For SeasideSusie, SlowDragon, greygoose, MurphysMum, humanbean, DoubleM and chocoholic17
Thank you all for your comments on my first post ‘Terrified’. Here are my blood results and the written report along with it. Apologies in advance for the long post. Cheers!
Quote:
Here are the results of your Thyroid Check Ultravit.
We note that you are taking this test to monitor a condition.
I note your history of hypothyroidism, hypertension and IBS.
Your thyroid stimulating hormone is low and you have high free thyroxine and T3 which suggests that your levothyroxine dose may be too high. I recommend discussing this result with your doctor.
Having very low levels of thyroid stimulating hormone for several years has been associated with the development of osteoporosis. If your thyroid stimulating hormone always tends to be substantially below the normal range then it may be worth discussing with your GP whether a bone density scan is advised to monitor for the development of osteoporosis. You do not need to worry about the occasional low reading, only if you get repeated very low levels.
Your thyroglobulin antibodies are normal.
Your thyroid peroxidase antibodies are normal.
You have normal vitamin B12 levels.
You have low serum folate. I recommend checking your red cell folate to assess whether this is significant. Following this I recommend increasing your intake of folate rich foods such as broccoli, brussels sprouts, asparagus, peas, chickpeas and brown rice. You may also want to consider an over the counter folate supplement.
Your CRP level is normal, suggesting low levels of inflammation within the body.
You have high iron stores. This is likely to be due to a high dietary intake of iron or taking iron supplements. If you are taking supplements I recommend decreasing your intake. To exclude iron overload I recommend an iron deficiency check which will look at your other iron markers and help us to work out whether there may be iron overload.
Unquote.
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ZippyAppletush
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My interpretation of your results is that you are overmedicated and should consider reducing your dose of Levo. Your FT4 and FT3 are way over range.
Your nutrient levels aren't optimal and may be causing problems.
Active B12 below 70 can suggest B12 deficiency and yours is very close to this level. Check for signs of B12 deficiency here b12deficiency.info/signs-an...
Folate level is dire and you may need a prescription for folic acid. This shouldn't be started until further investigation into B12 has been carried out and B12 injections or supplementation started if necessary.
Vit D is too low lat 44.9nmol/L. The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L. You may not be prescribed anything by your GP at your level, in which case I would buy your own D3 softgels, eg Doctor's Best, and take 5000iu daily for 3 months then retest. When you've reached the recommended level then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error 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/
There are important cofactors needed when taking D3 as recommended by the Vit D Council -
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 such as hardening of the arteries, kidney stones, etc.
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. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium 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
Ferritin is very high, is there a reason for this? Are you supplementing or eating a very iron rich diet, eg. lots of liver, black pudding, liver pate, etc? If not it may be worth asking your GP to check this out.
You might want to consider checking adrenals with a 24 hours saliva test from Regenerus or Genova Diagnostics, details on ThyroidUK's main website
Hello Seaside Susie and thanks for your reply. I’m working my way through your comments, links, and making a list of the things you suggest to do.
My FT4 and FT3 were lower on figures I posted before; could the recent figures be because I withheld the Levo before the test? I have asked GP practice for blood results from 2009 (last year I saw my Endo) and 2014 (when I was at lowest dose at 150mcg) to compare numbers. I have to write for permission. May take a couple of days.
I am supposed to be reducing to 200mcg this month but I wanted these results first. I am feeling symptoms on 225mcg already and I fear lowering my dose further. (I feel like I am letting myself down.) Is it feasible then that correcting the B12 etc would help the symptoms even with the lowered Levo? I am just terrified of being as bad as before and having a worse fall.
I am interested that you query my B12 results yet the test shows normal? Is this because ranges are so different?
Re the iron, I’m not taking supplements and I don’t eat liver products.
Folic acid I last took when I was pregnant; around mid 90’s. I had a sterilisation done in 1995.
