Son's TFT Results... Normal!!!!!

[pussycatwillow]

My 24 year old son had blood test in October

TSH 7.28 (0.30 - 5.50)

T4 15.2 (10.30 - 24.50)

Levo increased from 125mg to 150mg

January Blood Test

TSH 3.65 (0.30 - 5.50)

T4 15.60 (10.30 - 24.50)

Vitamin D 61 Therapeutic Target >80

Vitamin B12 518 (180 - 1100)

Folate 2.7 (3.00 - 13.00)

Ferritin 127.9 (20.00 - 300.00)

Usual response of "normal" although low Vitamin D mentioned, but no reference to folate which I think is woefully low.

Needless to say, T3 not done.

GP has agreed to further blood test and ultrasound scan.

Any comments please and recommendation to increase folate levels.

My son is still very tired and lacking energy.

Thanks

[SeasideSusie Remembering]

pussycatwillow Because of the folate being under range, a couple of articles worth reading:

nhs.uk/conditions/Anaemia-v...

patient.info/health/folic-a...

He could supplement to get Vit D up to recommended level of 100-150nmol/L.

Ferritin could do with being half way through range (160), eating liver once a week should raise that.

He could do with an increase in Levo as TSH is too high and FT4 too low. The aim of a treated hypo patient is for TSH to be 1 or below or wherever it is needed for FT4 and FT3 to be in the upper part of their respective reference ranges if that is where you feel well.

[pussycatwillow in reply to SeasideSusie]

Thanks Susie.

He is a fussy eater... sadly there is no way I can force liver down him. Will look at other options

[SeasideSusie Remembering in reply to pussycatwillow]

You can hide the liver quite easily in things like casserole, cottage pie, curry, bolognese sauce. If he has iron supplements he needs to take them with 1000mg Vit C with each tablet and 4 hours away from thyroid meds, other supplements and medication as iron interferes with their absorption.

[pussycatwillow in reply to SeasideSusie]

Lambs Liver? I have never bought liver!

[SeasideSusie Remembering in reply to pussycatwillow]

Lamb's liver is fine, or chicken liver might have a milder flavour. I've not used chicken liver as I'm happy with lamb's liver. If you use a butcher, ask which is mildest.

Does he like pate? That's another way of getting liver.

[pussycatwillow in reply to SeasideSusie]

Yes he loves pâté 😀

Great idea

[helvella in reply to pussycatwillow]

Check the liver content - certainly you can easily find products as low as about 30% (some could be lower).

[humanbean in reply to pussycatwillow]

If he eats other kinds of meat...

Make a stew of some kind that you know he will eat.

Fry the liver. Mince it up, then put it into the stew a few minutes before serving it.

Or alternatively, mince it up while still raw and put it in the stew 10 minutes before serving.

If he comments on the flavour say you are trying out a new combination of herbs or a different brand of stock cubes.

I'm not usually a fan of being under-handed with food (or people), but if I eat stuff I don't like for the good of my health, then I don't see why other people won't!

[pussycatwillow in reply to humanbean]

Thanks human bean... couldn't agree more..

Have to say I am not a fan of liver either!

[Clutter]

Pussycatwillow,

Vitamin D 61 is sub optimal, around 100nmol/L is optimal. Your son should supplement 5,000iu D for 6-8 weeks and then reduce to 5,000iu alternate days and retest in May.

Folate is deficient. Your son's B12 is fine but needs folate to work. My GP prescribed 5mg folic acid for a couple of months to correct my folate deficiency. Lower dose folic acid or methylfolate are available without prescription.

Ferritin is fine.

[Clutter in reply to Clutter]

Pussycatwillow,

I edited my post above as I missed that your son is taking 150mcg Levothyroxine. He is still under medicated and dose should be increased to 175mcg. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 1.0 or lower with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your son's GP.

It takes 7-10 days for a Levothyroxine dose increase to be absorbed before it starts working and it will take up to six weeks to feel the full impact of the dose. Symptoms may lag behind good biochemistry by several months.

Your son should have a follow up thyroid test 6-8 weeks after starting Levothyroxine. Arrange an early morning and fasting (water only) blood draw when TSH is highest, and take Levothyroxine after his blood draw.

[pussycatwillow]

Thanks Clutter. We are considering seeing someone private, hence the post re London hospitals.