Thyroid UK
87,682 members102,366 posts

Re A Tale of 2 Tests - they seek it here - they seek it there

Re A Tale of 2 Tests - they seek it here - they seek it there

Hi All

Re my post before Xmas I have today had my bloods re-tested (NHS) as the elusive T3 request by GP never happened. As an update for us all the reasons given by the Lab was that TSH was within normal range and although the GP and HCA requested T3 it was an online request only. Allegedly our region Lab require any unusual requests to be written on the old paper requests slip accompanying the blood sample and clearly brought to their attention. Hmmmm and there was me thinking technology was meant to improve our lives!

GP has asked me to share BH test results with her along with BP and pulse monitoring over the holiday period. I have a phone appointment with her on 10th January and meanwhile we wait..................... getting progressively more unwell!

9 Replies
oldestnewest

What were you latest BH blood test results?

Reply

Hi SlowDragon here is a copy of BH results

Finally got private test results and would appreciate your valuable knowledge on interpretation.

Blood draw taken 9.00 December 19th on fast and without any medication for 24hrs

Vitamin B12 206 pg/ml (197 - 771)

Folate (serum) 7.3 ug/L (>2.9)

Ferritin 35 ug/L (optimum >27 for females)

C Reactive Protein 1.6 mg/L (<5.0)

total Thyroxine T4 95 nmol/L (59 -154)

TSH 0.42 mIU/L (0.27 - 4.2)

Free Thyroxine 17.7 pmol/L (12.0 - 22.0)

Free T3 3.8 pmol/L (3.1 - 6.8)

25 OH Vitamin D 39 nmol/L (50 - 200)

Thyroglobulin Antibody 14.3IU/mL ( 0 - 115 )

Thyroid Peroxidase Antibodies <9.0 IU/mL (0 - 34)

Drs comments B12 insufficient Vit D insufficient

My interpretation of these results are that I am a poor converter from T4 - T3 which is compunded by vitamin insufficiency. Do you agree? I would also be grateful to receive your advice in taking this forward to my GP and guidance on supplements.

Happy Christmas to all and a Healthy New Year.

Regards HypoT

Reply

Yes your vitamins are low. Probably because you are a poor converter. But then it becomes a vicious circle. Getting vitamins correct is first step

B12 , is much too low. Ask GP for testing for Pernicious Anaemia. They should offer B12 injections regardless. But if not you can supplement B12 sublingual lozenges and good Vitamin B complex with folate in.

(remember to stop any supplements with Biotin in 3-5 days before future blood tests as biotin can falsely affect test results)

Vitamin D - how much are you taking at the moment. It's not enough. Better You vitamin D mouth spray is good as avoids poor gut function. Comes in various strengths. Try 3000iu? Possibly 5000iu Retest in 2-3 months. Looking to keep around 100nmol. Test twice a year. Will need to work out what you need as maintenance dose once you get to required level. Plus magnesium and vitamin K2 Mk7.

Ferritin, there's no top of range so its slightly difficult to tell. Usually it needs to be half way in range. Eating liver once a week would help. Ferrous fumerate supplements are available over the counter. Like Vitamin D, you must not take too much iron so important to retest regularly if supplementing

Your total T4 is long way from top of range. You probably have room for dose increase. This should improve FT3 a bit, but would suspect not enough

Get vitamins optimal, try an increase in Levo, if FT3 remains low then likely you need addition of small dose of T3

You might consider doing DIO2 gene test

Your antibodies are low, but apparently about 20% with hashimoto's never have raised antibodies. Have you had thyroid scanned? Might be useful if you could persuade GP

Personally I would try gluten free diet anyway, if not on one already

Definitely try avoid absolutely all soya including soya lecithin. Fluoride free toothpaste too. Check your water supply is not fluoridated, if it is drink bottled water

Reply

Thanks SlowDragon your advice is valued.

I am still negotiating with my GP surgery to get any of the above addressed.

At present I am not taking any supplements because I did not want to skew any base rates with NHS testing. They are still bleating about Hyperthyroid and wanting to decrease my levo dose further which I cannot afford to let them do.

I do not eat any meat. Since having my gall bladder removed last April/May I cannot even smell it without feeling sick. I also could not eat eggs for a few months last year but am beginning to eat one or two now.

The gluten free diet I will look into once I find out whether my absorbtion is a problem. My diet is quite restricted so I will have to be very careful before restricting further. I have never been able to digest soya and avoid it as much as possible.

1 like
Reply

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 articles from Thyroid UK email print it and highlight question 6 to show your doctor

please email Dionne:
tukadmin@thyroiduk.org

Prof Toft - article just published now saying T3 is likely essential for many Or they will have to have high dose Levo, high FT4 and suppressed TSH

rcpe.ac.uk/sites/default/fi...

If you can afford it see a T3 friendly endo

Email Thyroid UK for list of recommended thyroid specialists

please email Dionne:
tukadmin@thyroiduk.org

1 like
Reply

I agree with Slow dragon and just wanted to underline that you are quite undermedicated. I'm not so sure about poor conversion, as it's harder to tell when the dose is low. When on Levothyroxine only It's common to need freeT4 right at the top of the range in order to get decent freeT3, yours is only about halfway up.

That's not to say you wouldn't benefit from T3 if you can get it! But raising vitamins and a raised hormone dose will probably be easier to achieve.

1 like
Reply

Thanks SilverAvocado

I do realise I am undermedicated but I wasnt until my b......dy GP surgery reduced my dosage on numbers blood tests Dec 2016. Since then I have become more and more unwell. They just do not see any reason to get moving on this.

We wait 2 weeks for a GP appt - 5 months for a consultant referral I guess all of us with non urgent conditions just have to support each other and wait................... for what I'm not sure!

Reply

They are so cruel :( I was explaining this to a younger family member over Christmas and they were so shocked. I was shocked they were shocked as I'm used to talking mainly to disabled people :p

Cases like yours make me very angry. Your blood tests have got issues all over the place and it may not have been that way before your dosage was reduced :(

1 like
Reply

In your position I'd be tempted to buy a little T3 and supplement your dose yourself. I've been helping a friend in a similar position do this recently.

Although of course your TSH will go lower so if you're dosed on that by GPs you'll have problems. The other option is just not to turn up for their tests. My friend was getting offered a test less than once a year anyway!

1 like
Reply

You may also like...