Latest Blood results all fine no cause for concern according to GP and have another test in a year!

[nigelm]

My doctor seems to be pleased with my latest results and has said have my next check up in a year. However I feel my vitamins and iron are still too low for someone with and underatcive thyroid I am on 125mg levothyroxine a day. My results are

Free T4 24.8 (12.0 - 22.0) and TSH 0.02 (0.27 - 4.2) - should I be concerned that both these figures are out of range - TSH I know is fine but first time my T4 has gone out of range since being treated?

I was not tested for T3 this time (was for my previous two last time 5.8 (3.1-6.8))

Vit D 83 (50-120) - I am self supplementing with 1000ui a day following course by GP raised it to 82 last time

B12 241 (197-771) - Is this far too low (was up from 215 last time)? What do you advise to help myself in this area?

Folate 5.0 (3.9 - 25.0) - this has been going down was 5.9 last time

Ferritin 124 (30-400) - have recently stopped iron supplements from GP as was at 35 when I first raised concern, 49 last time but he put me on them any way. I will be adding more liver to my diet to try and keep this in shape.

As for myself I don't feel as bad as I did a year ago when I was diagnosed and started treatment, I still get tired and muscle aches (takes a few days to recover from a good session in the ring horse riding) - again he was not concerned about that when I mentioned it and said my dosage was fine. One great thing is the loss of weight as I was way over 15 stone now I'm around 13 and still loosing.

Any advise on how I can help myself as the doctor does not want to know any more as I am within range.

[bluebug]

Iron you can self supplement however some of your test results to get proper advice on this are missing. So if you have a full blood counts and iron panel please add your results.

For vitamin B12 and folate take a good vitamin B complex daily. You ideally want folate halfway in range. There is a disagreement about vitamin B12 levels but you want them at least at the top of the range. Also serum/blood B12 tests are useless once you are supplementing.

Vitamin D is fine.

[Clutter in reply to bluebug]

Bluebug,

I don't think PAS agree that B12 does need to be top of range.

[Polaris in reply to Clutter]

Sally Pacholok and Dr Stuart consider B12 test levels are set too low, as does Professor David Smith, especially for people over 60 years of age.

Test results at any age should definitely not be taken in isolation - latest BMJ research advises that symptoms are paramount, especially when combined with autoimmune hypothyroidism - although many symptoms overlap, if there are neurological symptoms, possible malabsorption should be investigated.

This link posted by Dr John Midgley (Diogenes) shows how Hashimoto's (HT) (often silent) may progress to gastric atrophy leading to impairment of the parietal cells and eventually PA.

journal.frontiersin.org/art...

[Clutter in reply to Polaris]

Polaris,

They may be set to low but does that mean that they are saying results should be top of range? I've seen top of range 725 through to 2,000.

I read Diogenes research on Hashimoto's and GA a while back but the link you've posted doesn't work.

[Polaris in reply to Clutter]

Oops - have edited the link and hope it now works Clutter 🙂

Latest BMJ research document advises that, as there is no gold standard test, clinical symptoms are of more importance - especially if already supplementing with tablets, as serum B12 will usually be high regardless of whether this treatment is effective.

Sally Pacholok, in her book on B12 deficiency believes iB12 def. is commonly undertreated and misdiagnosed. She advocates treatment of patients with a serum level below 450 pg/ml. (nearer 1000 for those over 60) as deficiencies begin to appear in the cerebral spinal fluid below 550

[Clutter in reply to Polaris]

Polaris,

As ever there are differing views as to the right course of action and levels and I don't pretend to any expertise about B12 which is why I post b12deficiency.info/signs-an... and advise members with low B12 and/or symptoms to go to PAS for advice before supplementing.

[nigelm in reply to bluebug]

Thanks bluebug, I hear eating liver is good for Iron and luckily I do like it. What tests results are you after the only other thing they tested was bone profile - I can post them if that is what you are after (although there are 8 different tests!).

[bluebug in reply to nigelm]

Bone profile goes with your vitamin D test result and as that is fine there is no need to post them.

[Clutter]

Nigelm,

I agree that TSH 0.02 and FT4 24.8 are fine unless you feel overmedicated in which case you should reduce dose and FT4 will drop and TSH rise. What was FT4 when FT3 was 5.8?

VitD 83 is in the replete range 75-200. If you are getting a couple of hours sun on your face and arms each week you could stop supplementing but most of us need to maintain vitD levels during Oct-Apr with 2,000-3,000iu D3. Vitamin D should be taken 4 hours away from Levothyroxine.

B12 and folate are low. If you have symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice on supplementing.

Ferritin 124 is fine but if it drops now you've stopped taking iron you may need to resume taking it as a maintenance dose.

You might try supplementing magnesium citrate for aching muscles. Magnesium needs to be taken 4 hours away from Levothyroxine but most people take it at night as it can relax muscles. You can also use magnesium oil spray and Epsom Salt baths to relax muscles.

[nigelm in reply to Clutter]

Thanks Clutter my FT4 was 20.4 last time. Thanks for confirming Vit D levels are fine I will continue with 1000iu if I don't get any sun and will double the dose in winter.

I don't have many of the symptoms of B12 deficiency so think I am fine there and I will check out the other forum for advice.

I'll investigate the magnesium and see if that will help with my aches.

[Clutter in reply to nigelm]

Nigelm,

I expect FT3 is a little higher than 5.8 as FT4 has risen but hopefully remains under 6.8.