New to site help needed: Hi all, diagnosed almost... - Thyroid UK

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New to site help needed

Pearlanncollins profile image
17 Replies

Hi all, diagnosed almost 30 years ago on 100mcg levothyroxine. I have never had regular blood tests or any tests for vitamin deficiency thus the need to decipher thes results,Doc has given me some iron tablets and I am to repeat blood test in 8 weeks, advise please. Results as follows Serum total protein level8.2g/L(60.0-80.0).Serum albumin45g/L (35.0-50.0).Serum globulin level 37g/L (20.0-35.0).Serum alkaline phosphatese level 131 u/L (30.0-130.0). plasma fasting glucose level 7.4mmo/L (3.5-6.0). Thyroid function test 4.19 my/L (0.3-5.0). Blood count RDW17.5%

(11.0-14.8).Mean cell volume 77.0fl (80.0-100.0).Mean cell haemaglbin level 24.7 ph (27.0-30.0). Neutrophil count 7.60 10*9/L (1.7-7.5)). Lymphocyte count 1.34 10*9/L (1.5-4.5). Serum vitamin B12 level 144 ng/L (120.0-900.0). Serum ferritin level 7.ng (15.0-300.0).

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Pearlanncollins
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17 Replies
jezebel69 profile image
jezebel69

Hi - best I can decipher is your low ferritin - hence the doc addressing your iron deficiency. But your TSH (thyroid function) is right near the top of the range and shouldnt be. It could mean you just need an increase in T4 and that would be a doctors first choice. Your B12 is way too low and you need to have vit D tested. Both of these should be top of their range for your thyroid to function adequately. I'm sure you'll get other more helpful comments

SlowDragon profile image
SlowDragonAdministrator

So your TSH is 4.19 (0.3-5.0)

This is much too high, should be around one (or even slightly lower)

This shows your Levothyroxine is too low. You probably need 25mcg dose increase, but your vitamins are extremely low and need improving

There's no FT4 or FT3 or thyroid antibodies test

These all need testing. Ask GP to do so

B12 144 (120-900)

This is much too low

Folate should always be tested alongside B12 - ask for this to be tested

You may need evaluation for Pernicious Anaemia

Ferritin 7 ( 15-300)

is absolutely dire - you almost certainly need to have iron infusion and certainly full iron panel doing

Highly likely vitamin D is far too low as well

I will add SeasideSusie - she is the vitamin supplements guru

You have been very poorly served by current GP. Is there another GP you can see?

Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine,

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.

In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l.

Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.

This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."

You can obtain a copy of the article by emailing louise.roberts@thyroiduk.org print it and highlight question 6 to show your doctor.

If you can't get full thyroid and vitamin testing from GP

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

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH and most consistent results

SeasideSusie profile image
SeasideSusieRemembering

Pearlanncollins

Serum ferritin level 7.ng (15.0-300.0)

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.

Mean cell volume 77.0fl (80.0-100.0).Mean cell haemaglbin level 24.7 ph (27.0-30.0)

These results, along with your dire ferritin level, suggest iron deficiency anaemia.

What dose of iron tablets has your GP prescribed? For iron deficiency anaemia it should be 2 or 3 ferrous fumarate daily.

However, with such a low ferritin level you really need an iron infusion so ask for one as it will raise your level within 24-48 hours, tablets will take many months.

When taking iron tablets, take each one 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.

You can also 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...

**

Serum vitamin B12 level 144 ng/L (120.0-900.0)

You need your folate level testing as folate and B12 work together.

Your B12 is very low in range and you should ask for intrinsic factor antibodies testing for Pernicious Anaemia.

Do you have any signs of B12 deficiency - check here b12deficiency.info/signs-an...

I suggest you post on the Pernicious Anaemia Society forum for further advice. Post your B12 and ferritin results, your MCV and haemoglobin levels.

Pearlanncollins profile image
Pearlanncollins

Doc has put me on ferrous fumarate 210mg three times a day. Thanks for all your comments

judburke profile image
judburke

You need to ask your Dr why your iron/ferritin and B12 are so low! It is possible that you have a gut absorption problem - this can be caused by something like Coeliac or sometimes medications such as PPI's for acid can inhibit absorption of food and medications.

I had unexplained low levels but it was 2 years before I asked why and then I was diagnosed coeliac - hence my comments to you - Please ask why

SlowDragon profile image
SlowDragonAdministrator

Gluten intolerance (no NHS test available) can also cause similar results.

Ask GP for Endoscopy for coeliac testing.

What else is your doctor doing?

What other investigations?

What other treatments /supplements?

Pearlanncollins profile image
Pearlanncollins in reply to Mary-intussuception

Doctor has asked for GFF, TFT2,HBAC?,FERRATIN AND TIBC AND ALSO PUT ON BLOOD TEST FORM ION DIFFICIENT + ? DM SHOULD HE TEST MY T3? Many thanks

Mary-intussuception profile image
Mary-intussuception in reply to Pearlanncollins

Yes, you were advised this and others 2 months ago ??

Pearlanncollins profile image
Pearlanncollins

Yes advised by Doctor to just take iron tablets (prescribed) eight weeks ago and to have retest in 8 weeks ie tomorrow, let’s see what these results show, will post these as soon as I have them .

Many thanks

Pearlanncollins profile image
Pearlanncollins

Sorry forgot Doctor advised no other tests or treatment just iron tablets, am taking B12 and folate, Doctor did not advise me to take these. Just advice from this site .

Mary-intussuception profile image
Mary-intussuception in reply to Pearlanncollins

1)

Are all the results above (in post) copied correctly?

