Well, it turns out that the figures the NHS rely on say that my thyroid is fine.
The only figure NOT fine is the rT3. What scrappy literature there is available tells me that the ratio of FT3 to rT3 should be 20 or more, and mine is around 10. This could explain my mild hypothyroid symptoms of low basal temperature and sensitivity to cold, and even, possibly, my high cholesterol.
Next, a cortisol test.
bwims Well, fine just means that the results are somewhere within the range, but it doesn't mean that they are optimal or where they need to be for you to feel well.
Why don't you post your results, with reference ranges, give us a bit more information and maybe we can comment 
I understand that the NHS doesn't do rT3 testing, was that a private test? Can we have those results too, to compare with your NHS ones.
Sure, I didn't have time earlier.
This is the Medichecks THYROID CHECK ULTRAVIT RT3
TestResult+Units \Range
TSH 1.2 mIU/L \0.27 - 4.20
FT4 17.42 pmol/L \12.00 - 22.00
TT4 90.7 nmol/L \59.00 - 154.00
FT3 4.11 pmol/L \3.10 - 6.80
rT3 *26 ng/dL \10.00 - 24.00
FT3/rT3 *10.29 \15.01 - 75.00
Note that there is a lot of variation in the units used. I suspect the rT3 test got done in the USA, though I have no proof except the 2 week turnaround and the odd units.
[Edit]
These are the NHS values{from the same blood draw}:
TSH 0.8 mIU/L
FT4 14 pmol/L
[Slightly worrying that there such a difference between the lab results!]
NB I cannot find a sensible paper anywhere that defines how the ratio is calculated. The Medichecks doctor confirmed that the answer is multiplied by 1000 to get a sensible figure. I also cannot find anything authoritative about what the value should be.... it all seems to be an oral tradition among Thyroid sufferer groups.
Incidentally, if anyone else wants that test, it's worth phoning and asking for a discount code.
I found out also that my antibodies were not significant, and my vitamin levels are ok too.
I would upload the results of those if it wasn't such a faff. Doesn't this forum have a means of uploading screenshots?
Bwims - It's possible to add one image in the first post of a thread. As Health Unlocked provide these forums free of charge to charities, they're rather short on bells and whistles
I wouldn't worry about the variation in units. Both Blue Horizon and Medichecks use the same labs so we are used to seeing results exactly like yours. As long there is a reference range with the result there's no problem.
As far as the ratio is concerned, my research led me to working it out when the units are the same, but as it's been worked out by the lab then it's of no concern really.
These are three of the links I checked out when I was looking
stopthethyroidmadness.com/r...
tpauk.com/main/article/how-...
holistic-hypothyroidism-sol...
Normally, with high rT3, one would expect to see a high FT4 and a lowish FT3 which could indicate that T4 is making rT3 instead of enough FT3. This can happen when taking higher and higher doses of Levo to try and alleviate symptoms but conversion just isn't working properly. This happened in my case.
I assume you don't take Levo and your results look good on the face of it, but your FT4 is 54% through it's range and FT3 is 27% through it's range, with a FT4:FT3 ratio of 4.2 : 1 so conversion just slightly less than it should be (good conversion takes place when the ratio is 4:1 or less).
Conversion can be improved by supplementing with selenium L-selenomethionine 200mcg daily and by having optimal nutrient levels which are
Vit D - 100-150nmol/L
B12 - very top of range
Folate - at least half way through range
Ferritin - halfway through range
However, there are other reasons for high rT3 as I have discovered. I am long term diagnosed and treated Hypo and I reduced my rT3 by optimising my vitamins and minerals, reducing Levo and adding T3. This worked well and my rT3 was 22 and ratio 27. After tweaking doses to try and reduce rT3 further, I find myself with rT3 of 29 with a ratio of 13. It didn't make sense until I researched further.
Here are some links that list other reasons for high rT3
Extreme dieting, the RT3 increases to slow the metabolism and make better use of the available food
Low Iron (including Ferritin)
High cortisol, this disturbs the balance of the thyroid hormones
Low cortisol, this again disturbs the balance of the thyroid hormones
Insulin dependent Diabetes
Low Vitamin B12 levels
Graves disease or other causes of being Hyper Thyroid
Other forms of thyroid resistance causing heavy supplementation of thyroid Meds containing T4 (straight T4 or natural thyroid).
