Hi all , I'm new to this and was wondering whether anyone could help me understand my latest test results taken on the 4th May 2018

[Mourastar]

I am currently on 100mg Levo daily & diagnosed feb 2015. struggle with weight since diagnosis

TSH : 4.26 (lab range 0,27 – 4.20)

Free T3 : not tested

Free T4 : 17 ( lab range 12 - 22)

Serum vitamin B12 159 (Lab range 191 - 663)

serum folate 13.1 ug/L 3.89 - 26.8

Serum ferritine : 174.2 (lab range 13-150)

Serum Iron level 22.3 umol/L 10 - 30

Serum Transferrin 2.2 g/L 2. - 3.6

Transferrin saturation index 40.5 -55

Vitamin D 47 (lab range 30- 50)

[SeasideSusie Remembering]

Mourastar

You are undermedicated to have a TSH over range and your FT4 is just 50% through range. You need a dose increase.

As you can see your B12 is below range. You should ask your GP to test for B12 deficiency /pernicious anaemia. You can check signs and symptoms here b12deficiency.info/signs-an...

[Mourastar in reply to SeasideSusie]

Thank you Seaside Susie, my Dr has prescribed a course of Cyanocobalamin tablets (50mg daily) & to retest B12 in 6 weeks (Hopefully I will be feeling a little better by then) & tells me that the rest of my results are all normal?

I am usually a very active and alert individual but have been feeling really tired and listless of late. My diet is generally very healthy and am trying to get back into an exercise regime (yoga, weight training and walking) .I used to run (5k's couple times a week etc but had to give up as kept getting injuries and then extreme tiredness which didn't help with work (I run my own business)

Thank you for the link , so much appreciated. Is there anything else I could be doing to improve my outcome?

[SeasideSusie Remembering in reply to Mourastar]

Mourastar

You should ask your GP how can an over range TSH be normal.

The aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.

To support your request for an increase in dose, use the following information from thyroiduk.org.uk/tuk/about_...

"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)."

Dr Toft is past president of the British Thyroid Association and leading endocrinologist.

You can tell your GP that you have taken advice from NHS Choices recommended source of information about thyroid disorders, which is ThyroidUK, don't mention the Internet or forum, they don't like that!

What is the unit of measurement for Vit D - ng/ml or nmol/L?

[Mourastar in reply to SeasideSusie]

I'm not sure as this result was given over the phone (after much persuasion) .I had to push to get a copy of the other results and ended up having to pay £10 to get them. I will check on Monday and ask for am appointment to discuss my results further. Thank you so much for the advice , I just hope the doctor will listen (we are new to each other as my other doctor left the practice and my bloods had not been done for nearly 2 years!!!) as I just feel quite sub par at present.

[greygoose in reply to Mourastar]

With such a high TSH, I think you ought to forget the weight training for the time being. Just gentle walking until your FT3 has risen a bit. Even yoga is pushing it a bit because it uses quite a lot of calories that are needed for conversion. You need to take it easy at the moment.

[Mourastar in reply to greygoose]

Thank you Greygoose for taking the time to reply - I will be mindful of your advice and cut back for now but I just don't want to put any more weight on Before diagnosis I was a steady 8 stone 10 (I'm 5 ft 3in) I went to 12 stone and have lost 1 and am not just over 11 and struggling to shift any more.

[greygoose in reply to Mourastar]

You're welcome.

[HLAB35]

I'm impressed that you are doing as much as you are give these results. Please take your B12 result to the Healthunlocked PA forum as they may be able to help recommend the best treatment options. Personally, I doubt this GP's experience of correct procedure (I suspect you need B12 injections) but better checked with them.

[Mourastar in reply to HLAB35]

I have just checked with my mum who is 86 and yes she too has needed B12 injections in the past and had propensity for having low B. I will discuss with the gp when (and if!!) I get an appointment and report back here.

[HLAB35 in reply to Mourastar]

In that case you should ask for some follow up blood tests to look into possible causes. Low stomach acid in undertreated Hypothyroidism doesn't help as B12 is a tricky molecule to absorb.

[Mourastar in reply to HLAB35]

Thank you HLAB35 - I will ask doctor on next appointment .

[KimberinUS]

Your b12 is too low. And your thyroid does not function properly without b12!

hypothyroidmom.com/10-nutri...

I used to run 3 miles 3 to 5 times weekly until I no longer could muster the energy. Then finally a year later i went the doctor because i was so tired all the time. I had a b12 deficiency.

Doctor said take suppliments. So i did for 16 months, as this was before i came to realize doctors dont have a lot of knowledge concerning b12. 220 mg a day of b12.

So here i am 16 months later, an i go to a different doctor because i feel worse. 2nd doctor said you have a b12 deficiency. I said i take b12. She said well, keep taking it.

An additional 14 months later i went to a 3rd doctor (by then i was sleeping 11-12 hours a day and no longer employed) and finally got an injection and oh the relief! Not well but way better.

I was finally diagnosised with h pylori some months later, which required 2 different rounds of antibiotics but i finally got a h pylori negative test result in February 2018.

It took about 4months after 2nd treatment (Treatment was in December 2017) before my stomach healed and started absorbing nutrients from food and my appetite and energy returned.

Please dont ignore low b12. By the end, I was concerned I had early on set dementia and was losing my mind and body. It got scary . And when that unwell it is very difficult to even have the energy to go to the doctor.

Best of luck and health.

[Mourastar in reply to KimberinUS]

Thank you KimberinUS for this information , I only beginning to realise how complicated this all is!!!