I was sleeping through the night whilst taking the HRT.

I've been on the same level of Levo for over a year, but have switched from Levothyroxine in the UK to Synthroid here in Canada about 6 weeks ago, so not sure if that's part of the problem.

I'm just a bit gutted that I may have found a dr that is a bit more knowledgeable about thyroid issues, but have blown my chance to try adding T3 because of what looks like good test results.

[puncturedbicycle in reply to Kiwidel]

Well I wouldn't say you've blown your chances. Your t3 is okay, but it's only in the middle third of the range so it could be better, and it would be good to see what it's like without such a recent dose of meds.

If you're symptomatic that should be a compelling enough reason to give you a trial. All those tests show is what's in your blood, not what's in your cells. My test results looked even better than yours but I still need t3 to feel okay.

Have a look:

thyroiduk.org.uk/tuk/testin...

ncbi.nlm.nih.gov/pmc/articl...

[bluebug]

Neutopenia can be caused by having malnutrition e.g. low iron, low B12. Also some of your symptoms are indicative of not having high enough iron and B12 levels. Are you supplementing both?

I presume you have had your folate and vitamin D levels tested, and they are both optimal not just adequate?

Without optimal nutrients your thyroid hormones can't work properly.

Also if HRT worked for you, you were happy on it and it decreased a lot of your symptoms then ask the doctor for another prescription. It is your body not his/hers.

[Kiwidel in reply to bluebug]

Hi, thanks for responding.

I had Vit d and folate tested in Dec before I left the UK (see following). At that point I was good at supplementing - I've fallen off the wagon a bit since immigrating so I know that's probably part of the problem re sore legs and perhaps some of the fatigue. There's lots of opportunities to be in the sun here so I don't think Vit D is a problem. 🙂

Vit D 92.1 nmol/L (>50 nmol/L suggests sufficiency)

Serum folate 12.6ng/mL (4.40-31)

Also the neutropenia hasn't really changed whether I'm supplementing or not.

[bluebug in reply to Kiwidel]

Your levels where good then but if you stopped supplementing they would drop. So you are right they would be contributing.

BTW I get p**sed with doctors telling people what they feel or don't feel. Also UK press stories like this one, mirror.co.uk/news/technolog... , before you left state doctors are making women suffer unnecessarily.

[Kiwidel in reply to bluebug]

To be fair I challenged my uk (male) dr on the safety of HRT when he very quickly moved to prescribe it as a result of tests confirming menopause, so he did know better. The two (female) Drs I've seen in Canada aren't so keen, but one was up for putting me back on the pill - with my symptoms birth control is low on the list of requirements! They might change their tune in a decade or two when they start to go through it! 😛

[humanbean]

Regarding the ferritin... Your doctor might think being 11% of the way through the reference range is fine but many people on this forum wouldn't. Ferritin is essential for good conversion from T4 to T3, so being low in the range is not ideal.

Most people feel at their best with ferritin in the middle of the range.

There are lots of different iron supplements available. Ferrous fumarate 210mg is often prescribed by NHS doctors, one to be taken three times a day. In the UK it is sold in boxes of 84 from pharmacies only. It can be bought online, but of course I don't know what restrictions you have to live with.

Another alternative, popular on this forum, which requires no prescription in the UK is iron bisglycinate also known as Gentle Iron. There are lots of brands available.

With each dose of iron you should take 500mg - 1000mg of vitamin C. Iron supplements cause constipation in many people. High dose vitamin C causes diarrhoea. Combine the two to hopefully avoid both problems. Vit C also helps the body to absorb iron.

Iron is poisonous in excess so regular testing is essential.

[Kiwidel in reply to humanbean]

Hi, thanks for responding.

After feeling breathless with a constant headache for a couple of days I went back and a second dr (I am stuck with a drop in clinic over here) said that they normally start treating at 70 so she's given me 6 months of 150mg ferrous polysaccharide - early days but I feel less breathless and the headaches gone. I've ordered some high strength B12 so will start that soon hopefully.

I was prescribed ferrous fumerate when first diagnosed back in 2014 which made me feel better, that was part of the reason for going back to the Drs this time. Would be good if the first dr had listened to me a bit more!

Thanks!

[humanbean in reply to Kiwidel]

I've never heard of ferrous polysaccharide, but if you are already feeling benefits you are obviously absorbing it well. Glad to hear you are feeling the benefit. Good luck.

[humanbean]

Regarding the itchy skin and sugar cravings there is a possibility you have a candida overgrowth in your gut. It can affect your gut from the mouth all the way through and out the other end, and can affect the genitals too. You might want to do a candida test first before embarking on any kind of treatment, but I must admit I haven't bothered. Genova Diagnostics UK do one. The saliva one is supposed to be the best.

I'm no expert on candida. I have issues with it myself. But some things I've found helpful are :

To reduce sugar cravings :

chromium picolinate

L-Glutamine powder - don't bother with capsules the dose is far too small, buy loose powder instead. You would need quite a high dose. Read this very useful link :

scdlifestyle.com/2015/09/l-...

Sadly for lovers of sugar, the best way of tackling candida is to eliminate sugar from the diet. I haven't taken things quite that far. I still eat fruit.

You almost certainly have leaky gut and low stomach acid to go along with the candida overgrowth, and these are things you will need to research for yourself. They are huge subjects. You'll find lots on low stomach acid on this forum.

Something else I've found helpful is caprylic acid. I'm currently taking this one (one tablet twice a day) :

solgar.co.uk/SolgarProducts...

Probiotics are essential. You need to push out the excessive candida with good bacteria. Other things to consider are fermented vegetables e.g. sauerkraut, milk or water kefir, natto (never tried this myself) - you can find lists galore of fermented foods e.g.

globalhealingcenter.com/nat...

Finally, some people do well with fluconazole - the standard treatment for thrush that comes as a single pill and can be bought in pharmacies or online without prescription. I've tried this. In fact I've tried one pill taken at weekly intervals for three consecutive weeks. I don't react well to it at all so I won't try it again, but it is helpful for some people.

[wano]

Hi Kiwidel. I'm from Canada, too. Where do your source your Synthroid (pls private message me). I'm trying a run of Armour Thyroid for awhile but may have to switch back to Synthroid plus T3.

Have your symptoms improved?

[Kiwidel in reply to wano]

Hi Wano, I gave up on Synthroid and because the Doctor I was seeing wouldn't prescribe anything else, I sourced and started taking Dessicated Thyroid (Thyroid-s) in Nov 16. Since then pretty much all of my symptoms have improved. Also my weight which had been on a constant increase, finally stabilised. I joined weight watchers in March and so far have lost a little over 18lbs. I wouldn't go back on Synthroid even if you paid me!

For the sore ankles, I also started taking a borax solution 5 days a week which has also helped.

[wano in reply to Kiwidel]

Borax, interesting, will look into that.

I was okay on Synthroid (I think) for the first 3 years. But then again I never did have clarity and always struggled with anxiety and other symptoms.

Am trying Armour starting this week so we'll see if it works!

[Kiwidel in reply to wano]

This is helpful re Borax ... health-science-spirit.com/b...