Latest blood test results - advice please

[tzracer]

As a follow up from this post healthunlocked.com/thyroidu...

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)

Vitamin D 59 nmol/L (75-150)

! 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)

Have lots of other results but most are middle of their relative ranges.

The Serum Ferretin has been up to 57ug/L in the past with ferrous fumarate but has dropped again after that was stopped.

I have purchased some ferrous fumarate which has raised the serum ferretin in the past but is this the right way to go with the unsat iron binding capacity being over range?

As before any advice is much appreciated.

[Clutter]

Tzracer,

TSH 2.07 is a little high for some people taking Levothyroxine. The goal of Levothyroxine is to restore the patient to euthyroid status. For most patients that will be when TSH is 0.3 - 1.0 with FT4 in the upper range. FT4 needs to be in the upper range in order that sufficient T3 is converted. Read Treatment Options in thyroiduk.org.uk/tuk/about_... Email [e-mail] if you would like a copy of the Pulse article to show your GP.

Labs often decline to analyse FT3 unless TSH is <0.03. If your GP can't persuade the lab to test FT4 and FT3 you can order private thyroid tests via thyroiduk.org.uk/tuk/testin... Medichecks offer #ThyroidThursday discounts.

UIBC being over range + low ferritin can indicate iron deficiency. Iron level doesn't appear to be deficient though. labtestsonline.org.uk/under... Ferrous Fumarate will raise ferritin and iron. Take each tablet with 1,000mg vitamin C to aid absorption and minimise constipation. Take iron 4 hours away from Levothyroxine.

B12 323 is low in range. If your wife has symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice.

Folate is over the minimum level and creatinine is within range.

You haven't posted the vitamin D result. If you post it I can suggest a dose to supplement.

[tzracer in reply to Clutter]

Thanks for reply. I have corrected vit D 59nmol/L I had to re-type after loosing most of the post doing it on mobile 😭. She is just fatigued all the time, aching, can't loose weight and no energy to exercise.

I was confused at the TSH dropping, as since the doctor reduced the levo, (because her TSH was under 1) it had steadily been rising to 4.93. Shame we didn't know then that TSH that low was good.

I'll ask for a copy of the pulse article.

[Clutter in reply to tzracer]

Tzracer,

Aching joints and bones can be due to low vitD and low ferritin/iron can cause fatigue.

VitD is optimal around 100nmol/L. I suggest supplementing 5,000iu D3 daily x 6 weeks then reduce to 5,000iu alternate days and retest in 3-4 months. Vitamin D should be taken 4 hours away from Levo-thyroxine and T3. You can buy vitamin D3 without prescription. If you buy on Amazon please use the affiliate link healthunlocked.com/thyroidu...