Help with results please. always tired and feel like s**t feel depressed and getting worst

[mogamed]

Vitamin D

Serum total 25-hydroxy vitamin D level 43 nmol/L [50.0 - 120.0]

Total white blood count 9.7 10*9/L [4.0 - 10.0]

Red blood cell count 6.70 10*12/L [4.5 - 5.5]

Haemoglobin concentration 168 g/L [130.0 - 170.0]

Haematocrit 0.488 [0.4 - 0.5]

Mean cell volume 73 fL [83.0 - 101.0]

Platelet count - observation 246 10*9/L [150.0 - 410.0]

Neutrophil count 5.85 10*9/L [2.0 - 7.0]

Lymphocyte count 2.98 10*9/L [1.0 - 3.0]

Monocyte count - observation 0.81 10*9/L [0.2 - 1.0]

Eosinophil count - observation 0.05 10*9/L [0.02 - 0.5]

Basophil count 0.02 10*9/L [0.0 - 0.1]

Nucleated red blood cell count 0.00 10*9/L

Haemoglobin A1c level - IFCC standardised 74 mmol/mol

Serum sodium level 141 mmol/L [134.0 - 145.0]

Serum potassium level 3.9 mmol/L [3.6 - 5.0]

Serum urea level 4.6 mmol/L [1.7 - 7.1]

Serum creatinine level 68 umol/L [59.0 - 104.0]

Serum cholesterol level 3.9 mmol/L [3.6 - 5.0]

Serum ferritin level 64 ug/L [23.0 - 300.0]

Serum folate level

Serum vitamin B12 level 392 ng/L [130.0 - 1100.0]

Serum folate level 9.6 ug/L [2.7 - 15.0]

Serum total protein level 75 g/L [63.0 - 82.0]

Albumin

Serum albumin level 40 g/L [35.0 - 50.0]

Serum TSH level 4.23 mu/L [0.35 - 3.5]

Serum free T4 level 13 pmol/L [8.0 - 21.0]

Serum TSH level 4.23 mu/L [0.35 - 3.5]

Liver function tests

Serum bilirubin level 18 umol/L [0.0 - 22.0]

Serum total protein level 75 g/L [63.0 - 82.0]

Serum albumin level 40 g/L [35.0 - 50.0]

Serum globulin level 35 g/L [21.0 - 35.0

Had the bloods done at my doctors

[SeasideSusie Remembering]

mogamed What dose of Levo are you currently taking? Do you take any supplements? Do you take any other medication?

Serum total 25-hydroxy vitamin D level 43 nmol/L [50.0 - 120.0] - this is too low. The recommended level is 100-150nmol/L according to the Vit D Council. You should supplement with D3 with it's important co-factors vitamindcouncil.org/about-v... I would suggest 5000iu D3 daily for 3 months then retest. When you've reached the recommended level reduce to 5000iu alternate days, or 2000iu daily, as a maintenance dose. Retest once or twice a year to keep within the recommended range, private fingerprick blood spot tests are available for £28 from City Assays vitamindtest.org.uk/index.html

**

Mean cell volume 73 fL [83.0 - 101.0] - what has your GP said about this? Low MCV can indicate iron anaemia - talk to your GP.

**

Serum ferritin level 64 ug/L [23.0 - 300.0]

- this is on the low side. Thyroid hormone can't work and T4 to T3 conversion can't take place unless ferritin is at least 70. It's generally said that ferritin should be half way through it's range. To improve your level, eat liver regularly, maximum 200g a week and eat lots of iron rich foods apjcn.nhri.org.tw/server/in... - so much easier than trying to fit iron tablets around thyroid meds and other supplements.

**

Serum vitamin B12 level 392 ng/L [130.0 - 1100.0]

- this is too low. Anything under 500 can cause neurological symptoms, it's said that us Hypos need it at the very top of it's range. You can supplement with sublingual methylcobalamin 5000mcg daily, when the bottle is finished then buy the 1000mcg strength as a maintenance dose.

When supplementing with B12, we need a B Complex to balance all the B vitamins. Buy one with methylfolate rather than folic acid. Your folate level is fine, you need to maintain it at least half way through it's range and the B Complex will do that.

**

Serum TSH level 4.23 mu/L [0.35 - 3.5]

Serum free T4 level 13 pmol/L [8.0 - 21.0]

You are undermedicated. Your TSH is over range and FT4 not even half way through range. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it s needed for FT4 and FT3 to be in the upper part of their respective reference ranges, when on Levo only. You need an increase.

