Blood test results - please advise

[spidernose]

I've been on levo for 15+ years and I have felt awful for the majorty of those years, weight gain, fatigue, feeling cold, memory fog, aches and pains, depression, anxiety, carpal tunnel, thinning hair, you name it I feel it. I discovered this forum and decided to have a private blood test as I initially thought that I needed some T3. Here are my results with the Doctors recommendations at the bottom.

I'm going to make an apt to see my own GP to discuss but I don't know what to say, I'm not being fobbed off any longer so would really appreciate some advice

Patient result Normal range

Biochemistry

CRP H 7.30 <5.0 mg/L

Ferritin H 273. 1 20 - 150 ug/L

Thyroid Function

TSH 4.17 0.27 - 4.20 mIU/L

T4 Total 108.3 64.5 - 142.0 nmol/L

Free T4 17.50 12 - 22 pmol/L

Free T3 3.43 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs 7.2 <34 kIU/L

Anti-Thyroglobulin Abs 72 <115 kU/L

Vitamins

Vitamin D (25 OH) L 21 Deficient <25 nmol/L

Insufficient 25 - 50

Consider reducing dose >175

Vitamin B12 L 202 Deficient <140 pmol/L

Insufficient 140 - 250

Consider reducing dose >725

Serum Folate L 5.76 8.83 - 60.8 nmol/L

There is a significant Vitamin D insufficiency. Vitamin D is manufactured in our skin as a direct result of sunlight exposure. One potential complication of prolonged Vitamin D lack is osteomalacia, a disease which causes severe structural deformities to the skeleton. Lower level Vitamin D deficiency can lead to a number of non-specific symptoms, including possibly chronic fatigue (experts have for many years noted an association between sufferers of chronic fatigue syndrome or myalgic encephalitis (CFS or ME) and low blood levels of Vitamin D). It has been estimated that between 50-70% of people living in the northern Europe (where daylight length reduces your chances of receiving adequate sunlight in the winter) are deficient in this vitamin by March each year. Symptoms of vitamin D deficiency include chronic pain, weak bones, frequent infections (recent research has detected an association between vitamin D deficiency and severe pneumonia), depression and fatigue. Supplementation may be beneficial - please speak to your usual doctor about this result.

The Vitamin B12 level is insufficient. Some experts believe levels of 400-500 are desirable and that levels below this may lead to symptoms. Low Vitamin B12 levels can lead to Pernicious Anaemia (PA), a state of deficiency of the red blood cells in which there is reduced quality and number. Characteristically, the red blood cells are enlarged in this state (if the deficiency is severe and longstanding). A Full Blood Count is needed to check for this state, which is known as megaloblastic anaemia. Vitamin B12 is commonly found in many foods, particularly meats. Deficiency can develop if intake of the vitamin is reduced or if absorption from the gut is impaired. Poor absorption owing to a deficiency of Intrinsic Factor (IF) is the underlying reason for PA. Vitamin B12 deficiency in the longer run can lead to nervous system disorders - with sensation changes, loss of power or co-ordination, gut disorders and (rarely) dementia or mental illness. Lower level deficiency has been associated with a range of symptoms such as fatigue, memory impairment, irritability, depression and personality changes. Please discuss this finding with your usual doctor, supplementation may be advisable.

The Folate level is low. Folate (Folic acid or Vitamin B9) is one of the B group of vitamins, found in green vegetables, in particular. The body's reserves of Folate, unlike Vitamin B12, are low and only sufficient for about four months. Causes of deficiency include reduced intake from the diet or from poor absorption through the gut; increased demand for folate (for example, pregnancy) and side effects of some medication (for example, methotrexate). Symptoms of deficiency include fatigue, mild sensation changes and depression. Prolonged lack of Folate results in megaloblastic anaemia (a red blood cell deficiency in which the cells are characteristically large). Supplementation would be advisable - I advise you to discuss this result with your usual doctor.

The CRP is raised. A high CRP (C reactive protein) is associated with inflammation from some cause (as seen for example with arthritis or infection). It is not an exact test, and is nonspecific. An elevated CRP is not a normal finding and its presence should lead to further investigation to establish the cause. If you have any symptoms suggesting either infection (cough, fever, urinary symptoms etc) or inflammation (swollen painful joints or generalised aching, for example) is present, I advise you to speak to your doctor soon. In any event a discussion with your doctor in due course would be sensible.

The ferritin level is also high. In addition to excess iron supplementation, raised serum ferritin can be a sign of inflammation or infection - which, considering the elevated CRP, is possible here. Raised ferritin due to inflammation is not a sign of too much iron, and is not a sign of disease as such. Less commonly, higher ferritin levels can result from damage to bone marrow or liver, genetic conditions, following blood transfusion, and in chronic anaemias such as thalassaemia. Repeat testing in a few weeks’ time will enable you to spot any trends if you wish to be sure the levels are not persisting or rising - but of course you may wish to speak to your usual doctor.

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[Clutter]

Spidernose,

You are under medicated to have TSH >4. 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.

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

I advise you to contact healthunlocked.com/pasoc to discuss your low B12 and folate. My GP prescribed 5mg folic acid for a couple of months to correct my folate deficiency.

Vitamin D 21 is deficient. My GP prescribed 40,000iu D3 x 14 days followed by 2,000iu daily x 8 weeks which raised my vitD from <10 to 107. Take vitamin D 4 hours away from Levothyroxine.

The doctor's comments are comprehensive and helpful.

[spidernose in reply to Clutter]

thank you for the analysis

do I need to speak to my GP about upping my levo? I initially thought I needed T3, from the results is this not the case? Interestingly the Dr hasn't mentioned anything about my thyroid

I will contact pas regarding my low B12 and folate

[Clutter in reply to spidernose]

Spidernose,

Yes, you need a higher dose prescription. Your low FT3 is probably due to under medication. If FT3 remains low when TSH is 1.0 or lower and FT3 higher in range that would indicate poor conversion and T3 would be beneficial.

[spidernose]

A locum GP upped my levo and my regular GP went ballistic and put them back down again so I don't hold much hope of getting a higher dose. If I were to source T3 privately what dose should I be looking at and do I take them alongside levo?

[spidernose]

Been to see my GP today and what a horrible experience. He was annoyed that I'd gone for a private blood test and scoffed at the Doctors recommendations. He said it was a money making scheme, I said that I failed to see how because the Doctor has nothing to gain by providing false readings and recommending that I see my own GP but he wasn't having any of it. He dismissed the results and said he worked from different readings and they weren't of any concern. He has sent me for some more blood tests but to be honest what's the point if he's just going to dismiss the results.

I sat there and cried I was that frustrated and don't know if I have anymore fight in me