Please could I ask your advice on my FBC results as my GP said my iron levels are fine and has never suggested any other iron related tests?
Red blood cell count 0.2 (no range)
Haemoglobin 133 (115-164)
Haematocrit 0.4 (0.36-0.47)
(Platelets and white cell count - both at the very low end of ranges, if relevant)
I’m wondering if I should go ahead and get Vit D, B12, folate and ferritin bloods done at Medichecks ready for my 1st 3 month Levo review.
Thanks as always
Simple answer - no. How can your GP say your iron levels are fine if ferritin (iron store) isn't tested or your serum iron?
Ferritin is the usual test done, but the full iron panel would also include Serum iron, Transferrin Saturation and Total Iron Binding Capacity (TIBC).
A full blood count might suggest some kind of anaemia depending on the results of haemglobin, MCV, MCH, MCHC and RDW (Red Blood Cell Distribution Width) can indicate iron, B12 or folate deficiency.
Have you asked GP to test Vitamin D, Calcium, B12, Folate and Ferritin?
Not yet. My GP wasn’t keen on treating my hypo even though levels had risen up to TSH 12 recently so put me on ‘a fob off’ dose of 25mcg with a review in 3 months. So wanted to be prepared as I think I will still feel rubbish and if by fluke my thyroid bloods have improved I can then push for these iron tests.
If you are under 50 years old NHS guidelines saying standard starter dose is 50mcgs
beta.nhs.uk/medicines/levot...
I would get vitamins tested privately if GP continues to be unhelpful
Push GP to test B12 and folate, vitamin D and ferritin
Private tests via Medichecks if not
Vitamin D testing via NHS postal kit £29
Thyroid levels should be retested 6-8 weeks after starting on Levothyroxine
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)
Always take Levo on empty stomach and then nothing apart from water for at least an hour after.
Many take early morning 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 or at repeat prescription.
Many patients do not get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients
Great advice and tips. Thank you
If GP won't treat you then ask for a referal to an Endocrinologist (and hope for better care !?!?).
I would have have expected a 50mcg start dose and a possible increase after follow up tests.
Thank you for your advice
Maybe there's some confusion about which tests you are supposed to have when? Thyroid checks should be every 6-8 weeks, but it seems the standard interval for other tests (vitamins, minerals and FBC) could be 3 months, or longer if you are stabilised. At least that's the only thing that seems to make sense of what happened to me.
When I was started on Levo (only 25 mcg because I'm older and have high blood pressure) they told me to retest in 2 months, then, I had a total of THREE letters over a couple of weeks telling me to have another blood test in 3 months. I queried the first one and they agreed it was a mistake, but they only tested TSH the next time (which was still above range). The three months for the more complete test is up in September, as well as the 6-8 weeks for the next thyroid check since going up to 50mcg, so perhaps I can have all the tests together.
On the 50mcg, there was little or no change for a couple of weeks, then a slight improvement, which seems to have plateaued now. Apparently this is usual - not much change at first, then an improvement then you can feel worse when coming up to the 6-8 week mark. This shows you need an increase and is nothing to worry about. Last time I got permission to get the test nearer to 6 than 8 weeks, so it's worth asking.
Sorry if the above isn't very clear, running out of mental energy at the moment!
Think I will ask for an earlier review too then. Thanks for your advice.
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