Been diagnosed approximately 12 days ago these are my results. Went to surgery today on unrelated issue and asked reception for my results. No problem she just said ok and printed them out. Anyway here goes I'm just going to type as it says because I'm new to all this hope it makes sense.
Serum TSH level 6.17miu/L
Serum free T4 level 11.9pmol/L
Serum 25- Hydroxy vitamin D3 level<10.0nmol/L
Thyroid peroxidase antibody level 7U/ml
TPO antibody negative
Serum ferritin level 62ng/ml
Serum folate level <2.0ng/mL
Serum vitamin B12 level 262pgmL
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Gracefulgiraffe
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TSH over range means you have primary hypothyroidism due to failure of your thyroid gland. FT4 is below range so you are overtly hypothyroid as opposed to subclinically hypothyroid with high TSH and FT4 within range.
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_...
Thyroid peroxidase antibodies are negative for autoimmune thyroiditis (Hashimoto's).
For maximum absorption Levothyroxine should be taken with water 1 hour before, or 2 hours after, food and drink, 2 hours away from other medication and supplements, and 4 hours away from calcium, iron, vitamin D supplements, magnesium and oestrogen.
It takes 7-10 days for Levothyroxine 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.
You 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 your blood draw.
Vitamin D <10 is severely deficient. My GP prescribed a loading dose of D3 40,000iu daily x 14 days followed by 2,000iu daily x 8 weeks to raise my vitD from <10 to 107.
Ferritin is optimal halfway through range so 62 is sub optimal. You could eat more iron rich food to increase ferritin or supplement iron with 1,000mcg vitamin C which aids absorption and minimises constipation. If you supplement iron retest in 4-6 months and take it 4 hours away from Levothyroxine.
Folate is deficient. Your GP should prescribe 5mg folic acid for 2-4 months to raise folate.
Hi thanks for all the information. I'm 42 years old and was placed immediately on Levothyroxine 25 mg folic acid 5mg and cholecalciferol 50000 for six weeks. I also take omeprazole 20mg daily. I'm seeing GP on 10th April. Can you explain overtly hypothyroid and sub clinical hypothyroid and primary hypothyroid please . Should I ask dr for B12 supplement and vitamin C to help with iron absorption.
Be sure to take Levothyroxine away from other medication and supplements as I advised above and make sure you have a follow up thyroid test in 6-8 weeks.
Overt hypothyroidism is TSH in range 5-10 with FT4 below range ie <12.0. Subclinical hypothyroidism is TSH in range 5-10 with FT4 in normal range (12-22). Primary hypothyroidism is failure of the thyroid gland to produce sufficient T4 and T3 hormone.
Your GP probably won't prescribe B12 because it is within range. Ditto iron. You can buy B12, iron and vitamin C over the counter without a prescription.
Thanks so much for the advice and explanations. I will buy B12 iron and vitamin C over the counter. Is there a level of these that I'm looking for , sorry to keep asking questions.
If you don't have B12 deficiency symptoms you may not need to supplement. Look at the link I posted and ask on PASoc for advice about B12 and folate.
Ferritin is optimal half way through range so 75 in your range. You may not need to supplement iron if you eat more iron rich food ie red meat and liver.
"The 2006 Thyroid Function Test Guidelines state, “There is no evidence to support the benefit of routine early treatment with thyroxine in non-pregnant patients with a serum TSH above the reference range but <10mU/L.” which in layman’s terms means that patients who have a TSH of less than 10 need not be treated because it doesn’t help. However, they also state that, “Physicians may wish to consider the suitability of a therapeutic trial of thyroxine on an individual patient basis.”
If your TSH test is above the range but less than 10, it might be an idea to discuss these Guidelines with your doctor as it may persuade him to give you a trial of thyroxine. In our experience, patients with signs and symptoms of hypothyroidism who have a normal TSH and low normal FT4 also benefit from a trial of thyroxine."
I would discuss this with your GP.
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Also, what is he doing about your severely deficient Vit D at <10. You need supplementation starting with a loading dose of D3. Come back and tell us what he's going to do.
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What is he doing about your below range folate level?
Your B12 is too low. Anything below 500 can cause neurological problems. Recommended is very top of range, even 900-1000. Unfortunately because it's in range your GP won't see a problem but it needs supplementing. Tell us what your GP is doing about your folate level then comment can be made about B12 supplements. B12 and folate work together.
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Ferritin isn't bad but it needs to be a minimum of 70 for thyroid hormone (our own or replacement) to work properly, and for females 100-130 is considered best. Eating liver once a week will raise your level and you won't need to faff about with iron supplements.
The reason ranges are important is that labs differ in their machines, so have different ranges - just to make things more complicated.
Levothyroxine should be taken on an empty stomach with one full glass of water and wait about an hour before eating. Food can interfere with the uptake as can coffee.
When you have blood tests, usually every six to eight weeks, you get an increase of 25mcg of levothyroxine until you are symptom-free.
Blood tests have to be the earliest possible, fasting (you can drink water) and allow approx 24 hours gap between last dose of levo and the test and take afterwards. This keeps the TSH at its highest as doctor are apt to prescribe on the TSH alone and don't take into account clinical symptoms we still have.
Always get a print-out with the ranges for your own records and you can post if you have a query.
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