I had to go to a cancer clinic during the time my Levo was lowered as I started bleeding and had finished the menopause. It turned out to be related to the hormones issue, but the whole experience was traumatic for myself and family. It shouldn’t have happened!
Regarding the VitD, the consultant appears to have finally written in response to our last meeting (19/06 - I haven’t received my copy as yet) and the GP has issued me with Calcichew D3 500mg/200IU tabs.
I think I’ve covered as much as I can for now, and I’ll go off and sort through the rest. Thank you so much again for your comments and advice.
could the recent figures be because I withheld the Levo before the test?
How long before your test did you take your last dose of Levo?
If you take Levo close to the blood draw, that gives a false high FT4. If you take Levo more than 24 hours before blood draw that gives a false low FT4. So if you withheld Levo before the test you would get a lower FT4 than normal circulating amount.
I have asked GP practice for blood results from 2009 (last year I saw my Endo) and 2014 (when I was at lowest dose at 150mcg) to compare numbers.
You can only compare results accurately if the tests were done under the same conditions, which is why we always advise here that blood draw is early morning, no later than 9am, fasting (breakfast after blood draw) with water only, and leave off Levo for 24 hours.
Is it feasible then that correcting the B12 etc would help the symptoms even with the lowered Levo?
Low nutrient levels bring their own symptoms, some of which are similar to hypo symptoms.
I am interested that you query my B12 results yet the test shows normal? Is this because ranges are so different?
Your result is "normal" because it falls within the range. However, this link suggests that an Active B12 result below 70 suggests testing for B12 deficiency
All I am saying is that yours is very close to that level so suggested that you check for signs and symptoms of B12 deficiency.
Re the iron, I’m not taking supplements and I don’t eat liver products.
I think your very high level should be discussed with your GP then.
the GP has issued me with Calcichew D3 500mg/200IU tabs.
Was calcium tested? It should have been before giving a calcium supplement. And 200iu D3 wont raise a low D3 level, it's not even a maintenance dose for someone with a decent level to start with. How many Calcichew per day have you been prescribed?
Hello again and apologies for the longer delay in replying.
“How long before your test did you take your last dose of Levo?”
I took my last dose on the Monday evening as I did the test on the Wednesday morning, so over 24 hours.
“You can only compare results accurately if the tests were done under the same conditions...”
I was just curious as to the figures in comparison to those issued by the Endo at present.
“All I am saying is that yours is very close to that level so suggested that you check for signs and symptoms of B12 deficiency.”
I’m going to get my copy of the letter from the Endo to the GP to find out what is written in there. Along with your very useful information I will list symptoms from the nutrient
issues and discuss with the Endo.
Re the iron...
“I think your very high level should be discussed with your GP then.”
As with the B12, I will discuss it. I prefer the Endo at this time as it is all relative.
“Was calcium tested? How many Calcichew per day have you been prescribed?”
I’m not sure that calcium was tested; the only connection made at the appointment was the pre-osteoporosis level. I’m presuming from your reply that I’m prescribed nothing better than a placebo? I am to take 2 a day.
I have just checked my last bloods request in June and it shows
FT4, Cortisol, HbA1c and Coeliac. I don’t know the Endo’s response until I get my hands on the letter.
Thank you again for all your help with this post. Much appreciated!
“How long before your test did you take your last dose of Levo?”
I took my last dose on the Monday evening as I did the test on the Wednesday morning, so over 24 hours.
So your last dose was something like, assuming Levo take around bedtime, say 11pm Monday, and blood draw maybe 9am Wednesday, so it could be something like 34 hours. ln that case you are very overmedicated. If you had taken your Levo at the recommended time (24 hours before blood draw) your FT4 would have been even higher.
“Was calcium tested? How many Calcichew per day have you been prescribed?”
I’m not sure that calcium was tested; the only connection made at the appointment was the pre-osteoporosis level. I’m presuming from your reply that I’m prescribed nothing better than a placebo? I am to take 2 a day.
