THYROID STIMULATING HORMONE 1.97 mIU/L 0.27 - 4.20
FREE THYROXINE 15.6 pmol/L 12.00 - 22.00
TOTAL THYROXINE(T4) 89.5 nmol/L 59.00 - 154.00
FREE T3 4.41 pmol/L 3.10 - 6.80
This is a 'normal' set of results in that they fall just about where you'd expect to see with someone who doesn't have a thyroid problem. TSH is below 2 which is about right, your T4 is converting to T3 well, and your free Ts are OK although less than half way through range but that could be normal for you.
REVERSE T3 *26 ng/dL 10.00 - 24.00
REVERSE T3 RATIO *11.04 15.01 - 75.00
rT3 can be a result of illness/infection and very low calorie diets, otherwise it would be an excess of T4 making rT3 instead of FT3 which obviously isn't the case with you.
THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 - 115.00
THYROID PEROXIDASE ANTIBODIES 14.6 IU/mL 0.00 - 34.00
Antibodies nice and low so not indicative any autoimmune thyroid disease.
VITAMIN B12 181 pmol/L 140.00 - 724.00
FOLATE (SERUM) 4.24 ug/L 2.91 - 50.00
Very low folate and B12 which could very well be causing you problems. Do you have any signs of B12 deficiency b12deficiency.info/signs-an... If so please post on the Pernicous Anaemia Society forum here on Health Unlocked for further advice healthunlocked.com/pasoc
You may need testing for Pernicious Anaemia and you may need B12 injections, see what the PA forum advises then speak to your GP.
Folate should be at least half way through it's range and 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."
25 OH VITAMIN D *26.5 nmol/L 50.00 - 200.00
You are very deficient and should speak to your GP. Point out the NICE treatment summary for 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. Do not accept 800iu D3 daily, that isn't even a decent maintenance dose for someone with a good level already, you need the loading doses followed by a sensible maintenance dose which is more likely going to be around 2000iu daily. Please come back and tell us what your GP is going to do.
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
Check out the other cofactors too.
Don't expect your GP to know anything about vitamins and minerals, optimal levels or important cofactors. They aren't taught nutrition so don't know about it.
FERRITIN 82.4 ug/L 13.00 - 150.00
Ferritin level is good. Recommended is half way through it's range and at least 70 for thyroid hormone to work, and that's our own hormone as well as replacement.
CRP - HIGH SENSITIVITY 4.3 mg/l 0.00 - 5.00
Within range so not a problem.