Advice re medichecks results- what next?

[Judithdalston]

First complete thyroid/vitamin etc bloods for 12 years ( via Medichecks, thus their ranges/units) , advice and recommendations would be appreciated on what to do next for better health...

results May 3,2018

TSH: 0.175 (0.27-4.20)

Free thyroxine: 22.6 (12-22)

Total thyroxine: 106 (59-154)

Free T3: 4.72 (3.1-6.8)

Thyroglobulin antibodies: 32.3 (0-115)

Thyroid peroxidase antibodies: 13.6 (0-34)

Active B12: >300 (25.10-165)

Folate (serum): 7.48 (2.91-50)

25 OH Vitamin D: 90.1 (50-200)

Inflammation marker CPP: 1.52 (0-5)

Iron status: 62.8 (13-150)

The reason for the blood test was I still feel bad with plenty of hypothyroid symptoms from low basal temperature, exhaustion, all over pains, hair falling out... and was diagnosed with fibromyalgia in May 2017 ( please see my profile for further details). I want to be the best hypothyroid I can.

Ignoring what the Medichecks doctor suggests ( all normal ranges except low TSH and high borderline free thyroxine), I interpret these as suggestioning my FT3 is proportionately low with ratio T4 to T3 too high at 4.79, and not under 4 : 1. The T4 might be abit high as I have raised the levothyroxin dose over the last 12 weeks from 100mg, then 125 mg ( with TSH GP tested at 1.27), then added another 12.5mg but at the same time as started taking this dose also changed time of taking to 3-4 am instead of near breakfast and coffee. So it is perhaps not surprising the final 12.5mg dose seems to have been slightly too much, will reduce to 125, with say 137.5 mg on 1 or 2 days per week. I have taken B12, Vitamin D , folic acid etc for years at high dose ( as part of a cocktail of supplements including COQu10 to heal after years of statins medication). I have recorded from advice on this site that my B12, though regarded as high by Medichecks, at >300, should be 'at least 450' , is that correct? I stopped the vitamins about 4-5 days before the drug test, but have been taking 1,000ug B12 daily. I do take metformin which is suggested to deplete B12. Similarly I am surprised the Vit D at 90.1 is as low as this normally taking 5,000 ug( but until c.9 months ago 10,000 ug daily), and should be raised up to 150nmol/L. I have taken 400 ug of folic acid daily plus B6, selenium (220mg), 'Iron' (14 mg), magnesium etc.

Although I have gleaned lots of really useful information about various ideal blood levels from this forum, I must admit I can't understand some of the advice about iron levels/status, which seems to be something I need to improve. Is the 'iron status' on the Medichecks test the same as ferritin levels? I.e. I need to raise this from 62.8 to 70-100. Folate too needs increasing to 27 plus Ug/L from 7.48. How? - any animal liver products ( whether tiny bit to taste or smell) makes me heave!

Finally do you think any form of T3 added might make a difference, I am prepared to at least try? At suggestions most gratefully received after 12 years of thyroid neglect.

[Marz]

Once supplementing B12 - further testing throws up skewed results. You had the Active B12 test done which shows the amount of B12 in the blood that is available to be transported to the cells where it is needed. It is the routine serum test for B12 that is suggested should be high in the range - over 500. This test involves both bound and unbound B12. Both tests only show what is in the blood and NOT the amount in the cells - where it is needed. If you tick all the boxes for B12 Deficiency then consider testing for Homocysteine and MMA.

As you are taking a good dose of VitD - I suggest adding in VitK2-MK7 to ensure improved levels of calcium are directed away from the arteries and into bones and teeth.

I believe Metformin is indicated in other issues in addition to B12 - not sure what they are - but have read bits and pieces. Have you tried to modify sugar levels with diet ? Could that improve your overall health ? - just saying

Check out Dr Rangan Chattergee - aka Doctor in the House from the TV !

[Judithdalston in reply to Marz]

I wrote a reply to you Marz ages ago but appear not to have posted it, apologies. Yes I will add VitK2 mark7 to my Vit D dose ( I was saving adding such improvements till after this blood test was back). I have a note re Metformin and B12 depletion but no more detail, or even a record of where the information came from, but since I am not low on this I won't worry about it. It's the iron and folic levels I want to raise a bit ( I will try SeasideSusie's black pudding, as I can't stand liver). I note the smiley face re blood sugar levels ( a very endocrinologist response, as diabetes trumps everything else of course), but the one advantage of diabetes is that it easy to check blood sugars daily and in my case even adjust insulin, and as my HbA1C is 'low risk' under 58 i don't think it is my diet. I think I saw the Dr Chatterjee programme you are referring to where a woman was given antibiotics to get rid of bad gut flora ( I had wondered whether that was why I decreased weight after powerful antibiotics were given to me in Intensive Care after septic shock set on. I am very pro Tom Spector, but my GP isn't!). I hope to go down adding T3.... many thanks for reply.

[SeasideSusie Remembering]

Judith

I have recorded from advice on this site that my B12, though regarded as high by Medichecks, at >300, should be 'at least 450' , is that correct?

No. Medichecks to an Active B12 test with an upper range limit of 165 so you are way over that and should stop supplementing. The "at least 450" is for the serum B12 test where the range can go up to 800-900. It's a different test.

Is the 'iron status' on the Medichecks test the same as ferritin levels?

Ferritin is included in that test. This test has now been changed to "Iron Deficiency Check" and includes 5 tests:

Iron

TIBC

Transferrin

Ferritin

CRP

To raise ferritin eating liver is the best way, also including iron rich foods in your diet apjcn.nhri.org.tw/server/in...

Do you like liver pate? Black pudding?

It's not possible to say whether taking iron tablets is the correct thing to do untill you see your other iron panel results and I'm not knowledgeable enough about iron to suggest using them.

How close to your breakfast and coffee do you take your Levo?

Do you have low stomach acid - easy home self test suggestion here (baking soda test)

scdlifestyle.com/2012/03/3-...

Your results are showing poor conversion and if they were mine I would reduce your Levo slightly and start adding T3.

[Judithdalston in reply to SeasideSusie]

So the 'iron status' on the Medichecks test is no longer specific enough to say how I need to increase the level? I like black pudding, but no liver pate is still a definite 'Nono'. Perhaps the 'iron specialists' on the website can suggest improvements, any supplements? Over the last 6 plus weeks I have taken my levothyroxin at 3-4 am in the middle of the night, as literally took my dose just before or after breakfast before. I shall look at the stomach acid test. I am pleased you agree with my conclusion SeasideSusie to drop T4 a little, and try to add T3. - a whole new ball game, and further post for private messaging. Thank you.

[SeasideSusie Remembering in reply to Judithdalston]

The iron status test (iron deficiency test now) is exactly the same but they have added an extra test, the CRP. Helpful in a way because raised ferritin can be caused by inflammation and infecion, and if CRP is raised as well then because that's an inflammation marke it would sort of confirm what the raised ferritin could be saying.

This is where optimal levels should be rt3-adrenals.org/Iron_test_...

But how you achieve them when they are out of kilter I don't know. It's easy enough, I assume, if you have low ferritin and low serum iron, I expect iron tablets will do the job. But when you have low ferritin and perhaps high serum iron, then taking iron tablets wouldn't be the answer. Or high ferritin and low serum iron. I really don't understand it enough, my brain can't cope with it!!

[Judithdalston in reply to SeasideSusie]

Snap re my brain and iron levels. I'm in for a burpy weekend I see.

[Judithdalston]

Mampea1. Thanks for message , I have replied but not sure if it got thru to you as never used message before. Did it get thru?