Hopping mad!

Had my bloods taken a week ago as I have been feeling pants since before Christmas, ahead of a telephone appointment with my new gp next Monday - old one left the practice.

Called into the surgery to get the results this pm to be told they would be discussed Monday. First hackle up!

Explained that given it is a telephone appointment as that was all I could get with my doctor this month, that I would like a copy beforehand to make the consultation more meaningful. After a wrangle she agreed to ask the doctor and I walked around the block!

On my return I was pleased to hear that permission had been granted and they were printed awaiting my return. Great! Until I read them that is. Despite the GP writing up a T3 test and the nurse reassuring me that T3 was on the list (as I take T3 prescribed - good idea to test for it?!?) there was no T3 result on the sheet! Grrrrrrrrr

Not a happy bunny. Understatement.

Perhaps you eminently sensible people can help with my interpretations and suggested actions for the call.

Vitamin B12

I supplement with 1x5000 micro grams of Jarrows Methyl b12 - not everyday

Result = 1166.0 ng/l [range 211-911]

Action = maybe use the 1000 micro version instead?

Vitamin D

I supplement with 1 x 5000 iu a day

Result = 198.6 nmol/l [range below 30 deficient, above 50 sufficient for most, over 500 toxic

Action = maybe use a slightly less potent version instead?

Folate

I take a good B complex daily

Result=greater than 24ug/l [range = greater than 5.38]

Action = none

Ferritin

I take 1x ferrous sulphate 200mg every other day

Result = 303.4 ug/l [range 10.0 - 291]

Action

None - worked hard to get it up - hair no longer falling out - endo recommended getting it over 80 but no one prescribed anything for it - guess work on my part! Not much over range

Now to the thyroid results!

TSH below reference = as expected and normal for me - probably freaking my new gp out though!

Free T4

I take 100 Levo and 20 T3 daily

Result =12.2 pmol/l [range 10.0 - 19.8]

Action - think this is too low - should be upper quartile?

Million dollar question though in the absence of a T3 result - what do i increase; T3 or T4 - or is it do nothing until I get a T3 done?

Calmed down a bit now - but boy - no wonder you get into a rage eh??

All input gratefully received by you lovely knowledgeable people.

25 Replies

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  • I take 100 Levo and 20 T3 daily

    Result =12.2 pmol/l [range 10.0 - 19.8]

    Action - think this is too low - should be upper quartile?

    Upper quartile is recommended in people who take Levo only. Taking any T3 will lower your body's production of T4 from the thyroid (assuming you have one), and so a lower level of Free T4 is to be expected. The more important factor is how you feel.

  • Thanks human bean

    I am tired, irritable, angry and cold. And I know it's Feb but it's been going on since Dec. Hung on for a holiday in the sunshine at Christmas (probably why vit D so high lol!) wanted to rule out Thyroid and vits before asking for more tests. Has some coldsores before Xmas that got infected so perhaps I'm post viral like half the country.

  • You really need to get Free T3 tested. It's a better indicator of symptoms in many people than either Free t4 or TSH.

  • On the case. Grrrrr.

  • Jayneywales B12 is fine at 1166. Reduce to 1000mcg daily as a maintenance dose now. Continue with the B Complex to balance the B vits.

    Vit D should ideally be 100-150nmol/L. Reduce your dose. I'd suggest that whilst you have some 5000iu ones, finish them off by maybe taking one every 3 days for now. Retest in about 4 months and re-evaluate. A maintenance dose of possibly 2000iu daily once you're within the right range.

    Are you taking Vit D's important co-factors K2-MK7 and magnesium?

    Ferritin should be half way through range, I'd suggest you stop supplementing now and eat liver once a fortnight. Too much iron is as bad as too little.

    As far as your thyroid results are concerned, there's no way you can decide what to do until you have FT4 and FT3 results from the same blood draw. If you are taking T3 it generally lowers FT4 so it's the FT3 result that's important. There's no particular need for FT4 to be in the upper quartile when taking T3, that's for when on Levo only.

  • Thanks seasidesusie.

    Recently been to the sun at Christmas so perhaps I've overcooked the vit d!

    Take magnesium bur not potassium- will get some ordered. Take selenium and zinc too.

    Can't handle liver so will take some iron maybe once a week. It's shot up though which I see as good.

    Thanks for the advice.

  • I wouldn't take any iron for now. Leave off supplementing for a while, retest in, say, 2-3 months and if the level has reduced to half way in range then take a maintenance dose. It's good that you've raised your level, but over range isn't good.

  • Ta

  • Potassium - you don't need to supplement - can just eat bananas.

  • Ok. Have one a day already with my porridge. Enough?!?

  • I find one banana a day on my home made gluten free muesli seems fine.

  • Great

  • when on T3 or NDT which also contains t3 your TSH will always be near zero or totally suppresed its the perfectly normal pituarity feedback response and a basic biological fact

    trouble is far too many doctors seem to be wedded to tsh must not be suppressed routine

    its nonsense of course and my husband who has been on NDT for 12 yrs always has a zero TSH just as it was when he was on T3 it was also zero

    he is 74 and perfectly fit and healthy unlike all his miserable years on levo then t3

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  • Oh dear,when will they ever learn! TSH ignore as taking T3 in any form and it can Beas low as zero but But FT4 is low and without the FT3 reading it can be low because you are not taking enough meds or it can be low because your FT3 could be at the very top or just over the top of the range. So two very different scenarios as it could be to high or too low so what is he going to do, toss a coin! It would be funny if it wasn't so serious.

