update re: blood tests please?

[jbthyro]

Hi, please could I ask advice before I visit my GP again on thursday this week?

After 3 years battling obvious hypothyroidism, I had a blood test done with BlueHorizon with the full set of Thyroid Function Test carried out. I have written about this in previous posts and several people thought that it was likely that I may have ISTH so would need T3.

Following that test my GP finally prescribed T4, but only at 25mg which was a ridiculous dose to start with but she was not to be budged! that was in April.

In July, after another blood test (the earliest she was happy to do it!) I had another blood test but with the NHS so only TSH and T4 and as the T4 has not skyrocketed through the roof (obviously we know that it wouldn't but she has no understanding of the effect of taking Levo has on the blood test!) she finally agreed to up the Levo to 50mg! Still not enough obviously!

I would like to see what you all think I should be asking for on Thursday (2 days time). I have no improvement in symptoms still.

Do I ask for 75mg of Levo, she cannot offer T3 because I have asked on numerous occasions.

Or do I just bite the bullet now and leave it at 50mg and buy some T3. If I go this route, what would the recommended dose be to start off with please for those who know more about this?

The results are below:-

15th July - MOST RECENT BLOOD TEST - NHS

TSH - 2.95 (0.27-4.2)

Free T4 - 17 (12-22)

Serum Iron - 18.8umol/L (6.6-26)

Serum transferrin - 2.42 (2.0-3.6)

Transferrin saturation index - 34% (15.0-50.0)

Serum ferritin - 41 ng/mL (no range given)

B12 - 1081 (197-771)

Anti-tissue transglutaminase level - 1.2 (0.0-7.0) - [Celiac]

D3 - 63.9 nmol/L

calcium - 2.20 (2.2-2.6)

24th March

TSH - 4.39 - (0.27-4.20)

T4 Total - 100 (64.5-142.0)

Free T4 - 14.86 (12-22)

Free T3 - 4.51 (3.1-6.8)

Reverse T3* - 23.0 (10-24)

Reverse T3 Ratio - 19.61(>20

Anti-thyroidperoxidase abs 10.5 (,34

Anti-Thyroglobulin Abs - 86.2 (,115)

Vit D - 86

Vit B12 - 573

Serum Folate - 28.07 (10.4-42.4)

Thank you all so much in advance, I don't know what I would have done without this community.

Jbthyro x x

[SmallBlueThing]

Patience, Grasshopper! You don't want to suffer a setback.

A further increase of Levothyroxine could easily bring your TSH down to around 1.0, although there'd be no certainty of an improvement with how you feel at that level.

75 mcg (not mg!) of Levo also gives you more pills to play with, if/when you add some T3.

Are you noticing any twitches or prickles from your calcium level?

[jbthyro in reply to SmallBlueThing]

Hi SmallBlueThing, no twitches or prickles! Do you expect I would then after looking at my calcium levels or something? I have never heard about that!

jbthyro

[SmallBlueThing in reply to jbthyro]

You could experience twitches and prickles around the lips, nose and eyes plus prickles in your hands and/or feet with numbness at the extremities. Arm muscle twitches, too. Seizures for really bad cases.

My symptoms became quite noticeable with calcium of 2.19 and same range as yours. My GP is testing it every six months (apart from a PTH test), but keeps fobbing me off. Back in range for last test, but I know I'm under again, right now.

[SlowDragon Administrator in reply to SmallBlueThing]

Yes I noticed calcium looks a bit low. Might be due to falling vitamin D?

[SlowDragon Administrator]

Was most recent blood test done early in morning? And no Levo in the 24 hours beforehand?

If it was........TSH might be a bit high......usual advice is to aim for around, or just under one.

But you don't want to increase too fast and miss your sweet spot, levels may improve a bit more yet.

You could perhaps ask to tweek up to 50mcg and 75mcg alternate days

Your vitamin D result has fallen between March and July......despite it being summer. Are you taking any vitamin D? If so how much?

B12 looks good, assume you are supplementing

If so, are you also supplementing B complex

There's no recent folate result

vitamindcouncil.org/tag/aut...

[jbthyro in reply to SlowDragon]

Yes the blood test was done early morning and before levo.

I have not been supplementing B12 for a while now which is strange, but am eating more foods containing it I guess!

I am an outdoor person so always out in sunshine, not use sunscreen and sit in shade for lots of time too, so sensible about it all. 2 years ago I had Vit D at 19 so do supplement on days I am not outools and take 10,000 in each dose of vit D3.

Folate was not carried out this time even though I asked for it!

I have only just started supplementing with B-complex so not when blood test was done.

I do wonder if there is an absorption problem looking at the Vit D result and calcium especially as I do have celiac disease too (although I regimentally eat absolutely no gluten or 'may contain' foods at all and the gluten antibody is always spot on low.

So maybe I will try to ask for 50 and 75 levo on alternate days.

Should I hold fire on the T3 for now until I see whether the T4 is going to have any effect?

Thanks again to you all

Jbthyro x

[SlowDragon Administrator]

Ah......yep celiac ....(just been diagnosed myself)

Can be difficult to keep Vit D, calcium and/or magnesium levels up

Google has more info on all three

You might want to investigate B12/folate ....perhaps consider active B12 test.

[jbthyro in reply to SlowDragon]

what is the best way to get Calcium up, I have vit D and magnesium supplements?

Is there a certain type of Calcium compound that is best for absorption?

Also I would like to get my folate up, any suggestions on that please anyone too.

jbthyro

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[Kalicocat]

I've read/heard that hydroxyapatite is the most absorbable form of calcium. I've just started taking New Roots Strong Bones which has everything needed for proper absorption, so they tell me. I just learned about the K2-MK7 requirement for calcium absorption (from this site), so have switched to this brand since it has everything included. I also take 4,000 IU (4 drops) of liquid D3 as I was very low a couple of years ago.

[jbthyro]

Well...... GP said she will NOT increase my Levo any further from 50mcg!

She will not do blood test again until October so I am going to do a Blue Horizon Blood test myself around the same time to prove (hopefully) that my private blood test results correlate with the TSH and T4 done on the NHS!

But she will not increase, she openly admitted it. She will not order T3 (or cannot) so now I am in a quandry about what to do next!

Shall I purchase more T4 to enable me to increase the dose or get some T3 myself to see if a little helps.

I would like to try NDT but would need to ask people to p.m. me with suppliers that they use and needs to be gluten free as I am celiac too.

GP agrees that there MAY be an absorption problem as Vit D and Calcium low in range but is not wholly convinced!

I have sent off for some Calcium as recommended by KalicoCat so should arrive tomorrow.

Any thoughts from people would be much appreciated!

jbthyro

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