Could you lovely people help me read these lab results

[Tadlock]

These are my brother's latest results (we both have Hashimoto's). From what I see he definitely needs an increase of medication (he's on L-thyroxin). What about the vitamins and minerals? His B's are on the lowish side, at least the folate is. Iron panel has always been confusing to me so I'm gonna need help with that too. Thank you!

FT3 4.03 (3.20 - 6.80)

FT4 17.18 (12.00 - 22.00)

TSH 7.300 (0.300 - 4.200)

Anti Tg 13.62 <115

Anti TPO 44.37 <34

B12 234.00 (114 - 489)

Folate 12.28 (10.4 - 42.4)

Vitamin D total (25-OH Vitamin D) 86.67 (50 - 120)

Iron 18.15 (11.00 - 36.00)

UIBC 38.30 (20.00 - 62.00)

TIBC 56.45 (42.00 - 78.00)

Ferritin 149.00 (30.00 - 400.00)

[SeasideSusie Remembering]

Tadlock

FT3 4.03 (3.20 - 6.80)

FT4 17.18 (12.00 - 22.00)

TSH 7.300 (0.300 - 4.200)

Yes, he definitely needs an increase in dose as shown by his FT4 and FT3, they are both too low.. His TSH is remarkably high considering his FT4 is half way through range. Does he take a B Complex or Biotin, and did he leave it off for 5 days before testing? If not then I would be looking at retesting because such a high TSH isn't right with those free Ts. If this was a GP test I would test with a private company, he could do a fingerprick test for just the basic Tsh/FT4/FT3. If it was a private test then do one with a different company.

**

B12 234.00 (114 - 489)

This is far too low. And that is a very strange upper limit to the range, normally it's something like 700-900ish.

Does he have signs of B12 deficiency b12deficiency.info/signs-an... If so he needs further testing.

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."

If definitely no signs of B12 deficiency then he could supplement with sublingual methylcobalamin lozenges 5000mcg daily to start with then when that bottle is finished change to 1000mcg daily.

**

Folate 12.28 (10.4 - 42.4)

Folate should be at least half way through range, so 26+ with that range. A good B Complex containing 400mcg methylfolate will help raise folate level, look at Thorne Basic B. A B Complex needs to be taken if supplementing with B12 in any form.

**

Vitamin D total (25-OH Vitamin D) 86.67 (50 - 120)

I take it the unit of measurement is NMOL/L in which case the Vit D Council recommends a level of 100-150nmol. He could raise his level by taking D3 along with it's important cofactors vitamindcouncil.org/about-v...

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

naturalnews.com/046401_magn...

Check out the other cofactors too.

As he has Hashi's, for best absorption an oral spray is recommended. Look at BetterYou who do a combined D3/K2-MK7 spray. I think the combined spray only comes in 3000iu dose so he could take that for a couple of months then when he's reached the recommended level he could reduce the nunmber of days per week he takes it to maintain the level.

It's trial and error finding our maintenance dose, it may be 2000iu daily (average), maybe more, maybe less, maybe less in summer and more in winter, so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/

**

Ferritin 149.00 (30.00 - 400.00)

This seems to be good, it's recommended to be half way through it's range, but I have also read that for males it should be around 150.

Iron 18.15 (11.00 - 36.00)

UIBC 38.30 (20.00 - 62.00)

TIBC 56.45 (42.00 - 78.00)

Here is an article which explains where these other values should be

rt3-adrenals.org/Iron_test_...

[Tadlock in reply to SeasideSusie]

Thanks, SeasideSusie, for the thorough reply!

What I forgot to mention is his initial diagnosis was Hyperthyroidism (I am not sure if Grave's). He had a partial thyroidectomy a couple of years ago. I read in a forum (not this one) that high TSH with high FT4 is common for people after thyroidectomy. Do you know anything about that?

[SeasideSusie Remembering in reply to Tadlock]

Sorry Tadlock, I don't know anything about thyroidectomy and high TSH/FT4.

[silverfox7]

I tend to give a tick if good advice I agree with is given. Sadly I can only give one tick to show my approval as SSS advice is wonderful! Please follow and implement her advice.