Part 3: GP Blood Tests results / Seeing GP on Monday - would like some advice on what to ask.

[PebbleOnTheBeach]

Hello,

I'm looking for interpretation of blood tests please. Am seeing GP on Monday (a double appointment), so I'd like to know what I should ask.

I'm trying to get older, (over 3 years ago), results from previous GP for comparison. I have also requested blood results from previous hospital (from around time of first 2 FNAs - 3 years ago).

Am I right in thinking that without both antibodies being tested at same time it's not possible to tell if there is an auto-immune issue?

Is there any info to be gleaned from these results? The GP also did lots of other blood tests on 31 Oct, (incl Serum Cortisol), so I can post that if it'll help.

I intend to order private blood tests so I'd like to know, do I need to order ALL the Thyroid tests (to be done together), or can I just get the ones the GP hasn't done, (ie FT4, FT3, TT4 , TPO AND TgAB antibodies)? I am trying to keep costs down.

Please also refer to my previous posts, (esp re supplementation).

Blood test 31/10/17 (between 8am and 8.10am)

TSH 3.65 (0.27 - 4.20 miU/L) - "Normal - no action- Dr J"

FT4 GP won't order this.

FT3 GP can't / won't order this.

TT4 GP won't order this.

TPO GP won't re-test (< 34 ku/L)

TgAB & TPO GP won't order TgAB.

Vit D2 & D3 combined 68 (50 - 200 mmol/L) - "Normal - no action- Dr J"

Serum Folate 17.5 (3.9 - 26.8 ug/L) - "Normal - no action- Dr J"

Serum Ferritin 41 (13 - 150) - "Normal - no action- Dr J"

Serum Vit B12 398 (197 - 771) - "Normal - no action- Dr J"

Previous results 12/04/2017 (between 8am and 8.10am)

TSH 2.67 (0.27 - 4.20 miU/L) - "Normal - no action- Dr J"

FT4 GP won't order this.

FT3 GP can't / won't order this.

TT4 GP won't order this.

TPO 11 (< 34 ku/L) - "Normal - no action- Dr J"

TgAB & TPO GP won't order

Vit D2 & D3 combined 39 (50 - 200 mmol/L) - GP said buy over counter VitD (which I did)

Serum Folate not tested

Serum Ferritin not tested

Serum Vit B12 278 (197 - 771) - "Normal - no action- Dr J". (I began to self medicate B Complex).

*I also began to self medicate Iron & Magnesium around May*

Thank you.

PoB

[shaws]

First thing is you are underdosed. You are not provided with an Optimum dose of levothyroxine. The aim is a TSH of 1 or lower.

I will add in SeasideSusie re your other blood tests. I am sure she will have some comments to be made about 'normal' in some of them.

Email [e-mail] and ask for the copy of Dr Toft's Pulse Online article (he was President of the BTA. Highlight question s6 and I think you will be surprised of the recommendation for the TSH.

He was President of the BTA.

I hate the 'normal' attached to results as if hypo we have to have everything 'optimal' For instance the Serum Vit B12 @ 278 is too low. The new recommendation is towards 1,000. So 'normal' is meaningless.

[PebbleOnTheBeach in reply to shaws]

Thank you

shaws .

I've not been diagnosed re a Thyroid disorder by GP so not on levo or anything else.

I'll get that article, thank you.

Yes, 'normal' is rubbish when v low in range. I told GP on Monday that I'm aiming for optimal.

Am wondering if I've got absorption issues.

Cheers.

PB

[Clutter]

Pebbleonthebeach,

Your thyroid is failing as TSH is high in range but NHS won't diagnose hypothyroidism until TSH is over range or FT4 below range. NHS usually only tests TPOab once and TPOab 11 was negative. Negative TPOab doesn't conclusively rule out Hashimoto's as it is possible that TgAb is positive.

Order TSH, FT4, FT3, TT4 and TT3 and thyroid antibodies.