It's not a placebo effect that's worrying, it's the fact that you are taking calcium and not knowing if you need it. You need to know if it has been tested. To give calcium supplements without testing is foolish. Who knows, you may already have high calcium levels and the supplements could take your level even higher and cause problems.
Also, taking D3 increases uptake of calcium from food so take enough D3 and calcium level will rise, which is why it's recommended to always take K2-MK7 when taking D3 as this directs calcium to bones and teeth where it's needed and away from arteries and soft tissues where it can be deposited and cause problems like kidney stones, calcification of arteries etc. Unless there is a specific need for calcium supplements, and testing has been carried out to show the need, then it's not a good idea to supplement.
Also, a total of 400iu D3 daily isn't going to raise your level, it's not even a proper maintenance dose for someone with a good level. As mentioned in my previous reply, you need around 5000iu daily for now until your level reaches that recommended by the Vit D Council, etc.
I’m supposed to have been lowering my Levo to 200mcg from 1st August but wanted to wait for the MC results. Also I am meant to be having a blood test on 25th August but 3 weeks isn’t enough time to register a change in meds is it? I hate doing it but I will lower to 200 until my appointment in January and then discuss the symptoms then.
If lowering my Levo is to be better for me then the other issues need to be addressed correctly to bring my health back to my ‘normal’.
I have a GP meds review in November but my daughter’s is sooner so I think an error has been made as we both had reviews done at the same time last year. I will ask to be seen with her and mention the iron results then.
Regarding the calcium tablets, I will leave for the time being and ask the Endo in January.
You really need 6-8 weeks after a dose change before retesting for levels to stabilise. An sooner lthan 6 weeks and it wont reflect the new dose properly.
Thank you for that, SeasideSusie. One more point in my favour when I ask questions. As mentioned, your advice is much appreciated. I’ll keep you posted!
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Hello helvella and apologies for the longer delay in replying. (Internet access restrictions.)
Thank you for your post and very informative! I will be going back to the surgery and taking the printout with me.
The person I spoke to actually said that ‘the GP “may” approve it. I said that it was my right to have the information (I didn’t know it could be verbal request) and she replied that I should write my request and it would be given to
the GP and generally they approved it. Which means sometimes they don’t?
In case my GP decides to play silly B’s and asks to see me, would I be within my rights to refuse and say that I don’t need to see the GP just to get my information?
I will put my request in writing nonetheless, to be polite.
Regarding the issue of osteoporosis, I am hypothyroid but I don't worry about it (osteoporosis) too much.
My late mother suffered severe osteoporosis. She desperately needed hip replacements in both hips but she was told she wasn't a suitable candidate because her bones were too crumbly for replacements to be screwed to.
My mum was also hypothyroid, and she was a doctor's dream patient. She was prescribed 75mcg Levo in the 1980s and her dose was never, ever changed. I think she was probably substantially under-dosed all that time (about 30 years). Mum never complained, she did what she was told, had a list of health problems as long as your arm, and took the dozens of pills she was prescribed. And despite all this medical "care" she developed osteoporosis which just got worse and worse and worse.
So, if doing what the doctors say still leaves me open to getting severe osteoporosis then I won't bother and I'll do my own thing (and worry about it if or when it happens). I consider it to be unlikely that I'll end up worse than my mother. I have greater access to information than my mother ever did, which helps immensely.
Hello humanbean and apologies for not replying sooner; internet access restrictions.
Thank you for your post, and disheartened to read about your mother’s issue with osteoporosis despite being “cared” for.
I am of the same mind as you with regards to the osteoporosis, and the length of time I have been on medication (from 6 months old)…I feel that if I was suffering osteoporosis I
would have had a worse outcome from the fall I sustained in 2014; instead of just torn ligaments it should have been broken bones. Having survived 53 years at that point a few more won’t make too much difference!
For SeasideSusie, helvella and humanbean, thank you for your replies. I’m on the move today...other half’s idea...so I won’t be able to respond until later, but I will! Cheers!
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