Advice on my wife's blood tests please

[tzracer]

Thanks for the advice on my own results, my wife and I have finally awoken from the delusion that the local GP's will help us.

My wife has been under active thyroid for years and feeling fatigued for years.

Most recent bloods, amazingly she got a T3 test, the surgery are pretty much only doing TSH now and not due to test again until Dec 17.

TSH (nov 16) 4.93 miu/L (0.30 - 5.00)

T4 (oct 15) 19.0 pmol/L (11.00 - 23.00)

T3 may 16) 4.2 pmol/L (3.10 - 6.80)

Serum para thyroid 3.0 pmol/L (1.10 - 6.90)

Vit D - never tested!

Folate (feb 16) 8.3 ug/L (4.6 - 18.70)

(sept 13) 7.4 ug/L (4.6 - 18.70)

B12 (feb 16) 437 ng/L (172 - 1162)

(sept 13) 485 ng/L (172 - 1162)

Ferretin 57 ug/L (10 -291)

Ferratin has been as low as 12 ug/L before doctor gave supplements to boost to 57 which was then 'nomal'?

Past TSH/T4 results (may help build a picture)

Oct 15 TSH 3.24 miu/L (0.30 - 5.00) T4 19.0 pmol/L (11.00 - 23.00) menopausal

Feb 15 TSH 2.86 miu/L (0.30 - 5.00) T4 17.6 pmol/L (11.00 - 23.00)

Nov 14 TSH 0.8 miu/L (0.30 - 5.00) T4 19.8 pmol/L (11.00 - 23.00)

Sept 14 TSH 0.24 miu/L (0.30 - 5.00) T4 18.4 pmol/L (11.00 - 23.00)

Sept 14 levo dropped to 100mcg from 125mcg

Jul 14 TSH 0.07 miu/L (0.30 - 5.00) T4 19.9 pmol/L (11.00 - 23.00)

Sept 13 TSH 0.11 miu/L (0.30 - 5.00) T4 19.4 pmol/L (11.00 - 23.00)

Dec 12 TSH 0.32 miu/L (0.30 - 5.00) T4 20.3 pmol/L (11.00 - 23.00)

From my limited reading on the forum it would look like she is converting and may need more levo but maybe not as high as 125mcg as the TSH was getting too low wasn't it. Or maybe a small amount of T3.

Then there's the vitamins, we need to try and get the Vit D tested and all the others are low, what level of supplements would you suggest to start with? I think it took a pretty high dose of iron to get it up ti the 57 ug/L.

Thank you in advance for your thought and input.

[Marz]

I see you have not had any replies - I have read your post a couple of times but was confused by all the figures. Why not post the most recent results and that may help you receive more advice. Less is more !! Remember we are mostly Hypo and cannot take in too much information in one go !!

[tzracer in reply to Marz]

Thanks Marz, I wasn't sure about putting the past results in but thought it may help as it clearly shows TSH going in wrong direction after Doctors lowered dose.

[Katepots]

Ok the latest bloods clearly show she is undermedicated. I'm sure she is feeling dreadful. Levo definitely needs to be upped.

I tend to go on how I feel rather than look at just TSH to be honest as when I feel well and am optimally medicated my TSH level is very low so it does not give an accurate picture in my opinion.How did your wife feel when TSH was low? Did she feel hyper or was GP just going on results?

Your wife could try alternate days of 100/125mcg as 100 clearly is not enough.

B12 needs to be above 600, I use now foods instant energy B12 it has complex Bvitamins too.

Folate and ferretin need to be mid range so I'd say the boost GP gave was not enough! What the Dr had given her obviously was working but just not on it for long enough.

The NHS will say levels are normal at much lower levels than they should be because of cost!

Yes get vitamin D tested. It should be at least 60, pretty much bound to be low.

How about thyroid antibodies? Very important to test for Hashimotos.

Have you thought of getting private bloods done to get more comprehensive testing?

Bluehorizonmedicals.co.uk

Thyroid plus 11,12&15 are all good tests. Worth thinking about. Not cheap though I'm afraid.

[tzracer in reply to Katepots]

Thanks Katepots, it's hard for her to say as the low iron (and possibly other vitamins) at that time could have been masking the thyroid being ok. She has felt tired for 15 years.

The doctors were only going on levels. Funny that she has now gone from bottom to top of the 'normal' range.

We will get some private blood tests, looking to get referred to see Endocrinologist was next step with GP, for what that is worth. Hopefully she will see the same one as me (who seems happy to support me self medicating).

Will order some vitamins to get those levels closer to your recommendations.

Just missed 20% off blood tests but sure they will have offer on again.

Will look back to see if antibodies have been tested.

[Angel_of_the_North in reply to tzracer]

Ask [e-mail] for the list of doctors and endos with a clue - there might be one in your area.

[Katepots]

Email them asking if they'll still honour 20% off or the 3for2 deal.

They're pretty reasonable to talk to. 😀

[tzracer in reply to Katepots]

Just looked again and they have the same offer for July 20% off with code: insideout7 😀

[Angel_of_the_North]

You need free T4 and free t3 done at the same time to see if conversion is good. Can't really tell much from the info given except that TSH was much too high in Nov 2016 suggesting undermedication. Tests should be done first thing in the morning, fasting and without taking levo for 24 hours. B12 and folate were both too low (over 500 for B12 and 50% of range for folate) and need to be supplemented. Low B12 can cause hypo=like symptoms). There were no signs in any of those results of overmedication - plenty of room for an increase in FT4, but your doctor is obvioulsy TSH-obsessed.