VitD68 is sub optimal, aim for 100. I recommend you supplement 5,000iu D3 for 8 weeks and then reduce to 5,000iu alternate days and retest in April.

Folate is good.

B12 is probably fine but if you have symptoms in b12deficiency.info/signs-an... go to healthunlocked.com/pasoc for advice.

Ferritin is optimal halfway through range to around 100. You can raise ferritin by supplementing iron with 1,000mg vitamin C to aid absorption and minimise constipation.

[SeasideSusie Remembering]

PebbleOnTheBeach You can get the tests your GP can't/wont do with a fingerprick test from Blue Horizon or Medichecks

medichecks.com/thyroid-health

bluehorizonmedicals.co.uk/t...

The 'bundles' tend to be much better value than individual tests.

**

Vit D2 & D3 combined 68 (50 - 200 mmol/L)

The Vit D Council recommend a level of 100-150nmol/L. I would follow Clutter's suggestion about supplementing. I did very well with these softgels bodykind.com/product/2463-b...

When you've reached the recommended dose then you'll need a maintenance dose which may be 2000iu 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

vitamindcouncil.org/about-v...

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 helps D3 to work and 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

naturalnews.com/046401_magn...

Check out the other cofactors too.

**

Serum Folate 17.5 (3.9 - 26.8 ug/L)

Folate should be half way through it's range so yours is good.

Serum Vit B12 398 (197 - 771)

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." So you should check for signs of B12 deficiency as Clutter suggests.

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."

If no signs of deficiency then you could supplement with sublingual methylcobalamin lozenges and I'd start with 5000mcg, finish the bottle then change to 1000mcg as a maintenance dose. When taking B12 we need a good B complex to balance all the B vitamins.

**

Serum Ferritin 41 (13 - 150)

Too high for your GP to do anything unless you've had an iron panel and full blood count and anything is indicated there, such as anaemia, but too low for thyroid hormone to work. For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.

You can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...

[PebbleOnTheBeach]

Thank you Clutter , SeasideSusie & shaws . Am re-reading and aiming to follow up on your advice. Had weird symptoms yesterday, shaky, weak like low blood sugar kind of feeling. Not quite sure what I am going to ask the GP today but have been trying to find a place that I can get to for an early morning blood test.

[shaws in reply to PebbleOnTheBeach]

I am having a blood test tomorrow - made 3 weeks ago but couldn't get earlier than 9.45 a.m. Usually it is 8.30 a.m. so I'll be quite hungry by time I get home.

Re a blood test, if you are going to get a private one we have two labs which will do home pin-prick tests. If so make sure you are well hydrated a couple of days before the blood draw.

thyroiduk.org.uk/tuk/testin...

[PebbleOnTheBeach in reply to shaws]

Thank you shaws . I've been looking at getting blood drawn rather than doing the finger prick myself. as some of the tests are marked as needing a venous sample, (please correct me if I am wrong). Am about to contact Medichecks (to see which locations open earliest) & Blue Horizon (too see what time the BMI hospitals open the earliest. Their Spire times are on their page).

Good luck with your test tomorrow. Such a shame you couldn't get an earlier one, especially as you booked in advance.

You are amazing , donating your time and knowledge gained to help total strangers. Thank you.

[shaws in reply to PebbleOnTheBeach]

That's good and for some tests you do need blood draw. We are all 'learners' when first diagnosed with hypo. Those that do fine on levo wont be on the internet. For us that don't it is 'sink or swim' and we are all swimming along until we hit the magic number, ie. the dose that relieves symptoms.

[PebbleOnTheBeach]

Hello Clutter , SeasideSusie and shaws , plus anyone else who might know the answer!

As per previous posts I've ordered blood tests with Medichecks and will pick up the kit from the Royal Mail delivery office tomorrow as was out when post person came to deliver.