**
verywell.com/the-role-of-re... :
elevated RT3 can be triggered by ongoing chronic physical or emotional stress, adrenal fatigue, low ferritin (stored iron) levels, acute illness and injury, and chronic disease, among other factors.
I can't find the other links at the moment but they all said the same thing and what stood out was chronic disease and infection and that actually explains why mine has risen.
Also low ferritin is mentioned, plus adrenals, so there are many things to look at as to the reason behind it.
Thanks for that, I'll have a look tomorrow. Meanwhile, the test did provide some vitamin checks...
VITAMIN B12 237.7 pmol/L Range:140.00 - 724.00
FOLATE (SERUM) 13.41 ug/L Range:2.91 - 50.00
25 OH VITAMIN D >175 nmol/L Range:50.00 - 200.00
and
FERRITIN 165 ug/L Range:30.00 - 400.00
CRP - HIGH SENSITIVITY 0.4 mg/l Range:0.00 - 5.00
Bwims - a few improvements can be made here.
VITAMIN B12 237.7 pmol/L Range:140.00 - 724.00
FOLATE (SERUM) 13.41 ug/L Range:2.91 - 50.00
Your B12 is really quite low. Do you have any signs and symptoms of B12 Deficiency, anything below 500 can cause neurological problems. Check here b12deficiency.info/signs-an...
If you have then you need to talk to your GP. If not then you can supplement with sublingual methylcobalamin lozenges. I'd suggest buying 5000mcg to start (eg Jarrow's), finish the bottle then buy the 1000mcg strength as a maintenance dose.
When taking B12 we also need a B Complex to balance all the B vitamins. Of you buy a good brand containing 400mcg methylfolate this will help raise your folate level which should be at least 26+. Thorne Basic B and Metabolics B Complex are good ones.
FERRITIN 165 ug/L Range:30.00 - 400.00
This needs to be around 215 so I would eat liver once a week to help raise this level. Also include iron rich foods in your diet apjcn.nhri.org.tw/server/in...
25 OH VITAMIN D >175 nmol/L Range:50.00 - 200.00
Was there no actual number for your result? >175 isn't normally how this is reported. That doesn't tell you if you are over range and have reached toxicity level. Excess vitamin D gets stored so we shouldn't go too high. Are you supplementing with D3? Or maybe you are a sun worshipper?
Many thanks! Coo, lots to answer:
B12
Part of the reason for this specific set of tests was for the B12 as I am trying to find the reason for high cholesterol and a high CAC score. I'd seen a video theorising that homocysteine is what causes the vascular damage in the first place, and B12 breaks it down.
So, I had bought some B12 supplements in readiness for after the blood withdrawal. Since then (2 weeks ago), I've been taking 1000ug daily. I was surprised that the report said I was normal, but it looks like maybe I'm not. I could not find the figure of 500 in the link you sent to me, but I did find it here:
medlineplus.gov/ency/articl...
"Older adults with vitamin B12 levels between 200 and 500 pg/mL may also have symptoms."
I do have some of the minor symptoms from time to time, but none that cannot be explained away otherwise. However, I'm definitely going to keep supplementing! Thanks for those links!
Ferritin. What units are you using?
165 ug/L = 165ng/mL = 370.755 pmol/L
I think you must mean 215 pmol/L = 95.675 ng/mL
I've seen several recommendations to keep below 90 ng/mL, (200 pmol/L) with an ideal upper limit of 60 ng/mL (135 pmol/L)
I've mentioned my coronary artery calicum. Apparently the risk is a lot higher with ferritin higher than 200 pmol/L, so I actually think I need to donate blood!
Vit D3
I got onto this and it's relationship with K2 back in 2015. I did find a test, just after I'd started taking 5000 IUs /day.
Back then, I was at 141.8 nmol/L, and I've been taking that dose ever since
I thought the >175 was a bit naughty too. Maybe I'll drop them during the sunny months!
