Blood Test Results - Advice Needed

[Haider5]

Hello All,

My recent blood tests from GP are as follows:

FBC - All within normal range

Vitamin B12 532ng/L (187-883)

TSH level 2.72 miu/L (0.34-5.6)

FT4 level 12.4pmol/L (7.5-21.1)

Cholesterol 5.21mmol/L (2.5-5.2) above reference range

Triglyceride 1.4mmol/L (0.8-1.7)

HDL Cholesterol 1.17mmol/L (>1)

LDL Cholesterol 3.4mmol/L (0-3) above reference range

Choles/HDL ratio 4.5mmol/mmol (0-5)

Alanine Aminotransferase 19iu/L (1-45)

Albumin 46g/L (35-50)

Urea and Electrolytes - all normal

Alkaline Phosphate 109iu/L (30-130)

Calcium 2.44 mmol/L (2.2-2.6)

Adjusted Calcium concentration 2.32mmol/L (2.2-2.6)

Ferritin 80ng/ml (11-336)

LFT - All Normal

CRP <2mg/L (0-8)

Urea 6mmol/L (2.5-7.8)

Vitamin D 77nmol/L (76-220) - replete. Do not treat. No Further Action

could you please advise as to what I should be doing to lower my LDL and total Cholesterol levels. I eat pretty clean with lots of fruits and vegs daily and drink plenty of mineral water..my FT4 levels have dropped from 18.8 to around 12 this time around, not sure why??

Also whether my calcium, ferritin, Vitamin D and Vitamin B12 levels are good or need supplementing and if so how much i should take every day.

Above tests were carried out by my GP and the next ones i have scheduled for myself privately next month are :

TSH, FT4, FT3, Thyroid Antibodies' tests and Folate

i am Hashi hypo and currently on 25mcg or Euthyroid daily.

thanks in advance

Haider

[greygoose]

You need an increase in dose. 25 mcg is only a starter dose. How long have you been on it? Your TSH is too high and your FT4 too low. That's why your cholesterol is high! But it is irrelevant! Instead of spending all that money testing cholesterol, they ought to test your FT3! Your cholesterol will come down as your FT3 comes up.

Calcium is ok; ferritin could be a tad higher - 100 would be better - same with vit D. If you take vit D3, don't forget to take some vit K2, because your calcium levels will rise and the K2 makes sure it goes into the bones and not the tissues. If you take iron, best to take 1000 mcg vit c with it, to help absorption.

Vit B12 is barely ok. Optimal is 1000. If I were you, I would take 1000 mcg sublingual methylcobalamin daily. With that, take a B complex, with methlyfolate, rather than folic acid. I don't see a folate result, so don't know if that is low. But, in any case, methylfolate is better than folic acid.

[Haider5 in reply to greygoose]

thank you Greygoose for the reply and recommendations. i have been on Euthyrox 25mcg since June when i was first diagnosed with hashi. I have a FT3 test (along with full thyroid panel and antibodies) scheduled for end of September. I have been supplementing with 1000iu D3, 100mg k2 and mag too but guess need to up my dose on D3. What supp would be ideal for increasing ferritin levels and how much?

You say Vitamin B12 should be around the 1000 mark which is consistent with what I have seen on this site but that would take one above the highest limit of lab reference range, would that still be okay? also will 1000 mcg sublingual methylcobalamin daily be sufficient to raise my levels from 500 to 1000?? at present i take a B complex pill daily comprising of 400mg of methylfolate.

[bluebug]

Apart from what greygoose said you should actually get all the figures for your FBC as the range of the lower end of the haemoglobin range for the NHS is set lower than what the WHO recommends. So if your level is under 12g/dl but above the NHS lab range you are mildly iron deficiency anaemic and need to supplement iron.

You also should keep a record of the actual numbers of your white cell count plus your lymphocytes and neutrophils in case in a year or more time you have issues. Increased or decreased levels of those even within the range can mean you have/have had issues with your hasimotos.

Generally cholesterol levels should NOT be target directly unless they are unusually high e.g. total cholesterol level of 9+. BE AWARE your GP will disagree with this due to how doctors have been taught for the last 30 years that it is fat that raises cholesterol levels and raised cholesterol levels cause heart disease. Research is showing that cholesterol levels are actually a reflection of things including:

1. Genetics

2. Other diseases e.g. hypothyroidism

3. Vitamin D intake

4. Sugar intake

And that cholesterol levels aren't directly correlated to heart disease.

As you can't do anything about genetics and you want a high vitamin D level the only things you can do that MAY alter your cholesterol level are sort out your other diseases that impact it e.g. sort out your hypothyroidism and reduce your sugar intake.

Greygoose has pointed out you need a dose increase of thyroid meds plus supplement vitamin D, however you also need to change your diet to a low carb high fat diet.

This means half your diet will be vegetables and fruit, except for normal potatoes, and the rest will be good fats and proteins. You should have refined carbs such as normal potatoes, bread, pasta, breakfast cereals sparingly and avoid foods that say low fat or have trans-fats in them. There is plenty of information on this diet online search for people like Dr Zoe Harcombe, Prof Tim Noakes, Dr Aseem Malhotra...

As you have hasimotos you should go gluten free as well. This easy to do if you make everything yourself as fresh meat, fresh chicken, fresh fish etc, olive oil, sweet potatoes, rice, full fat butter, full fat milk, vegetables and fruit don't contain gluten.

[Haider5 in reply to bluebug]

Bluebug, thank you for the info on diet and interpretation of my results. i will post my FBC levels below so you can see if they seem normal to you.

Regarding vit D3, shall i increase from 1000iu to 2000iu a day to raise my levels? also what can be done to further raise my ferritin levels if they are not optimal at 80?

i will definitely look into the diet you mentioned too. I never knew consuming low fat food could be bad for you if you were hashi..

mean cell haemoglobin concentration (429..) 34.5g/dL (31.5-35.9)

platelet count-observation (42P..) 179 10^9/L (14-400)

neutrophil count (42J..) 2.7 10^9/L (1.8-7.7)

mean cell volume (42A..) 85fL (80-98)

red blood cell distribution width (XE2mO) 13.7% (11-15)

mean cell haemoglobin level (XE2pb) 29.3pg (27-33)

basophil count (42L..) 0 10^9/L (0-.2)

lymphocyte count (42M..) 2.7 10^9/L (1-4.8)

monocyte couont-observation (42N..) 0.3 10^9/L (0.2-1.5)

eosinophil coount-observation (42K..) 0.2 10^9/L (0-0.5)

red blood cell count (426..) 4.88 10^12/L (4.5-6.5)

haemoglobin concentration (Xa96v) 14.3 g/dL (13-18)

haemotocrit (X76tb) 0.42 (0.4-0.54)

Full Blood Count (424..)

total white blood count (XaldY) 5.9 10^9/L (4-11)

Haemoglobin A1c Level-IFCC standardised (XaPbt) 35mmol/mol (20-41)

[bluebug in reply to Haider5]

At the moment they all look fine. However as I said before just keep the results in case you need to compare them in years to come.

[Haider5 in reply to bluebug]

okay will do for sure

thank you Bluebug

[Haider5]

Anyone knows how much should i be supplementing in terms of Vit D3 and B12 (methycobalamin) now to raise my levels and after how long i should revert back to maintenance dose?