I'm testing my TSH, FT4, FT3, TT4 and TT3 and the two thyroid antibodies. Expecting blood draw to be done on Mon or Tue or Wed (TBC due to availability of phlebotobist. I didn't want to do finger prick).

May I check, can I start back on my supplements before the blood draw or is it best to wait until afterwards?

Vit D

Vit B complex

Iron

Magnesium

Thank you, as ever. x

PS I will be sourcing K2 soon as poss.

[SeasideSusie Remembering in reply to PebbleOnTheBeach]

If you're not testing any of the vitamins and minerals then all you need to do is check to see if your B Complex contains Biotin (B7) and if it does then leave it off for about 3 days.

[PebbleOnTheBeach in reply to SeasideSusie]

thanks SeasideSusie

[Clutter in reply to PebbleOnTheBeach]

PebbleOnTheBeach,

You can resume your supplements except the B Complex if it contains biotin which can skew blood tests.

[PebbleOnTheBeach in reply to Clutter]

Thanks Clutter

[PebbleOnTheBeach]

Hello, 'just one more thing' as Columbo would say...

Vitamin D - Any brand or product you can recommend (apart from the bodykind softgels?)

Vitamin B12 - How many days on the 5000mcg? Any brand or product you can recommend?

Ferritin / Iron - Can I take Iron tablets AND eat up to 200g Liver per week?

Vitamin K2-MK7 - What sort of dose do I need? Any brand or product you can recommend?

Magnesium - What sort of dose do I need?

I hope to do some supplement shopping this weekend. Looked online this evening and it's too confusing for me.

Thanks in advance SeasideSusie , Clutter , & shaws and anyone else who feels like replying.

Have a great weekend & thank you.

[PebbleOnTheBeach]

Dear SeasideSusie , Clutter & shaws (and anyone else who might see this).

I posted a few days ago but haven't had any replies so I am re-posting.

I need to purchase some more supplements ASAP, I looked online before the weekend and it's too confusing for me so I could really do with a little more help to point me in the right direction. I wondering (hoping), that one or all of you might be able to advise me (further to the replies on my previous posts).

Vitamin D - Any brand or product you can recommend (apart from the bodykind softgels?)

Vitamin B12 - How many days on the 5000mcg? Any brand or product you can recommend?

Ferritin / Iron - Can I take Iron tablets AND eat up to 200g Liver per week?

Vitamin K2-MK7 - What sort of dose do I need? Any brand or product you can recommend?

Magnesium - What sort of dose do I need?

Many thanks in advance.

[SeasideSusie Remembering in reply to PebbleOnTheBeach]

Pebble

The reason you didn't get any replies is because you replied to your own original post. You need to tag a member or reply directly below their message for them to get notification. Posting a new message doesn't move threads to the top of the page on this forum so no-one would have known you'd made a new post on an old thread.

Vitamin D If you have Hashi's then an oral spray such as BetterYou, other than that Doctors Best softgels rate highly in my opinion, it's not Bodykind softgels, it's Doctors Best and bodykind.com have the best price.

Vitamin B12 Finish one bottle then change to 1000mcg. Or just take 1000mcg but it will take longer to get your level up.

Ferritin / Iron You can do both, but with a level of 41 liver alone will do a good job if you don't want the fuss of iron tablets.

Vitamin K2-MK7 Supplements are generally 90-100mcg. If you want a good brand with as few ingredients as possible, oil based for absorption, then Healthy Origins from bigvits.co.uk has a good deal on the larger size.

You could look for a D3/K2-MK7 combined supplement. BetterYou do an combined oral spray, dose 3000iu that might be enough.

Magnesium Whatever it says on the pack. Generally around 350-450mg.

[PebbleOnTheBeach in reply to SeasideSusie]

SeasideSusie Thank you sooo very much. I thought I'd tagged tbh but your reply makes sense. The supplement info really does help. I feel more confident now & will get cracking on some orders this week. I hope you are keeping well. Best wishes. X