Serum Protein 8.2 ( 60.0 - 80.0)

Glucose 7.4 (3.5 - 6)

I would have wanted GP to explain these. Did you also have urine samples tested?

You had other results that were outside range as well.

2)

Doctor has asked for - (above in your reply) :

GFF - Glomerular filtration fraction - Urinary Renal function tests.

TFT2 - not seen TFTS or TFT written like this (Thyroid Function Tests ) so can only guess GP is doing TSH & T4 ??

HBAC - HbA1c is a test for Diabetes.

TIBC - Total iron-binding capacity

It appears that he has noted on your blood form, under clinical info/comments, that you are iron deficient and he's queying Diabetes? Is that correct?

I think the 'advice' from this site was to request Folate test from your GP and investigations for Pernicious Anemia.

What became of your Haematology referal? Was it arrangel by phone?

What took you to GP 2 months ago ? Was it a Urine infection?

Your new post lacks info you have given here?

When posting your results it's best to use one line for each result and add any comments made after the ranges in brackets. Also give date of tests and refer to previous posts. Then people are best equipped to comment on the next steps you may consider taking.

Were you given instructions with regards fasting for toady?

If this were me then I would be making a double appointment with my GP to go through Kidney test results and Diabetes but I would be wanting ALL nutrients levels fully tested and addressed. I'd want full Thyroid tests done and/or referal to Endocrinologist. How are you? What are your symptoms?

Is there anyone you can take with you to see your GP?

It's best to make a list of all your questions and queries (all your abnormal results) and all your symptoms to refer to. Ask GP to write down any explanations/ diagnosis.

To find out about blood tests you can just Google search the letters then blood test. If an NHS site comes up then I suggest going to that one first. It will usually be more simplified than some others. Any conditions or diagnosis try Google searching NHS choices followed by the condition.

Keep seeing GP till you get full investigations for your Nutrients and Hypothyroidism because once you have them sorted and stable - general health should improve.

My Liver function test results were very abnormal. Gastroenterology were investigating fatty liver (it wasn't ) and couldn't figure out what it was. However, this was BEFORE my diagnosis and treatment of Hypothyroidism (have Hashimoto's Autoimmune Thyroiditis which causes the Hypothyroidism ). My liver recovered.

However, we are all different and I am not medically qualified. No one on here is.

You can Google all the tests/info I've given above to find out more details also.

Pearlanncollins profile image
Pearlanncollins

Yes Mary all those results were as posted, I asked for the tests whilst I was having the flu jab so it was actually the nurse who filled the form in and asked for those additional tests. This was after I discovered this sight and found out I knew Didley squat about my own health. Have not been referred to haematology, I did have a urine infection earlier this year which was treated with antbiotics, hav’nt had a recent urine tests. I was rang by gp after those blood tests but unfortunately was seen by a new go who only mention the low iron, it was’nt until later I got the copy of the blood tests that I found out about the rest of the abnormal results and as said rang docs to query what they should be doing about these, and was told by receptionist to just take the iron pills and have retest in 8 weeks, which I have done, the took 4 vials of blood so hopefully will test everything.

Pearlanncollins profile image
Pearlanncollins

Hi all

Just called into Doctors for my results, receptionist said they were fine. They did not do everything needed, but results are as follows

Plasma fasting glucose level(44g1) 5.0 mmoi/L (3.5-6.0)

Haemoglobin A1c level 34mmol/mol (20.0-42-0) comment on form HbA1c below 42 mmoi/mol indicates excellent glycaemic control in patients known to have diabetes. Check patient is not having unrecognised Hypoglycaemia. Diagnosis normal ( low risk of diabetes mellitus).

Serum ferritin level (XE24r).

24ng/mL (15.0-300.0).Ferritin>15 and <100ng/mL. With low Hb and MCB A NORMAL FERRITIN LEVEL in the presence of inflammatory changes does not exclude iron deficiency.

Thyroid function test (X77Wg).

Serum TSH level (XaELV).

3.35 my/L (03-5.0)

Serum free t4 level (XaERr) 12.1 pmol/L (7.9-16.0)

Serum free triodoththyronine level (XaERq), 5.6 pmol/L(3.8-6.0)

ANTI THYROID PEROXIDASE.

30iu/mL (0.0-9.0.

Above high reference limit, positive anti thyroid peroxidase antibody. Consistent with risk of autoimmune thyroid disease.

Associated with increased risk of other organ specific autoimmune disease (e.g pernicious anaemia. Addison’s disease.

Do these seem normal to you!!

Look forward to your comments thankyou.

Mary-intussuception profile image
Mary-intussuception in reply to Pearlanncollins

Look at the comments added by the lab / doctor.

I would only discuss with GP not receptionist.

Nothing to panick about, just see GP with your list of questions.

Linthyro profile image
Linthyro

Hi, do you have a regular blood test for your thyroxine T4 levels? If not, you should ask your GP for a blood test at least once a year.

Pearlanncollins profile image
Pearlanncollins in reply to Linthyro

Hi, had another blood test between Christmas and New Year, sorry can’t post results at the moment as cat sitting at my daughters and looks like I am snowed in, saw doctor after theses results which were not much better than the first one I posted, he refused to give me an increase in levo, I asked to be referred to endo, this could be a long wait as hospital phoned last week and said no appointments available and they will be in touch. I am still taking iron , B12, Folic acid and vit c. I am due another blood test and hopefully when I get home will arrange this. Daughter is back on Saturday, so snow willing can get home, thankyou for your reply, will post results when I can.

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