Bwims, I have given up trying to get my head around ferritin levels. I have seen that pre menopausal women have a different range from post menopausal women and again men have a different range.
Whenever I do my Blue Horizon tests, my birthdate is included in the information. So presumably they use the correct range for me. I've had the same range on all my tests with Blue Horizon which is 20-150ug/L as a post menopausal woman. The one I did with Medichecks a few months ago had the range 13-150ug/L and again they had my birthdate. Your range with Medichecks is 30-400ug/L so as it's different from mine maybe you are pre-menopausal. So that begs the question, why is the range different? And another question, if the range is different for pre and post menopausal, is the recommended optimal figure of, say 70ug/L, the same for both, and if so why have a different range?
All my questions regarding optimal ferritin level have had the answer 'half way through range' so I assume that applies to whichever range is appropriate for the person.
I've read that a minimum of 70 is necessary for thyroid hormone to work properly, I've read that the optimal level for thyroid function is between 90-110 ng/ml, and I've read it should be between 100-130 for females. But none of those articles make any reference to pre and post menopausal women, or women and men. So who knows because none of the articles I've read agree. I have never seen an article that says the ideal upper limit is 60ng/ml.
**
For D3, with a level of 141.8nmol/L you only needed a maintenance dose, something around 2000iu maybe, and possibly less in summer. Taking 5000iu daily is the sort of dose you'd expect to take to raise your level if it was around 40/50/60nmol/L with advice to retest after 3 months, then reduce to a maintenance dose once the recommended level of 100-150nmol/L had been reached, with the recommendation to test once or twice a year to keep within that range.
The Vit D Council has an article about the recommended level, giving the unit of measurement ng/ml but also telling you how to convert to nmol/L (you multiply by 2.5). Their recommendation is for 40-60ng/ml (100-150nmol/L) vitamindcouncil.org/i-teste...
Hello Susie,
Being a bloke, I'm definitely menopausal
(B=Brian)
Actually, I should start out thanking you for alerting me to the ferritin issue. It rang a bell with something I'd seen on a video about dealing with cholesterol issues (Ivor Cummings below).
I think the problem is that ferritin is important for the thyroid , but it's also quite critical if you have concerns about calcium buildup in your coronary arteries (like me). There is definitely a relationship with high ferritin levels (> 200 ug/L) and mortality.
So I need a "sweet spot" between the ideal value for a functioning Thyroid, but not too much to increase my heart disease risk.
I ought to make it clear that I started investigating my functional hypothyroidism as a means of explaining my high cholesterol levels which have given me a gallstone, and possible the reason why I have a lot of calcium in my coronary arteries.
{I'm definitely going to check on those vitamins though, and I'll be submitting a saliva test Monday morning to check my cortisol levels.}
It's quite hard to find anything that is authoritative regarding "ideal levels" of ferritin.
There is one "popular" medic on the web who gives his opinion here:-
articles.mercola.com/sites/...
in which he recommends 40 to 60 ng/ml as "ideal" (he doesn't give a reference, sadly)
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The following is some evidence that I was alerted to by an Ivor Cummings video here
"the case group that had serum ferritin ≥ 200 had a four-fold higher risk of atherosclerosis than the control group"
Pourmoghaddas, Ali, et al. "The relation between body iron store and ferritin, and coronary artery disease." ARYA atherosclerosis 10.1 (2014): 32.
ncbi.nlm.nih.gov/pmc/articl...
This next paper shows how high ferritin interacts with LDL cholesterol to increase carotid atherosclerosis and benefits there were at 50ug/L
"Association between high serum ferritin levels and carotid atherosclerosis in the study of health in Pomerania (SHIP)."
ncbi.nlm.nih.gov/pubmed/147...
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Anyhow, sorry about the earlier confusion!
Thanks,
Brian
[Edit]
PS, I have decided to abandon D3 supplements for the summer, while I'm out and about in the sunshine!
Not the K2 though.... again, very important from a non-thyroid perspective - D3+K2 ensures that calcium is deposited in the bones, rather than the arteries.
