Hi so as my fiancé has been saying I have hypothyroidism and also now Hashimotos which is under treated. GP says other results are fine and I would like to know if they are? Taking 800iu vitamin D which was prescribed to me in 2015. Complete blood count came back with GP comments saying not clinically significant. Results taken in May 2017. Thank you
++Serum folate - 4.2 ug/L (4.60 - 18.70) GP notes - only slightly under range
Serum vitamin B12 - 193 pg/L (180 - 900) GP notes - normal no action
++Serum ferritin - 23 ug/L (30 - 400) GP notes - only slightly under range
I will only mention one result and that is B12 which is near the bottom of the range. When our B12 is 500 or under changes begin in our spinal column fluid.
First ask your doctor to check the intrinsic factor of your B12 to exclude that you have Pernicious Anaemia which is an autoimmune disease also.
SeasideSusie will respond re your results when she reads your post and others who are good at results will also respond..
Your doctor hasn't tested for hypothyroidism. For that you would have to have the very earliest possible appointment, fasting (you can drink water). Ask him to test TSH, T4, T3, Free T3, Free t4 and thyroid antibodies.
He may only do the TSH and T4 but we have private labs which will do those he wont/Or lab wont.
The P.A. society recommends a B12 of 1,000 to help avoid dementia/alzeimers.
No, these are the proper blood tests. You have an Autoimmune Thyroid Disease called Hashimoto's due to having thyroid antibodies. So, yes, you should be taking levothyroxine. You should have a blood test every six weeks with an increase of 25mcg until you feel much better and a TSH of 1 or lower no somewhere in the range as some doctors may do.
You should have a had 25mcg increase every six weeks until your TSH is 1 or below.Both Frees are too low and have to be towards the upper part of the range.Going gluten-free can reduce the antibody attack on your thyroid gland. They wax and wane until you become hypothyroid.
So, if I understand correctly, you have been taking 50mcg levothyroxine for 4 years? I'd change your doctor as your thyroid hormone results are dire. particularly FT3, below range. and T3 is the only active thyroid hormone and it is required in our billions of receptor cells to enable us to function normally. I shall give you a link and it will explain why FT4 and FT3 are needed.
All good advice above. Ask your doctor why he/she thinks your Vit D blood result is not within a good range despite supplementing since 2015. Hopefully SeasideSusie will be along soon to give you the best advice about vit D. You need a higher dose. As Shaws says, get your doc to check for pernicious anaemia too. Check out HealthUnlocked Pernicious Anaemia forum to find out more about B vitamins and how crucial it is for them to be sufficient. NHS bottom of the range for B12 is not a good place to be.
Jenna2302 Well, whoever told you that these results are fine is talking out of an orificice other than his mouth!
Whenever I see the phrase "GP notes - only slightly under range" I want to shout at them "What the heck are ranges for then?"
++Serum folate - 4.2 ug/L (4.60 - 18.70) GP notes - only slightly under range
Serum vitamin B12 - 193 pg/L (180 - 900) GP notes - normal no action
Folate and B12 work together. You are folate deficienct (no other word for it if you are under range) and have a very low B12. Please check to see if you have any signs of B12 deficiency b12deficiency.info/signs-an...
If you have please post on the Pernicious Anaemia Society forum here on Health Unlocked for further advice healthunlocked.com/pasoc
Folate should be at least half way through it's range and for B12 I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
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++Serum ferritin - 23 ug/L (30 - 400) GP notes - only slightly under range
It's said that ferritin should be half way through it's range; however I've also seen it said that for females it should be 100-130. Whichever it is you are a very long way from that level, and it needs to be a minimum of 70 for thyroid hormone to work. Ideally you need an iron infusion so ask for one, but you may only be prescribed tablets which will take months to raise your level whereas an infusion will raise your level within 24-48 hours.
Mean corpuscular haemoglobin volume - 28.1 (28 - 32)
++Haemoglobin estimation - 118 (120 - 150)
This all suggests iron deficiency anaemia. You need to speak to your GP and point this out.
Treatment guidelines for iron deficiency anaemia state that ferrous fumarate should be prescribed, 1 tablet 2 or 3 times a day. With your low ferritin as well, I think you ought to have the maximum.
Take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.
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Total 25 OH vitamin D - 25.5 nmol/L (25 - 50 vitamin D deficiency. Supplementation is indicated)
Plelase read the NICE Clinical Knowledge Summary for treatment of Vit D Deficiency
Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and demand that he treats you according to the guidelines and prescribes the loading doses because your 800iu will never in the reign of pig's pudding raise your level. You might want to point out to your GP that you have been taking this dose for two years already and you are still very deficient, just 0.5 away from severe deficiency. Once these loading doses have been completed you will need a reduced amount to bring your level up to what's recommended by the Vit D Council which is 100-150nmol/L, and then you'll need a sensible maintenance dose which may be 2000iu daily (not 800iu daily), it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
There are important cofactors needed when taking D3
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
As for your fiance's post, regarding the Hashi's. Advice has been given about adopting a strict gluten free diet, I would also mention that supplementing with selenium l-selenomethionine 200mcg daily can also help reduce the antibodies, as can keeping TSH suppressed.
The only other thing I would say is that you really should ditch this endo, he is probably a diabetes specialist (most of them are) and has little knowledge of how to treat hypothyroidism and Hashi's. Find one knows about thyroid. Email louise.roberts@thyroiduk.org and ask for the list of thyroid friendly endos, then whoever is in your area ask for feedback from forum members.
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If your GP wont increase your Vit D dose, come back and we will give suggestions.
Do you think it was because patients didn't get to see their blood test results previously?? Cheaper to leave patient to suffer and tell them it's all in their head and prescribe anti-depressants because the drug companies are giving surgeries perks or because it ticks some Government box??
I can't really add much to these other, excellent responses. I too was horrified to read your post and that you'd been told 'normal' for results just bumping along at the bottom of (or just below) what in some cases are very wide ranges. As others say, it sounds like you need a new endo - though of course it's entirely possible you'll get better info on here!
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