Thyroid UK
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Blood Results please help

I've been having symptoms of under active thyroid which have got worse since having my gallbladder removed in August. I have no energy, yet can't sleep and my mood is so low I'm struggling to keep up with my two kids. I've had bloods back today but the doctor was extremely rude and walked out crying. I know there is something wrong and not just my depression please can someone help with my blood results so that I can understand whether it is a thyroid issue or I am just going mad.

Serum C protein - 2mg/l

Serum TSH Level - 2.88mU/l

Serum T4 - 8.7pmol/L

Vitamin B12 - 297ng/l

Serum Folate - 7.2ug/l

Serum Ferritin - 10 ug/l

Any advise would be amazing

13 Replies
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Please add the reference ranges (usually in brackets) so that we can interpret your results.

For example

TSH : 2.5 (0.2-4.2)

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Sorry

Serum TSH Level 2.88mu/l (0.35-5.50)

Serum Free T4 Level 8.7pmol/l (7.0-17.0)

Serum Vitamin B12 297ng/l (150-900)

Serum Folate 7.2ug/l (>3.0)

Serum Ferritin 10ug/l (15-3000)

Hope this helps

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He said my ferritin was low but my folate was in range so won't be treated.

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He also said I had a raised heart rate and putting me for an ECG I have been having palpitations and feel out of breath for no reason

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Breathlessness can be due to low ferritin.

Raised heart rate could be many things so wait for your ECG. Hopefully it wont be just a 2 minute one in the surgery, see if you can get a 24 or 48 hour monitor.

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Serum TSH Level 2.88mu/l (0.35-5.50)

A bit too high for comfort, shows your thyroid is beginning to struggle.

Serum Free T4 Level 8.7pmol/l (7.0-17.0)

Very low in range, confirms thyroid is struggling.

Unfortunately your thyroid test results aren't bad enough at the moment to get a diagnosis. Normally for primary hypothyroidism to be diagnosed TSH has to be over range and FT4 below range, or TSH has to be over 10.

However, there is Secondary Hypothyroidism where the problem lies with the pituitary or the hypothalamus.

From bestpractice.bmj.com/topics...

Diagnostic evaluation of central hypothyroidism includes serum TSH and free T4. In central hypothyroidism, free T4 is low and TSH may be low, normal, or minimally elevated. MRI may reveal sellar or parasellar pathology.

I would ask for a referral to a thyroid specialist - make sure it is not an endocrinologist who is a diabetes specialist, it must be a thyroid specialist. Email Dionne at tukadmin@thyroiduk.org for a list of thyroid friendly endos and ask for feedback on the forum for any you can get to. No guarantees but at least they shouldn't be diabetes specialists.

It might be an idea to do some research into Secondary/Central Hypothyroidism to persuade your GP to refer you.

**

Serum Vitamin B12 297ng/l (150-900)

Do you have any signs of B12 deficiency b12deficiency.info/signs-an... You may need testing for Pernicious Anaemia, some people with a level in the 300s require B12 injections.

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."

**

Serum Folate 7.2ug/l (>3.0)

Yes it is in range but it's difficult with these silly > limits, if your level was 3.1 you would be in range but it would be very low.

**

Serum Ferritin 10ug/l (15-3000)

What's your GP doing about our below range ferritin? You need an iron panel and full blood count because low ferritin can indicate iron deficiency anaemia.

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 really need an iron infusion to get your level up, that would be within 24-48 hours with an iron infusion. Then you would need to keep it there.

If you are given iron tablets, then take each one with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds (if you are prescribed any) and two hours away from other medication and supplements as it will affect absorption.

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...

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Thank you so much, you have given me hope in getting this sorted. Yes I am on metaformin for PCOS and already take a B12 supplement (Bought online not from doctor) as this is supposed to cause B12 to decrease. I will look into these and go back the doctors, you have restored some fight back into me. This is affecting my family life so I need to continue to ask for further tests. Thank you again

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How much B12 are you taking? I would suggest you go for 5000mcg to boost your level to over 500 then perhaps drop down to 1000mcg. Are you using sublingual lozenges - they are best for absorption as they bypass the stomach.

Also take a good B Compex to balance all the B vitamins.

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Hello meowcatuk

I am having very similar symptoms. Diagnosed 3 weeks ago with Sub-clinical hypothyroidism. (THS of 6.7) My symptoms are chest pain and breathlessness. Going for a CT heart scan next week. Also on Beta blockers for ectopic beats. The breathlessness is awful. I ended up in A&E two weeks ago due to the chest pains and breathlessness.

Only on 25mg of Levothyroxene till they determine if it is the under active thyroid or a heart complaint. Just want it sorted now. Hope they sort yours .

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Thanks, yeah awful feeling he said I'm having panic attacks but I know the difference as have struggled with them in the past! So annoying actually came out in tears. I wish I could get them to give me a low dose and see whether thats actually the problem or not. Hope you get your answers and feel better soon.

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You too- we'll get there. x

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Oh only 1000 at the moment, I will look into those lozenges now. Thanks again.

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Oh forgot to say Meowcatuk, I too have had my gallbladder removed 18months ago.

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