It would be helpful to have FT3 tested at the same time as FT4 to see if you are converting T4 to T3 well enough. Unfortunately, it's unlikely this will be done by your GP as labs only do them when there is something drastically wrong with TSH and FT4. You can get tested privately with a fingerprick test to do at home with Blue Horizon or Medichecks.

Do you have high antibodies, Hashimoto's? BH and Medichecks can test antibodies too, as part of a full thyroid panel thyroiduk.org.uk/tuk/testin...

**

As the others are in range, I haven't commented.

[mogamed in reply to SeasideSusie]

Hi Susie

Thanks for the reply

I am on levothyroxine 150 microgram

I am also on a few medication for diabetes

I have ibs D and low testosterone .... taking medication for it

also take simvastatine

I also take a multivitamins and iron tablet daily

[SeasideSusie Remembering in reply to mogamed]

Mogamed - Either your 150mcg Levo is not enough, or it's no getting absorbed properly or not converting to the active hormone T3. If I was you I'd get a thyroid panel done with Blue Horizon or Medichecks. If you haven't had antibodies tested the I'd go for

bluehorizonmedicals.co.uk/t... or

medichecks.com/thyroid-func...

If you've had a positive antibody test already, then you just need

bluehorizonmedicals.co.uk/t... or

medichecks.com/thyroid-func...

If you check on Thursday with Medichecks, they have discounts on some tests and you might be lucky that one of those is included.

Once you can see whether or not you are converting T4 to T3 well enough, that can be acted on or put aside.

**

You need to check whether any of your other medication is affecting absorption of your Levo. Google for 'Levothyroxine + xxxxxxxx'. In any case, any other medication needs to be taken at least two hours away from Levo.

**

Do you take your Levo on an empty stomach, one hour before or two hours after food and drink (except water)?

**

Supplements also should be taken two hours away from Levo, some need a four hour gap and iron is one of them. Also, take your iron tablet with 1000mg Vit C to aid absorption and help prevent constipation.

You should stilll talk to your GP about your low MCV because if you have iron anaemia the treatment is generally 1 x Ferrous Fumarate two or three times daily.

**

Multivitamins are generally useless, they contain very little of anything to help and usually use the wrong, least absorbable form of the active ingredient. And if it contains iron that cancels out everything else as iron affects absorption of everything and needs to be taken at least two hours away. You just need to supplement where you have deficiencies or low levels, with the exception of Vit C and B Complex, both of which are good general thyroid and adrenal support.

You could also take selenium l-selenomethionine 200mcg daily which is a good supplement as it helps with T4 to T3 conversion, as does zinc. A good multimineral containing some zinc (but no iron, calcium or iodine) is a useful supplement.

**

Another thing to check is whether you have low stomach acid, most of us Hypos do and this will affect absorption of everything. Easy to do baking soda test scdlifestyle.com/2012/03/3-...

[mogamed in reply to SeasideSusie]

thanks for the advice Susie

a lot to absorb and going to bring this up with the doctors too

yes I take the levo 2 hours before breakfast

I will check with Medichecks thanks for the link

[Nanaedake in reply to mogamed]

Great advice from SeasideSusie as always.

[bluebug]

Your Hb1Ac (Haemoglobin A1c ) result - which is a blood glucose indicator - is too high.

What has the doctor said about it? Have they indicated your low iron level may interfere with the measurement?

(See diabetes.co.uk/what-is-hba1... for the chart)

[mogamed in reply to bluebug]

Thanks bluebug

No they have not said anything other then its too high...control it

[bluebug in reply to mogamed]

You need to see if you can find another GP practice as this one wants to leave you seriously ill. They need to increase your thyroid medication, treat your iron and see if you still have a blood sugar problem, if you do then they need to treat it.

Oh and have a look at the forums on the site diabetes.co.uk. They have low carbohydrate diets which may help you control your blood sugar. Please note "low" and "no" are not the same thing.

.

[mogamed in reply to bluebug]

Thanks and yes im going to male a lot of noise at the doctors this week

[mhackett234]

I take 5,000 IUs of Vitamin D3 every day year round. Remember that you still need real sunshine. Go out for a 1/2 hour walk every day. If you wear contacts take them out (or glasses off) when you are walking outside so that real sunlight can go into your eyes like nature intended. Eat mostly vegetables, especially green and colorful ones.

[mogamed]

Thanks mhackett

Im out in the sun all day so a bit supprised about vit D but eill stsrt taking a supplement