my thyroid results - advice needed

[Haider5]

Biochemistry

hs-CRP 0.51 <5.0 mg/L

Ferritin 199.0 30 - 400 ug/L

Thyroid Function

TSH 3.23 0.27 - 4.20 mIU/L

T4 Total 83.4 66 - 181 nmol/L

Free T4 17.00 12.0 - 22.0 pmol/L

Free T3 4.49 3.1 - 6.8 pmol/L

Immunology

Anti-Thyroidperoxidase abs 15.6 <34 kIU/L

Anti-Thyroglobulin Abs <10 <115 kU/L

Vitamins

Vitamin B12 310 Deficient <145 pmol/L

Insufficient 145 - 250

Consider reducing dose >569

Serum Folate 13.10 8.83 - 60.8 nmol/L

My recent pathology results are above. Could someone please tell me if the results are good (as everything seems to be within the lab range) and if i could stop taking Levothyroxine now?

Currently i'm on 25mcg/day of Levothyroxine along with Jarrow's B Right. have not taken Vit D3, B12, K2 and magnesium for over a year now.

Many Thanks in Advance.

[Judithdalston]

Once on levothyroxin you cannot stop it as results are ok, as they will only drop down again and make you ill- it is a hormone replacement treatment for life. I was going to suggest upping you levothyroxin anyway as your FT3 is low, not even halfway through the range...better at 5 plus., plus the TSH is becoming highish. So add another 25 mcg T4 and have another blood test in 6 weeks; you might need another 25 mcg rise after that etc. Your 25 mcg current dose is regarded as a starter dose for elderly or those with heart problems, and would be expected to be raised. Currently your thyroid autoimmune antibodies are negative, but have you ever had them positive before and diagnosed with Hashimoto's ( the majority of hypothyroids are Hashimoto's)? Ferritin and folate should be halfway through range , so folate low at 13.10. B12 could be increased to 550; no Vit D result. Jarrow B Right has 400 mcg folate, 100 mcg B12 so perhaps not enough to get your levels up but ok for maintenance. Perhaps worth while going back to D3 etc you gave up a year ago. It is important to get VitD, b12, folate and ferritin up to optimum level and maintain them there, if you are Hashimoto's too then a characteristic of it is poor gut absorption and low nutrient levels.

[SlowDragon Administrator]

25mcg is only half the standard starter dose of Levothyroxine

When on Levothyroxine the aim is to bring TSH Down towards one and FT4 towards top of range and FT3 at least half way in range

These results suggest you need 25mcg dose increase in Levothyroxine

No vitamin D result?

Considering you are taking daily vitamin B complex, your B12 and folate are pretty low

Levothyroxine is a replacement hormone, not a medication. It's usually needed for life.

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

NHS guidelines saying standard starter dose is 50mcgs

beta.nhs.uk/medicines/levot...

All thyroid tests should be done as early as possible in morning and fasting and don't take Levo in the 24 hours prior to test, delay and take straight after. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, GP will be unaware)

Is this how you did the test?

[Gambit62]

re B12 - please note that the normal range for this is very large because people vary a lot in the levels that are right for them. Most people with a level of 300 will be perfectly fine.

Your body regulates your B12 levels at the level that is right for you - releasing stores from the liver as it needs to. If you have had B12 done previously and it was significantly higher then that would imply that you have an absorption problem, but going from a single measure it is impossible to say, using serum B12 whether the level is right for that particular individual. As far as I am aware there have been no actually studies of populations taking levo, in the absence of a treated B12 absorption problem) that have shown that the normal range changes just because of thyroid problems.

[Haider5]

Thank you so much for the assistance guys. yes i did the test first thing in morning while fasting and no levo for 24 hours.

yes i had hashimoto and antibodies were positive previously but now under control. I have now started taking an additional 25 mcg T4 from today so now will be on 50mcg/day Levo until i repeat my tests in 6 weeks.

Since you guys suggested that my B12 and Floate are on the lower side, how much of each i should be taking daily in addition to a B Right caps or should i switch to another multi-vit or B vit? also how much D3 i should take daily?

[Haider5]

can someone Please let me know on the above questions ??