I have had a couple of Blue Horizon tests. Thought I’d try a medi checks test and pay for RT3. Interesting. Although for some reason they don’t think I have Hashimoto’s which makes me doubt ALL of their results because every other test says I have !
I would be grateful for comments.
I am having another phase of headache, dizziness and a weight on my chest feeling as well as the more usual aches and pains and the “ mill stone round my neck “ fatigue feeling which have started since this blood test. I had been taking vitamins and minerals ( selenium, b12, D3 and B plus some evening primrose or cod liver oil ) but stopped about 4 weeks before this blood test to get a true picture.
Any thoughts ? Particularly on the Hashimotos but also on RT3/ft3 ratio.The notes suggest COPD, liver disease, diabetes and heart failure or low calorie diets can cause difficulties converting thyroxine to T3 and cause rT3 to rise.
Any thoughts, comments, help gratefully accepted. Clutter, Greygoose and Hashihouseman plus Seaside Susie and Jim111 have all helped in the past — and others whose names have escaped me.
Sorry for the long post.
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AliF
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As antibodies fluctuate, the chances are that when you did the Medichecks test your antibodies were low. It doesn't mean that you don't have Hashi's nor should you doubt any of the other results.
Post all the results with ranges and we can interpret them.
You can edit your opening post by clicking on the down arrow beneath your message V then choosing EDIT, ADD A PHOTO, then when your picture is added click the green EDIT RESPONSE button.
It might be just as quick to do an edit of your post and some cutting/pasting and some line spaces between the results.
Most levels are normal - thyroxine correct dose ( I am paraphrasing but that is the gist)
FT3/rT3 ratio is low which could suggest that you are not getting sufficient T3 into your cells. Other conditions can cause difficulties converting thyroxine to T3 causing rT3 to rise. These include COPD, liver disease, diabetes, heart failure and low calorie diets. “
My endo is about to try me on some T3. Would this help?
You don't need to stop supplementing before a test - with two exceptions
1) Iron - leave off for a week
2) B12 if you want a baseline to see how much you are holding on to and then you need to be off for about 4-5 months.
Other than that you carry on as normal but if taking Biotin as a standalone supplement or as part of a B Complex then that's best left off for 3-5 days as it can skew results if Biotin is used in the actual testing process. Vit D you take that day's dose after the blood draw.
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Active B12 127.000( pmol/L 25.10-165)
This is good, whatever you were supplementing you just need to take a few times a week as a maintenance dose. I take my B12 twice a week now.
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Folate (serum) 14.61 (ug/L 2.91-50.00)
This is too low and needs to be at least half way through it's range.
Personally I wouldn't take an "extra high potency B100", they're not balanced. Is it Solgar Vitamin B-Complex "100" Extra High Potency? If so then it contains 100mcg B6 and that is too much. Recommended is 10mcg B6 daily. Too much B6 long term can cause problems, eg tingling of the extremities. It contains folic acid and methylfolate is the recommended form. It also contains cyanocobalamin whereas methylcobalamin is the recommended form of B12. You would be much better off getting a decent, balanced one such as Thorne Basic B which has all the bioactive forms of ingredients in a much better balance.
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25 OH Vitamin D 103 (nmol/L) 50.00-200
Recommended level, according to the Vit D Council, is 100-150nmol/L. If supplementing then continue at a maintenance dose and make sure you take D3's important cofactors Vit K2-MK7 and magnesium.
D3 aids absorption of calcium from food and K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds.
Magnesium helps D3 to work and comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds
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.
As SlowDragon has said, 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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TSH 1.04 ( mIU/L 0.27-4.20)
Free thyroxine 15.3 (pool/L 12.00-22.00)
Total Thyroxine (T4) 93.4 ( nmol/L59.00-154.00)
FreeT3 3.59 (pmol/L 3.1 - 6.8 )
Your FT4 and FT3 are too low. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo.
According to the BMA's booklet, "Understanding Thyroid Disorders", many people do not feel well unless their levels are at the bottom of the TSH range or below and at the top of the FT4 range or a little above.
The booklet is written by Dr Anthony Toft, past president of the British Thyroid Association and leading endocrinologist. It's published by the British Medical Association for patients. Available on Amazon and from pharmacies for £4.95 and might be worth buying to highlight the appropriate part and show your doctor. However, I don't know if this is in the current edition as it has been reprinted a few times.
Also -
Dr Toft 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 Dionne at tukadmin@thyroiduk.org print it and highlight question 6 to show your doctor and ask for a 25mcg increase in Levo and see how your levels are then.
I would also ensure that you optimise your Ferritin so that your thyroid hormone can work properly.
When all levels are optimal, and after a dose increase, reassess. You may or may not need T3.
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Reverse T3 20 (Ng/dL 10.00 -24.00)
Reverse T3 ratio *11.69 (15.01-75.00)
I don't think you have a problem here. rT3 is in range. Ratio is low because FT3 is low.
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Wow ! That is very detailed Seaside Susie. Thank you so much for taking a lot of time to reply. I really do appreciate it. It will also take me a while to take in all the information you have given me and to process it. I am frantically searching for answers about why I feel so awful for so much of the time, and also find I have new symptoms and feel progressively worse as time goes on. I don’t have to take the T3. I can try more vitamins and minerals but I have got a big holiday in May and would like to try and enjoy it rather than just get through it so I suppose I want a quick fix which I know is not always possible or the right answer.
What I don’t want is to have palpitations and end up in hospital either here or while I am away ( in China). I have been trying to get myself right for several years.
Read it all now and had time to think. I was on 125mg levo. No improvement. Dropped back down to 100. Not any noticeable difference. Feel rubbish at both doses. My endo wanted TSH up before trying T3. He may want to give it a go. I am nervous though. Especially as a week ago my headache and chest pains started. Anyway thank you for all of the advice.
Thank you again. I will read thoroughly tomorrow. Dizziness/light headed ness, tinnitus and pressure headache are also driving me nuts at the moment. Ferritin is my first target to get right.
Very helpful and informative. I take solar b12 1000ug and B complex “100” extra high potency but hadn’t taken them for about 3/4 weeks when the bloods were done. I did the test though because I was feeling so rubbish !
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