Help with blood work

[Pkmkk]

Hi all,

This is my first time posting here. Apologies in advance for the long post.

Just over a year ago I had my thyroid removed for cancer. I originally had problem with just being on thyroxine alone, but thankfully I had a GP who prescribed me a combination of Armour (90mcg) and Thyroxine (50mcg) and all of the thyroid function is now normal. The Dr has been willing to adjust the dose based on symptoms along with the blood work.

So the TSH is now 0.196 with the range being 0.27 -4.2 mlU/L

The FT3 is 6.8 pmol/L with the range being 3.1-6.8

The FT4 is 14.1 pmol/L with the range being 12-22

All of the symptoms of my thyroid are gone but I’ll left with this run down fatigue feeling. It’s different to the thyroid fatigue.

Over the last few months my liver ALT enzymes have been slightly raised and the cholesterol levels have been elevated but have started to return to normal with the armour thyroid.

I thought I might be anemic or have low b12 or folate levels so I have those tested but I can make sense of the results. I was hoping so people here might have some ideas before I go back to my GP.

Cholesterol is 6.3 mmol/L Range: 2.0 - 5.0

Triglyceride is 2.07 mmol/L Range: 0.5-1.7

HDL Cholesterol is 1.16 mmol/L Range is 1.0-2.0

LDL Chol(Calc) is 4.2 mmol/L

Iron Transferrin Saturation is 22.7 umol/L range: 11-28

Ferritin is 364 ug/L Range is 30-400

Uric Acid is 498 umol/L. Range is 200-430

Liver ALT levels are 65 U/L Range is 5-41

All other liver levels are within the normal range

Vitamin B12 is 464 pg/ml Range is 197-771

Folate is 4.7 ng/ml Range is 3.0-26.8

My RBC levels is also slight elevated at 5.78 x10^12/L Range is 4.5-5.5

Lymphocytes are 3.88 x10^9/L Range is 1-3

All of the over figures for Blood Sugar, HB1ac , CRP, urea and creatine are normal.

I recently started a multivitamin about 10 days before the blood work was taken that contains small amount of B vitamins - B12 125mcg, 10mcg is Niacin.

I would really appreciate any insights people may have ?

[shaws Administrator]

Welcome to our forum and I am sorry you thyroid gland was removed due to cancer.

You seem to have a very god doctor who is going by your clinical symptoms, so that's excellent.

It is good you have been prescribed NDT and in that case blood tests will be slightly different as they were introduced for levothyroxine (T4) only.

Dose increases should depend upon how the patient feels on a particular dose and relief of clinical symptoms on an optimum dose. I am sorry you are still having fatigue of some sort. Your thyroid hormone results look good but others will respond re your other results.

[Pkmkk in reply to shaws]

Thanks Shaws,

Yes I’m very lucky to have a doctor that just look at a figure and say you must be fine. I have been blessed.

I’m pretty sure my Thyroid replacement is adequate at this stage, but I’m not sure what else is going on to indicate the other issues.

[shaws Administrator in reply to Pkmkk]

I think many of us would love to have an open-minded doctor and our vitamins/minerals also have to be optimal as deficiences can also cause symptoms.

[Pkmkk]

I’m just back from my GP today and she agreed to refer me to a new endcrologist, who uses NDT regularly, and is highly recommended. When I started using Armour back in December, the GP agreed to let me use it to see how I got on with it. It has led to my cholesterol coming down, lowered the triglycerides and increased the HDL levels. Long term as I had thyroid cancer, she thinks I need to be monitored by an Endo.

I have lost some weight (5kg) since starting the armour. So if I can lose some more we hope it will lower the liver ALT levels. I gain nearly 10 after the TT.

I talked to her at length about the B12 levels and folate levels. I was told they are within the ‘normal’ range. I personally feel they aren’t optimal, so I’m going to supplement myself to see how I get on.

I recently learned I have a MTFR mutation issue so I definitely want to the folate level up.

I’m confused though as to what the optimal B12 level should be ?

There seems to be confusion over what an optimal levels is. I read recently in Japan that anything below 500 is treated, but that isn’t the case here !