Blood tests

[Jackie-2124]

Hi, I'm looking for some help with interpreting my blood test results. I feel that everything is being looked at separately and no connections are being made. I had Laryngeal cancer last year and was treated with radical radiotherapy, my treatment finished in January 2016. I was diagnosed hypothyroid and stared on Levothyroxine in July. I'm now on 75mg a day and my current TSH is 3.6. Although my head and neck specialists say it was too soon to have been caused by the radiotherapy my gp refuses to test for antibodies, T3, T4, FT3 or FT4.

I have a history of autoimmune diseases including seronegative Sjögren's syndrome, myasthenia gravis, lichen sclerosus and probable Raynaud's. I have positive ANA. I also had extremely low vitamin D in in 2015 but that is now 54.5. I have just managed to get these other blood test results from my gp as when I phoned for results I was just told normal, no action required. I would appreciate any views on these other results considering my AI history and almost constant inflammation somewhere or other.

Serum vit B12 255ng/L. (180 - 1000)

Serum folate 4.3 ug/L. (>4.00)

Serum ferritin 68 ug/L. (10 - 300)

It does say the ferritin may not be accurate with co-existing inflammatory disease but no mention was made on the blood test form. Also no mention on the form of suspected autoimmune B12 deficiency although they should have requested intrinsic factor testing.

Thank you for taking the time to read all this.

[Clutter]

Welcome to the forum, Jackie-2124.

You are under medicated to have TSH 3.6 while taking Levothyroxine and should ask for a dose increase. 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 GP.

I would wait until your TSH is 1.0 or lower and then order private FT4, FT3 and thyroid antibodies. Blue Horizon Thyroid Plus 6 will cover the tests you want or Thyroid Plus 11 will include some vitamins and minerals. If autoimmune thyroiditis (Hashimoto's) is confirmed it won't change your thyroid treatment.

Vitamin D is optimal around 100. I would supplement 5,000iu D3 daily for 6-8 weeks and then reduce to 5,000iu alternate days and retest in May.

Ferritin is optimal halfway through range so you might want to supplement iron with 1,000mcg vitamin C to aid absorption and minimise constipation.

Take Levothyroxine 4 hours away from iron and vitamin D.

B12 and folate are low. As you have other autoimmune diseases it would be a good idea to have intrinsic factor antibodies tested to confirm or rule out pernicious anaemia as a cause of low B12. healthunlocked.com/pasoc are the experts on PA and B12 and folate deficiency.

[Jackie-2124 in reply to Clutter]

Thank you for that, it's been a big help. I felt that although they said it was normal my symptoms etc are far from normal. My ferritin was only tested as I have restless legs and I still feel that it is at least part of the cause.

[bluebug]

ferritin doctors know little about it and as long as it is in range they will say it's fine.

Standard treatment is 1 ferrous fumerate twice a day with vitamin C and water. Take 4 hours away from thyroid meds and 2 hours away from other food, drink and supplements to avoid intereactions.

If ferrous fumerate is too rough then try ferrous sulphate then ferrous gluconate. You need a tablet with about 65mg of elemental iron in it.

[Jackie-2124 in reply to bluebug]

Thank you Bluebug, I don't like taking things that aren't prescribed but in this case if my gp isn't going to do anything I will do it myself.

[bluebug in reply to Jackie-2124]

Iron isn't a prescription only medicine and neither are vitamin D supplements. In fact high dose vitamin D supplements are unlicenced even though people get them on prescription.