Help with blood results please

[Lordy40]

Had bloods in March as having female issues with non stop period for 5 weeks, results serum classed as normal.

TSH level 1 mil/l (0.27-4.20)

Serum free T4 Level 16.8 pmol/L (12.0-22.0)

My doctor allowed me to up my thyroxine dose from 150mcg alternate days with the other day being 125mcg to 150mcg every day as last time I had this female issue it seemed to correct things.

Just last week I had my Thyroid levels checked again to make sure I wasn't overmedicated and they read as follows -

Both normal

Tsh 1.52 Miu/L (0.27-4.20) and

T4 18.8 pmol/L (12.0-22.0)

Fingers crossed my female issues have stopped though having an ultrasound tomorrow to see what's going on. Was given tranexmeric acid tables and Norethisterone to stop bleeding which did not work, but not sure if a coincidence but by 5th week of upped thyroxine dose the bleeding has Stopped.

I also in March had full blood count and female hormones checked for any signs of perimenopause. They came back as following -

Serum LH level - 8.1 u/lnormal

Follicular phase 2.4-12.6 u/l

Ovulation phase 14.0-95.6 u/l

Literal phase 1.0-11.4 u/l

Peru menopausal 7.7-58.5 u/l

Serum FSH level normal 7.8 u/l

Follicular phase 3.5-12.5 u/l

Ovulation phase 4.7-21.5 u/l

Luteal phase 1.7-7.8 u/l

Peru menopausal >35 u/l

Don't know if anyone understands these results they mean nothing to me!

I feel generally well in my self and less tired since the dose increase although it's really only 25mcg every other day in affect. I seem to have more energy and feel any mood swings have settled down, was breathless and struggling with sweating the first couple of weeks but think this was the Norethisterone that has the same symptoms that settled once I stopped taking that.

The only concern I have is one swollen finger which I can no longer get my ring over knuckle not sure if that's connected with increase in meds?

Thanks in advance for any advice

[bluebug]

When they test your luteinizing hormone and follicle simulating hormone you need to know where in your cycle you are otherwise the results are completely meaning less. Ideally you should have the FSH test in the first few days of your menstrual cycle.

Have you ever had your thyroid antibodies tested to see if you have autoimmune thyroid disease?

Also due to your heavy period have you had a full blood count plus your ferritin level tested?

[Lordy40 in reply to bluebug]

Hi bluebug, I just checked my diary I was day 5 of my cycle when the hormone bloods were done. I'm not sure regarding whether I have had my thyroid antibodies tested to see if I have autoimmune thyroid disease, I will find out. Yes I had a full blood count and ferritin levels checked and they came back normal. I have a paper copy of the results. I take one ferritin tables a day.

[bluebug in reply to Lordy40]

"Normal" is meaningless with regards to blood test results.

Your ferritin needs to be half way in range to be optimal and your haemoglobin estimate must be over 120g/l. (Some NHS regions use a lower range boundary for haemoglobin. )

Many women have found if their iron levels are this high they are less likely to have heavy periods. (A period that lasts over 7 days counts as heavy like those where the actual bleeding is heavy.)

The reason I'm interested in whether you have autoimmune thyroid disease is due to the jump in TSH level on the increase of thyroxine. Did you have your thyroid hormone tests first thing in the morning on an empty stomach with the last dose of thyroxine the morning before?

Edited to add - it is up to you not the GP to sort out your iron levels to get and keep them optimal once you aren't considered iron deficient. The NHS only do the minimum. You can buy iron supplements without a prescription and will need to pay for your own private tests.

[Lordy40 in reply to bluebug]

Yes I did have the blood test first thing in the morning on an empty stomach, the last thyroxine dose was the morning before, I did wonder if the results would be squiffy as I had not slept all night before the test as my father in law passed away in the night, so that may have affected the result?

[bluebug in reply to Lordy40]

Very likely.

You want your TSH at 1 or below.

Free T4 in the top quarter of the range.

if you ever have Free T3 measured you want it in the top 3rd of the range.

[Lordy40 in reply to bluebug]

Just checked with the surgery and my notes say hasimoto was what the specialist thought was causing the hypothyroidism back in 1995.

[bluebug in reply to Lordy40]

Are you on a gluten free diet?

It apparently help controls thyroid antibodies and helps slow down your thyroid being destroyed.

[Lordy40 in reply to bluebug]

No I'm not, I don't seem to have any issues with gluten as far as I know. I have been thinking of looking into it to see if will help me lose weight, just nervous of doing as it's a big diet change

[Lordy40 in reply to bluebug]

My ferritin levels are 64ng/ml range 13-150ng/ml my haemoglobin estimation is 130g/l (115-160)

[bluebug in reply to Lordy40]

Haemoglobin is good. BTW notice your GP's lab range starts at 115 - it should be 120 according to NICE and the WHO. I know people who have naturally low levels but they have blood disorders.

Ferritin could be slightly higher and you should keep an eye on it if your periods are long.

[Lordy40 in reply to bluebug]

Thank you I will do, I only take one tablet a day so I can up it to up to 3.

[bluebug in reply to Lordy40]

You don't need 3 as you don't have iron deficiency anaemia.

The standard treatment for low ferritin is 1 tablet twice per day.

Also you need to be careful as you can overshoot the range and you don't want to do that. So get yourself a private test in about 8 weeks. it will give you an idea of how quickly your level increases.