Thyroid UK
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Help with blood test results

Hi I am new here and wondered if anyone could please advise me, have had Hashimotos and thyroid antibodies for 3 years started on 25 Levothyroxine now on 100 with worsening symptoms. I also have very bad flooding and have been fitted with a Mirena and take Norethisterone. I have a GP app tomorrow- last bloods were;

Haemoglobin 109 g/l

Platelet count 147 10*9/l

RBC 3.74 10*9/l

Haemocrit 0.328

Serum T4 11.6 pmcl/l

Serum TSH 25 min/l

Serum ferritin 23 if/l

I also take 210mg of ferrous fummerate x 3 daily.

I take vit D3, adrenal support supplement, magnesium citrate, Vit C, Selenium.

I hope someone can help and advise, panic attacks and fatigue and poor memory and depression are main symptoms.

Thank you

19 Replies
oldestnewest

I think that you’ll need to add the ranges for the tests please

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Sorry here you go

Haemoglobin 109 g/l range 115.00 - 164.00g/l

Platelet count 147 10*9/l range 150.00 - 400.0010*9/l

RBC 3.74 10*9/l range 3.90 - 5.6010*12/l

Haemocrit 0.328 range 0.36 - 0.47

Serum free T4 11.6 pmcl/l range 12.00 - 22.00 pmol/l

Serum TSH 25 min/l range 0.30 - 4.20miu/l

Serum ferritin 23 if/l range 13.00 - 200.00ug/l

Thank you

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You're under-medicated. How long have you been on 100 mcg? Your doctor should have increased the dose six weeks after you started it.

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Only since Thursday

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Has your GP increased dose from 25mcg to 100mcg in one go?

Obviously your results show you were very under medicated, but you may find such a huge jump in dose difficult to cope with.

If o you may need to drop dose to 75mcg for few days/weeks

Standard starter dose is 50mcgs and this is increased in 25mcg steps until TSH is around one and FT4 towards top of range and FT3 at least half way in range. Blood retested 6-8 weeks after each dose increase

NICE guidelines saying how to initiate and increase. Note that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine

cks.nice.org.uk/hypothyroid...

Low vitamin levels are common, especially if been under treated for some time

Heavy periods are classic sign of being hypothyroid an can lead to low ferritin

Ask GP to test vitamin D, folate, B12 and ferritin

Plus have you had thyroid antibodies tested.

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take on waking, but it may be more convenient and possibly more effective taken at bedtime

verywell.com/should-i-take-...

Many people find Levothyroxine brands are not interchangeable. Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased

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Thank you

No 25 3 years ago then 50 last November, 75 in Jan this year and 100 last Thursday

Thanks for the info and links

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Welcome to the forum!

Poor you left on such a low dose for so long. I'm thinking the change was brought about by a different doctor who knows more.

I was really wanting just to explain why we ask for ranges. Thyroid results hopefully give results for TSH, FT4 and FT3 but it's where in the range that is important but also the ranges can vary from lab to lab so the ranges I'm familiar with could be very difference to yours so without them it's difficult to advise as we don't know your labs ranges. I understand different machines work on different ranges and not something that can be standardised as I expect they are made by various companies and some will be much older than others.

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I do have thyroid antibodies but they haven’t been tested since last November- should I request these again? I do have a slight goitre

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If you have high thyroid antibodies then this is Hashimoto's.

NHS doesn't usually ever retest

Hashimoto's affects the gut and often leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies

Ideally ask GP for coeliac blood test first

amymyersmd.com/2017/02/3-im...

chriskresser.com/the-gluten...

thyroidpharmacist.com/artic...

scdlifestyle.com/2014/08/th...

drknews.com/changing-your-d...

thyroidpharmacist.com/artic...

Many of us who have made dietary changes find it useful to retest antibodies periodically to see if levels lower after going gluten or dairy free

Also NHS rarely test FT3 so many get private tests for this too

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Thank you, I have been gluten free for 8 months but my symptoms have got worse?!

I find it all so confusing and just don’t know what triggered this massive shift in my TSH and my symptoms, i feel helpless and I am also unable to get an endo referral- do you have any more advice

I’m very grateful

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Well I never made progress until getting full private testing done. More on my profile

You may have to get private endo appointment if GP refuses to refer. Thyroid UK have list of recommended thyroid specialists

But getting TSH down to around one and FT4 near top of range plus vitamins optimal first is extremely important

You will need to retest thyroid 6-8 weeks after this latest dose increase

1 like
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Thank you so much, I am going to discuss all of this with my GP tomorrow and see if I can get any further without going private.

Really appreciate your help

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Ask for vitamin D, folate, ferritin and B12 testing tomorrow

hypothyroidmom.com/92-of-ha...

Plus when thyroid is retested can they test FT3 as well as FT4 and a TSH

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I will do thank you.

Could you please tell me how your gp knew to prescribe you T3 along with your T4 please?

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Not down to GP. GP's are no longer allowed to initiate prescription (due to current ridiculous cost of T3)

Has to be decided/prescribed by NHS endocrinologist initially. Or private endo can give private prescription.

NHS GP only takes over prescribing after initial 3 month trial under NHS endo

Although very difficult, it is still possible on NHS

british-thyroid-association...

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Thank you again, am going to push for a referral again tomorrow - the last link on nutrition has been really helpful and am going to show the gp and hope she will order the tests for me

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Why did you retest after only a couple of days? Obviously the increase in dose won't show up in two days. Or do you mean that the dose was put up due to these low levels on this test? It really would help if you could give clearer details when you post. So many things can change the interpretation of blood test results that we need to know all the circumstances.

If you went up to 100 after this test, then you need to wait another six weeks and retest. Then we'll know more. :)

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nutrients that are often low with Hashimoto's

It's not how good a diet we eat, but what we manage to absorb in the gut that gives vitamin levels

thyroidpharmacist.com/artic...

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Thank you

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