Test results

[Jrouseuk]

Hi there

My endo recently increased my dose to 175 levothyroxine after I was continuously struggling to lose weight and tired. I was diagnosed after having my daughter about 2 years ago and also have a prolactinoma which I’m medicated for. Weirdly my T4 seems to have gone up above the range post this increase. He also ran a full blood test following low iron and folate levels (now on iron supplements and vit d3). My results are below. Any ideas why I’m still feeling knackered and not losing weight? Also should I be worried about my lymphocyte count being above range?

TSH 0.16 (0.35-5.0)

T4 23.2 (9-19)

Serum free triiodothyronine 4.3 (2.9-6.1)

Prolactin 13 (20-700) * I also have a prolactinoma which is why this is tested I’m medicated for this

Folate 5.1 (3-20)

Heamoglobin 138 (115-155)

Platelet count 267 (140-400)

Red blood cell count 4.46 (3.8-5.8)

Packed cell volume 0.43 (0.37-0.47)

Mean cell volume 97 (83-101)

Mean haemoglobin level 31.1 (27-32)

Mean cell haemoglobin concentration 320 (320-360)

Red blood cell distribution width 11.7% (11.6-14.8)

Total white blood count 8.4 (4-11)

Neutrophil count 3.8 (1.5-7.5)

Lymphocyte count 3.8 (1-3.5)

Monocyte count 0.5 (0.2-0.8)

Eosinophil count 0.2 (<0.4)

Basophils count 0 (<0.1)

[Kes8]

Any results for ferritin or B12?

[Jrouseuk in reply to Kes8]

Hi @Kes8 I've included my results from September (which include this) below:

TSH - 0.925 (0.27 - 4.20)

Free Thyroxine - 20.3 (12 - 22)

Total T4 - 121 (59 - 154)

Free T3 - 5.38 (3.10 - 6.8)

Thyroglobulin Antibodies - 443 (0 - 115)

Thyroid peroxidase antibodies - 27.5 (0 - 34)

B12 - 199 (140 - 724)

Folate - 3.44 (2.91 - 50)

Vit D - 57.4 (50 - 200)

CRP - 0.8 (0 - 5)

Ferritin - 67.1 (13 - 150)

[SlowDragon Administrator]

So are you supplementing for B12 and folate too

B12 was far too low.

Vitamin D remains far too low. How long have you been supplementing and at what dose (hopefully not just 800iu)

Ferritin needs retesting.

When ferritin, folate, B12 and vitamin D are all too low (which your are) then you can't utilise your thyroid hormones. Your blood tests then appear fine, but you remain hypo

See SeasideSusie detailed vitamin supplements advice

Also low prolactin can be due to being hypothyroid.

pituitary.org.uk/informatio...

You have poor conversion from FT4 to FT3.

Your FT4 is over range, yet FT3 is only 4.3

You probably need slight reduction in Levo and addition of small dose of T3

But essential to get vitamins levels much better first. This might improve conversion

[Jrouseuk in reply to SlowDragon]

Hi @slowdragon I’m on 5000iu of D3 and taking 25mg of iron bisglycinate but that’s all I’m taking. Does that help?