I'd get private tests done through Blue Horizon or Medichecks and then you'll know where you are.

[tzracer in reply to Angel_of_the_North]

Thanks for the encouraging input it's good that everyone is saying the same thing. I have been looking at blood tests so will get one ordered. Is the B12 better as injection or is that if tablets don't work?

[Katepots in reply to tzracer]

Injection if they'll do it.

[tzracer in reply to Katepots]

😀 I doubt the GP will be up for that. Injection off the internet?

[tzracer]

Thanks for the reply, never thought of cookwear, we use mainly stainless steel and some nonstick.

Hope this doesn't sound funny but what do you recommend vitC wise, I use vit c powder (L-Ascorbic Acid) to avoid the sweeteners in a lot of the tablets. But she doesn't take it.

Will get liver on the menu once a week 😀

[humanbean]

Ferretin 57 ug/L (10 -291)

Iron has been as low as 12 ug/L before doctor gave supplements to boost to 57 which was then 'nomal'?

I assume you mean that "Ferritin has been as low as 12 ug/L..." Although they are strongly related, iron and ferritin aren't the same thing.

For most people who lose iron easily and who are hypothyroid, ferritin ideally needs to be roughly mid-range or a little bit over. So, with the reference range given I would suggest getting it up to 150 - 180. Iron is poisonous in overdose so be careful not to go higher than that. The cheapest private iron test I know of that is worth doing is this one - a finger-prick test :

medichecks.com/tests/iron-s...

And for information on optimum results for iron :

rt3-adrenals.org/Iron_test_...

Once your wife gets her levels up to optimum she needs to keep them there. It can be difficult to find the sweet spot that will keep results optimal. She may need to take 1 iron tablet a day or take 1 tablet 3 times a week or... Lots of trial and error...

Another alternative is eating liver once a week, if she is a meat eater, which many of us find simpler.

[tzracer in reply to humanbean]

Thanks, yes I meant ferretin, sorry I thought they were one and the same. Will correct. She has had more detailed iron studies done buy the GP. And the second she got within range Doctors stopped supplementing.

[humanbean in reply to tzracer]

So a couple of weeks later she would have been under range again. What is the point of that?

What was your wife taking to improve her iron results?

***

Ferritin is an iron storage molecule.

Ferritin is protein produced by nearly every cell of the body. Ferritin molecules are large; each molecule can hold 4,500 atoms of iron.

Source : irondisorders.org/Websites/...

[tzracer in reply to humanbean]

She was given standard iron tablets to take with meals, can't remember dose but it was much higher than over the counter stuff

[humanbean in reply to tzracer]

Was it ferrous fumarate? Or ferrous sulfate?

[tzracer in reply to humanbean]

Good job we're hoarders, found an old script, ferrous fumarate 210mg 3 times a day

[humanbean in reply to tzracer]

Okay, well the good news is that, in the UK, you can buy ferrous fumarate 210mg without a prescription.

It comes in boxes of 84 and costs about £5 or a bit less (it's been a while since I bought it so I might be out-of-date) per box. 84 tablets is enough for three tablets a day for 28 days.

You can either go to a pharmacy and ask for it or buy it online. If you go to a pharmacy it is up to the pharmacist's discretion whether or not they sell it without prescription. Boots often refuses, but Tesco and Lloyds Pharmacies are usually okay. If you get refused at one pharmacy, try another.

It is a very bad idea to supplement iron without regular testing because it is poisonous in overdose, so test every 8 weeks or so to begin with, assuming she is starting from a very low level. After a couple of tests you will know more about how fast your wife absorbs iron, so can adjust frequency of testing accordingly. But if anything in your wife's health or diet changes then speed of absorption may well change.

[Anecdote : I was very slow to absorb iron. My levels rose at snail's pace and I had been supplementing 3 ferrous fumarate per day for about 20 months or so. Then I went gluten-free and suddenly my levels shot up very suddenly and I overshot my target. Luckily for me I still lost iron as quickly as ever...]

Iron testing can be done with finger-prick testing by post :

medichecks.com/tests/iron-s...

Once you have some results, post them on here and ask for feedback.

[tzracer in reply to humanbean]

Picked some up from Tesco like you said. No questions asked.😀

[tzracer in reply to humanbean]

Hi, thanks for your help so far, I have posted latest blood results here healthunlocked.com/thyroidu...

You seem well informed when it comes to iron issues would you mind taking a look if you get a moment.

Many thanks

[tzracer in reply to tzracer]

Sorry went back and reread your adrenals link, mustn't have sunk in first time, my memory fog is bad with my own symptoms. Makes a bit more sense now.

All point to supplemental iron if i'm interpreting correctly.

[tzracer]

We have some updated bloods after trying to get the doctor to do T3 T4 again but no luck. Doc blames lab even though he puts it on the form.

TSH has dropped from 4.93 to 2.07 miu/L (0.30-5.00) without a dose change.

Iron studies done.

Serum iron level 17 umol/L (10-33)

Serum transferrin 3.48 g/L (2.5-3.8)

! Unsat iron binding capacity 87umol/L (36-77)

Transferrin saturation index 19%

Serum Ferritin 18 ug/L (10-291)

! Serum total 25-OH vit D level - slight vitamin D deficiency - collect leaflet from desk (leaflet was about diet!)

Serum vitamin B12 323 ng/L (181-910)

Serum folate 8.3 ug/L (>5.40)

Serum creatine 82 umol/L (53-97)

[Marz in reply to tzracer]

Better to start a new thread 😊 - this will be missed ....

[tzracer in reply to Marz]

Thanks Marz have done that now