Back again with my test results

[Antherb]

Hi, thanks for all you posts around 26/05/17 in reply to me.

The following are my results from a blood test at my GPs on the 15/06/17 that were taken after a 24 hour fast following the the advice from some of you;

TSH 2.56miU/L. (0.27 - 4.2)

Free T4. 14.8pmol/L (12 - 22)

Free T3. 4.7pmol/L. (3.1- 6.8)

Vitamin D. 72nmol/l.

Vitamin B12. 340ng/L. (180 - 900)

Ferritin. 164ug/L. (33 - 490)

Folate. 16ug/L. (2.5 - 19.5)

The results all showed up Normal no action needed, although I was prescribed 25mg of Levothyroxine extra to my already prescribed 50mg making a total of 75mg for six weeks before I have next blood test.

I'd welcome any good advice to wether I need to change at this point any other of the results I've shown above, or are there any other tests etc I should have done, the ones above was all at this stage to GP would allow.

[Learner1]

Your GP sounds sensible. Your TSH is slightly high and FT4/FT3 are low normal, so upping your dose to lower TSH and raise FT4/FT3 to the higher end of the normal range makes sense.

You might ask for rT3 and thyroid antibodies next time.

And you might benefit from B12 and vitamin D supplements. Though your "normal", you're below optimum.

[Antherb in reply to Learner1]

Hi Learner1

Thanks for your post, I would like to ask; are the rT3 and Thyroid antibodies blood tests and what would they show in the light of my condition?

You also mention supplementing Vitamin D and B12 to more optimum levels, what would be the best way of achieving and monitoring this?

Thanks again for your time.

[Learner1 in reply to Antherb]

T4 converts to T3 which is am the active hormone your body uses. Some T4 can also be converted to reverse T3, instead of T3, typically when your body is under stress (social, emotional, physical, illness, toxicity, etc.) So, your FT4 can look fantastic, but if you don't know about FT3 and rT3, you don't know what your body is doing with it.

Thyroid antibodies are an autoimmune attack on your thyroid gland, typically TPO and thyroglobulin, aka Hashimotos. Your other numbers can look fine, but your thyroid can be slowly destroyed. If you have hypo or hyperthyroid symptoms but your TSH, FT4, etc look fine, this could be why.

As for vitamin D, you could try taking 2,000 IUs a day. There are lots of good products.

For B12, you want it at the high end of the range. Being at the lower end puts you at risk for fatigue, dementia, etc. Animal proteins are a natural source. Having good digestion helps. But the easiest thing would be to take a supplement, ideally methylcobalamin or adenosylcobalamin, NOT cyanocobalamin. Its near impossible to overdose on it.

You can try it alone or in a B complex, like Thorne Research B Complex 12. If you have any symptoms, its usually a sign you need other Bs, too.

[SeasideSusie Remembering]

Next time you have a test, you only need to fast overnight, have your evening meal as usual then water only until after the early morning blood draw. Not sure who said to fast for 24 hours.

[Antherb in reply to SeasideSusie]

Hi Seaside Susie,

Yes I got the 24hour fast thing wrong, I should have said 12 hours, what I actually did was fasted from lunchtime until lunchtime the next day and in that time only had water, also missed out my dose of Levothyroxine that time as I take that around 10.30pm before bedtime everyday, had the blood draw at 11.00am the earliest appointment I could get and hour before finishing the fast.

Thank you for your post

[Gambit62]

Antherb,

please note on B12 supplementation that, although B12 isn't toxic, having high levels in your blood can cause a reaction in some people that leads to B12 being trapped in your blood and not able to pass through to cells for use.

Your result is well into the normal range making it unlikely that you are B12 deficient.

Serum B12 is a problematic test and will miss 25% of people who aren't B12 deficient but will also pick up 5% who aren't so looking at symptoms is important if you are thinking about supplementing with very high doses of B12 and I really wouldn't advise this without taking professional advice (though I recognise that it can be really difficult to find medical professionals who are really aware of B12 deficiency, how it works, how best to treat it and related conditions).

'Optimum' levels for B12 depend on the individual - there are a number of genetic factors involved and I think medical science has only just started to scratch the surface on all the very complex interactions and certainly isn't at the point of knowing how to predict exactly what levels are right for any individual.

There is a lot of talk about optimal levels of 1000 but this is a figure quoted out of context and actually relates to the levels that, on average, people who are being treated for a B12 absorption with very high doses of B12 need to maintain their levels to feel okay. This isn't a normal population where conclusions can be applied to general populations, if only because of the reaction mentioned in my first paragraph.

People vary a lot in how they respond to the different types of cobalamin - for most people there is absolutely no reason to advise against the use of cyanocobalamin - the exception being a rare hereditary condition (more prevalent in males) called lebers - which has a particular sensitivity to cyanide and even the extremely low amount in cyanocobalamin can lead to issues and cause blindness. People with this condition are also advised not to smoke because of the small trace amounts of cyanide in tobacco from the way it is processed - so we really are talking about an extreme hypersensitivity.

There is a lot more discussion of B12 on the PAS forum and you may find it useful to look through the pinned posts there before making any decision on supplementation. Even if you have symptoms there is such an overlap with thyroid that I would be inclined to make sure that thyroid is properly under-control before concluding that you are B12 deficient.