Advice on bloods please.

[Gillybean129]

I have been on NDT for weeks, I requested T4 and antibodies as well but they aren't back yet - T3 they won't do. My TSH has never been this low so pleased with that!

Do my results look OK not sure how to interpret them. Thanks.Blood haematinic levels

Serum folate level 7.6 ug/L [4.6 - 18.7]

Serum ferritin level 135 ug/L [30.0 - 400.0]

Ferritin may be elevated due to inflammatory response

and therefore not reflect iron stores.

Serum vitamin B12 level 577 ng/L [197.0 - 771.0]

Roche B12 II assay & new ref. intervals from 19.11.15

Serum TSH level 0.39 mIU/L [0.27 - 4.2]

Accurate clinical details help to ensure the indicated

tests are done and appropriate comments are added.

The goal of TSH monitoring in primary hypothyroidism is

usually to maintain TSH within the reference range.

Serum total 25-hydroxy vitamin D level 70.0 nmol/L

Musculoskeletal symptoms or fatigue are unlikely to

be due to a vitamin D <30 nmol/L if calcium, alkaline

phosphatase and PTH are normal. Such symptoms

would NOT be expected at vitamin D levels >30 nmol/L.

<30 nmol/L - High dose supplementation recommended.

30-50 nmol/L - If bone health an issue,

suggest standard-dose supplementation.

No repeat vitamin D measurement needed.

50-125 nmol/L - No action needed.

Serum iron tests

Serum iron level 15.0 umol/L [6.6 - 26.0]

Serum TIBC 58.0 umol/L [45.0 - 81.0]

Transferrin saturation index 25.9 % [15.0 - 45.0]

Routine Biochemistry

Serum magnesium level 0.81 mmol/L [0.7 - 1.0]

Global comments See comment below

Guidelines on investigation are available at:

nww.sth.nhs.uk/NHS/Laborato...

GP_Guidelines.htm

Please contact the duty biochemist via switchboard if

you wish to discuss any of these results.

eGFR using creatinine (CKD-EPI) per 1.73 square metres 82 ml/min/1.73m^2

Reported eGFR is not adjusted for race(x1.159 if black)

In the presence of acute kidney injury or unstable

creatinine, eGFR will be invalid.

eGFR calculated using CKD-EPI equation from 03.08.15.

-------------------------------------------------------

Classify CKD using a combination of GFR and

albumin:creatinine ratio (ACR) categories.

nice.org.uk/guidance/cg182

Serum creatinine level 72 umol/L [44.0 - 80.0]

Serum albumin level 46 g/L [35.0 - 50.0]

Serum calcium level 2.35 mmol/L [2.2 - 2.6]

Serum adjusted calcium concentration 2.30 mmol/L [2.2 - 2.6]

Adj. calcium equation changed on 11/09/2014. NB Calcium

adjustment for albumin in an individual patient is

based on an average correction factor. Please interpret

results near decision points with caution.

Serum inorganic phosphate level 0.76 mmol/L [0.8 - 1.5]

Outside reference range

Serum alkaline phosphatase level 68 iu/L [30.0 - 130.0]

[puncturedbicycle]

Folate and iron could use a boost (there are some tests there that I also don't know how to interpret). You could do the Blue Horizon tft at some stage to check your t3, would be good to know. How do you feel?

[Gillybean129 in reply to puncturedbicycle]

I feel so much better, no aches or pains any longer in a short space of time. Still a long way to go but early days yet. My eyebrows are growing at the edges, I've lost 2 kg and my face doesn't look as swollen. Yes I have thought about the blue horizon one.

[puncturedbicycle in reply to Gillybean129]

Oh wow, that's great. So that's a good indication that you're on the right track.

When I started t3 (added to levo) within days of taking 10mcg I woke up and looked in the mirror and my face looked so much different. I seemed to shed all that water weight at one time. Now I know from that symptom if something needs a tweak.

[shaws Administrator in reply to Gillybean129]

Well done and I am pleased for you. The fact that before the blood tests were introduced along with levo, we were given NDT until symptoms were relieved. This doctor only took tests initially.

web.archive.org/web/2010103...

[Gillybean129]

It's weird isn't it. I heard rumours that they are stopping T3, I really hope not

[shaws Administrator in reply to Gillybean129]

Some members have had their T3 stopped due to the cost (it is assumed) as it has escalated over these past few months. Doctors wont prescribe on a named-patient basis for the other T3s available as they aren't licenced.