Medicheck results advice/help

[sunsetstrip]

Hi, can someone help interpret my medicheck blood results.... Many thanks

GP requested blood test

Dec 2017. 3pm

Serum total 25-OH vit D level 40 nmol/L 50 - 140nmol/L

Serum TSH level 0.76 mIU/L 0.27 - 4.2mIU/L

Eosinophil count 0.7 x10^9/L 0 - .4x10^9/L

Serum folate 4.3 ug/L 3.9 - 20ug/L

Serum ferritin 53 ug/L 30 - 400ug/L

Serum vitamin B12 467 ng/L 197 - 771ng/L

Started daily Vitamin D & Folic acid & Iron tablets.

Medichecks blood test

Feb 2018. 11am. Fasting.

THYROID STIMULATING HORMONE 1.61 mIU/L 0.27 - 4.20

FREE THYROXINE 16.6 pmol/L 12.00 - 22.00

TOTAL THYROXINE(T4) 110.0 nmol/L 59.00 - 154.00

FREE T3 4.99 pmol/L 3.10 - 6.80

THYROGLOBULIN ANTIBODY <10 IU/mL 0.00 - 115.00

THYROID PEROXIDASE ANTIBODIES 9.55 IU/mL 0.00 - 34.0

VITAMIN B12 420 pmol/L 140.00 - 724.00

FOLATE (SERUM) 16.76 ug/L 2.91 - 50.00

Inflammation Marker

CRP - HIGH SENSITIVITY 0.4 mg/l 0.00 - 5.00

Iron Status

FERRITIN 44.7 ug/L 30.00 - 400.00

[bluebug]

Can you state what dose of supplements you are on? As you may not be on enough. Give your vitamin D supplement dose in IU (international units) as it's easier for people then to tell you whether to increase it.

Your results do indicate that you do need to increase your vitamin D, iron and folate but specifically your vitamin D.

[sunsetstrip in reply to bluebug]

Thanks bluebug....

Doses :

Ferrous Fumarate 210mg / One daily

Foluc acid 5mg / One daily

Vitamin D3 400IU / One daily (taking tablets not capsules. Is there a certain brand I should get? Is it better to take tablets or capsules or does it not matter?)

Thank you again

[bluebug in reply to sunsetstrip]

You need to take more vitamin D. The dose you have been told to take is for a child not an adult with vitamin D deficiency.

Unfortunately as you are not severely deficient it is up to you to purchase the tablets and take private tests as required as the NHS will not pay for them unless it is linked to a condition under the care of a specialist like osteoporosis.

Ideally purchase 5,000IU tablets and take one per day for 8 to 12 weeks then take one every other day. (I don't know the brand as I tend to get my own tablets from a local pharmacy that don't brand their vitamin D supplements. Look on Amazon for brands without soya in them.) Then around May have a private test to see what your level is. City Assays, a NHS lab in the West Midlands, provides private spot tests which you can do by post for £28. You should aim to get your level to 100nmol/l. You don't want to go higher than 150nmol/l as you risk going into toxicity levels if you go on a sunny holiday or sit in the sun in summer.

Once your level is around 100nmol/l then you need to maintain that with a maintenance dose. This is tricky as this varies from person to person. Some people like me have to take 2,000IU per day throughout the year, while others don't need to take anything in summer but need to take 1,000IU per day in winter, while others have to double their dose in winter.

Regardless you need to supplement vitamin D for the rest of your life and have a private test every year to check your levels as the NHS won't normally pay for it. Once your levels are stable tests should be done around October every year to know what winter supplement regime you need.

Vitamin D needs to be taken 4 hours away from thyroid hormones and with a meal with fat in it. Those who are deficient can find it stimulating so best take it with lunch. As iron can cause digestive problems take it at a different time from iron.

Complementary nutrients to take with vitamin D are magnesium such as oral magnesium citrate or Epsom salts in a bath plus vitamin K2-MK7 supplements. Many people find without them they struggle to increase and/or maintain their levels or have calcium level problems. You DO NOT need to supplement calcium. (If you decide to supplement zinc you can take a combined magnesium and zinc supplement but ensure it has a small amount of copper in it as they compete with each other.)

Your iron supplement is fine just ensure you take it 4 hours away from thyroid hormones, and leave 2 hours from calcium containing foods e.g dairy products and tannin containing foods e.g. coffee, tea, chocolate when taking it. Definitely ensure you take it with vitamin C. In addition some people find taking a supplement with the amino acid lysine helps to get levels raised. You won't need to iron for the rest of your life. Though some people find their levels yo-yo and they have to keep taking iron supplements on and off. There is a disagreement at what level ferritin should be at. Some people say around 90 while others say halfway in the range. NHS doctors say just in range, over 30 or over 50 - all of which will still mean you have hair problems if you currently have them.

Generally for folic acid the advice on here is to supplement with a vitamin B complex to ensure all B vitamins are balanced out as they complement each other. As B vitamins are water soluble just take with food whenever you like. There are iron preparations with B vitamins in them so in theory you could take it when you take iron but in practice due to the gastrointestinal upset iron causes I wouldn't. Taking a B vitamin for the rest of your life won't cause any harm as you pee the excess out, and there is no evidence that a high level of serum vitamin B12 is dangerous. Just ensure 5 days before any blood test you stop taking the B complex as biotin can muck up test results.

[sunsetstrip in reply to bluebug]

Thank you bluebug for the detailed help. Much appreciated

My GP has not prescribed any thyroid medication. Only Iron & folate, I am buying the VitD myself.

Judging from the results of both the GP thyroid blood test and the Medichecks thyroid test, do you interpret 'no thyroid medication required' to be correct? Or should I be on something for thyroid?

Yes, I do have hair problems so will also continue the iron tablets with Vit C.

[SeasideSusie Remembering in reply to sunsetstrip]

Good forms of D3 are softgels as they contain olive oil to aid absorption and no unnecessary ingredients (Doctors Best and Now Foods are good brands) or an oral spray such as BetterYou.

[sunsetstrip in reply to SeasideSusie]

Thanks seasidesusie for those recommendations

[bluebug in reply to sunsetstrip]

Yep you are euthyroid (normal thyroid function)

Be aware having low levels in any nutrient can cause hair loss. So for example you may get your iron levels up but if you neglect to take your vitamin D supplements then you will still suffer hair loss.

Also ensure you don't go mad with any nutrient as they can all cause problems. Many people think taking more than what is recommended or taking it for longer is better, when the fact more of anything can lead to horrible side effects. This is why you need regular testing for some nutrients like iron and vitamin D, and others - like vitamin B complexes - you just need to be wary of the dose you are taking.

[sunsetstrip in reply to bluebug]

Thank you bluebug for the advice. Much appreciated