  • You are right - if it wasn't serious I'd be laughing too! Another week of wait to come then - pah! If I can get an appt to get a blood test that quickly! Deep joy.

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  • Twice Southampton labs were asked for Blood Tests this month and 2x they did NOT give T3 as Consultant @ Bournemouth pointed out. A friend just retired from NHS says they will not prescribe T3 as its so expensive (£300 for 2 months). Dr ex Head of Thyroid Assoc says its cheap to produce so has be due rotten Drug co's. On Trust me I'm Doc lady was refused T3 after taking it. She takes chance and buys on line, says cant do without. lf l turn out to need it l will ring Swiss Embassy for name of Pharmacy (safer than on line) or try France. l took VitD spray as read on reviews it helped thyroid and stopped hair falling out which used cover dark coat collar. As it said, that stopped after a week of double dose and had it for years.

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  • I know you have been supplementing iron but your iron stores are far too high. Too much iron in the body - cells/blood is dangerous. That is why your intelligent body puts it into storage (ferritin) where it should not damage your body or feed pathogens. The thing is as I understand it, millions off cells are being killed every day by the body and many are being damaged and replaced. Cells containing your stored iron will still get damaged - the problem is then, that the iron will then be released into your system - bad scenario for all health conditions especially heart health.

    If you still have periods - your blood loss every month under normal health will bring your ferritin levels down and keep in a safe range hopefully Once thru menopause or bleeding very little your ferritin levels can easily climb. This is why men have a greater heart attack/health risk than women but when thru menopause the risk becomes similar. Anyone with a ferritin level over 100 is advised to become a blood donor. It is no coincidence that statistics show that blood donors live longer. Chris Kresser (Functional Clinician)/ Chris Masterjohn (researcher) have written a lot about this - so you can find further info. I believe CK recommends ferritin should be ideally 65/75 def below 100.

    The thing is your body is intelligent and if it feels that it is under attack from pathogens (lots of inflammation about - have CRP /C Reactive Protein tested- indicator of inflammation in the body) it will produce the hormone hepcidin which keeps iron in storage and blocks the body from using it while the signs are it is under threat. This is fine if laid low with flu or a temporary illness but if a more permanent situation of chronic inflammation then the body will store the iron and ferritin levels will climb because it doesn't want the perceived pathogens to feed on the available iron. But because of this action the body can become deficient in iron even with high stores because the iron is not made available to the body. Known as anaemia of inflammation. GP's sometimes don't understand this - they know ferritin is an acute phase reactant because it says so on lab reports and says so may not give a true picture of iron levels. They seem to think that means often that ferritin may show high but isn't really! What it means is the high ferritin which is undoubtedly high if tested as such doesnt give a true picture of useable iron in the body and so further indepth iron tests need taking.

    You obviously thought that you had to take iron supplements because you thought that you may be deficient in iron for some reason/symptom. I think we should always get as many tests from GP as can to obtain a true picture of what's going on. Go armed to your appointment with knowledge about iron. (don't mention supplementation if don't have to) and this is your perfect opportunity to find out about your iron metabolism. Ask for more indepth blood tests re iron status, because iron stores are too high and so you need to know true useable iron picture. Which is serum iron, and transferrin saturation % blood test. You could say that you still have symptoms of low iron (tiredness low energy - yes, the symptoms of thyroid dysregulation too and B12 - everything works synergystically together) But your storage of iron is high and possibly this could be the result of action of hepcidin and inflammation. Get the serum iron tests - get the true picture, make sure all that iron you have been taking has been made accessible to your body and not just put in storage. I am sure your serum iron and saturation is fine and your ferritin is massively high (normal range is crazy) because you have been supplementing too much and a bit of blood donation will sort to get it down over a few times, so months. If you cannot donate blood because of a health condition and so the blood bank doesn't want it - your GP can write you a prescription for therapeutic blood withdrawal - where they just throw it away.

    Ask for a double appointment time with your GP - you have a lot to talk about. Also tell him it is a double appointment as receptionist don't always make that clear - so he doesn't keep looking at his watch and getting stressed. My GP always thanks me for being considerate enough to make a double appointment - lol

  • The top of the reference range for ferritin is already one of the highest I can remember seeing.

    Seems medics don't usually panic until ferrritin is even higher, but it is already high enough to stop any iron supplements.

    As LynneG says, you must be regularly tested when supplementing iron to ensure you don't go sailing right past appropriate levels. It only changes slowly, so doesn't need to be frequent, but does need to be tested every so often.

    Also, ferritin only gives one dimension of iron in your body.

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  • Thyroid results pretty meaningless without FT3 if you take T3. You'd expect low FT4 and low TSH if you are taking T3. FT4 in top quarter of range is for those on levo only. High iron is not good for you - stop supplementing. I wouldn't worry about any of the others, as long as you feel OK.

  • Thanks

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