Just had blood tests, what do you think?

[hellybaybee]

Hey, I finally had a private blood test and I wondered if anyone could offer some thoughts. I know tsh (I've always done better below 1), ft4 and b12 are out of whack but what should I be aiming for?

CRP 3.0 (<5.0)

Ferritin 59.6 (20-150)

Tsh 2.11 (0.27-4.20)

T4 total 67.4 (64.5-142.0)

Free t4 9.65 (12-22)

Free t3 4.35 (3.1-6.8)

Anti thyroidperoxidase abs 10.6 (<34)

Anti thyroglobulin abs 21.7 (<115)

Vitamin d 97 (taking supplements)

Vitamin b12 226

Serum folate 9.77 (8.83-60.8)

I know b12 deficiency is common in hypothyroid patients, is this linked to pernicious anaemia? I also read that it can cause weight loss which is definitely not the case for me, I have gone from a size 8 -14. Sorry if I sound a bit ignorant, I just don't know a lot about this stuff.

I'm taking 2 grains nature throid and 20000 iu vitamin d

[Clutter]

Hellybaybee,

What medication are you taking?

[hellybaybee in reply to Clutter]

2 grains nature throid and 20000 iu vitamin d

[Clutter in reply to hellybaybee]

Hellybaybee,

OK, the T3 in NDT is why your FT4 is low. That's not a problem. TSH is a bit high for someone on replacement and most people on NDT need FT3 higher in range to feel well. If you are symptomatic you could increase dose in half grain increments to 3 grains, hold for 6-8 weeks, and retest.

Thyroid antibodies are negative for autoimmune thyroiditis (Hashimoto's).

VitD is optimal but I would maintain level with current dose until April when ultraviolet light is strong enough to stimulate natural vitD.

B12 is low but probably within range. Pernicious anaemia can cause B12 deficiency but so can malabsorption &/or vegetarian diet. Ideally, your GP will test for pernicious anaemia before you start supplementing. If PA is confirmed you will need regular B12 injections. Otherwise supplementing methylcobalamin sublingually or via spray or patches will probably be sufficient.

Folate is low in range. I would supplement folic acid or methylfolate before starting B12 injections or supplementing methylcobalamin.

healthunlocked.com/pasoc is the best place for advice on PA, B12 and folate.

CRP is an inflammation marker. Very low is optimal.

Ferritin is optimal halfway through range. You could eat more iron rich food or supplement iron with 1,000mcg vitamin C to aid absorption and minimise constipation.

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I am not a medical professional and this information is not intended to be a substitute for medical advice from your own doctor. Please check with your personal physician before applying any of these suggestions.

[hellybaybee in reply to Clutter]

Thanks for this, it helps a lot. I doubt it's diet as I have a meat rich diet, drink plenty of milk and eat butter and yoghurt. On the blood test itself they have highlighted it as deficient, I'm not really sure of the range as they have put deficient <140 and insufficient as 140-250 (so I would have thought it would have been insufficient 🤔). Definitely symptomatic, want to sleep all the time and my back hips and knees are constantly painful (not to mention the pins and needles!). I'm going to my endo next week so I'm glad to have this, I feel better equipped.

[SeasideSusie Remembering]

hellybaybee Now that you have almost reached the recommended level for Vit D (100-150nmol/L is recommended) I would reduce your dose to 5000iu daily then retest again in the Spring. Are you also taking K2-MK7 and magnesium, important co-factors when taking D3?

vitamindcouncil.org/about-v...

What is the bottom of the range for B12? If it is about 190 or 200 then I would ask your GP to test for Pernicious Anaemia as it is so low. Also your folate is very low. B12 and folate work together. It would be worth popping over to the Pernicious Anaemia Society forum here on Health Unlocked for further advice on these low levels before supplementing healthunlocked.com/pasoc

Ferritin needs to be at least 70 for thyroid hormone to work properly, usually half way through range is recommended and I've read that for females 100-130 is best. You could eat liver once a week to raise ferritin level. I got mine up from less than 50 to about 90 just by eating liver, so much easier than faffing about with iron supplements and trying to keep them 4 hours away from thyroid meds and other supplements, and possible tummy upset or constipation. Otherwise, you can use Ferrous Fumarate (from Amazon), one tablet twice a day and retest after finishing the packet. Take each tablet with 1000mg Vit C to aid absorption and help prevent constipation.

You could increase your NDT to get your TSH down and there's plenty of room for your FT3 to increase.

[hellybaybee in reply to SeasideSusie]

My mom bought me some vitamin c and iron tablets when I had a cold a few weeks back, I thought it helped a bit but wondered if I was imagining it. I'm not taking any other supplements atm. I am seeing endo next week so will speak to her about it - thanks for the info, I will look into getting more supplements, think I need to take better care of myself tbh.

Forgot to say, I'm not really sure of the range as they have put deficient <140 and insufficient as 140-250 so not sure if that gives any indicator.

[SeasideSusie Remembering in reply to hellybaybee]

140 will be the bottom of the range (for B12) so at 226, although in the insufficient range, you may not be low enough for your GP to test for Pernicious Anaemia. However, as the people on the PA forum know more about B12 and Folate than we do, I would still pop over there and seek their advice before doing anything about supplementing B12 and Folate.

You definitely need to get your Ferritin up and as you are a meat eater I would definitely incorporate it into your diet once a week. I ate approx 120g in one meal a week (liver and onions for me) but you can put some in cottage pie, curry, bolognese sauce, casserole, anything using red meat, also liver pate if you like that. It really is so much easier than trying to fit iron supplements around thyroid meds and other things.

[hellybaybee in reply to SeasideSusie]

Okay, thanks for this 😊