Advice with some tests done by GP please - Thyroid UK

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Advice with some tests done by GP please

Fanfeck profile image
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51y/o male, been on 100mg Levo for about 10 years. Been to gp and he's done some blood tests, which he says are fine barring low potassium, which I have history with. Just wanted to see what you guys think of some of the vitamins done. All in range, but seem a bit low. Thank you

Folate 7.5 microG/L. 3.0-20.0

B12 258NG/L. 180-900

Ferritin. 45.5microG/L 20-300

TSH. 2.23MU/L 0.3- 4.2

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SeasideSusie profile image
SeasideSusieRemembering

Fanfeck

Yes they are low.

Folate should be at least half way through range.

B12, according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml." PG/ML is the same as NG/L so these levels apply to your result.

Ferritin should be half way through it's range.

As all your levels are within range, but not optimal, you're unlikely to get anything prescribed by your GP. They only go by "in range", doesn't matter whether it's low, high or middling, in range is enough for them to say everything is fine.

Vit D should be tested.

TSH is too high. The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their respective reference ranges when on Levo if that is where you feel well. You could do with yoru FT4 and FT3 testing as well, chances are they're too low in range.

Have you ever had thyroid antibodies testing - Thyroid Peroxidase and Thyroglobulin?

How do you feel? Lots of things there to make you feel unwell.

I think your B12 is low but GPs tend to go by ranges. Do you have any symptoms? If you have symptoms of deficiency you may consider asking for testing for Pernicious Anemia. You could also read through Pernicious Anemia forum.

Your Ferritin is far better than mine.

What are you doing about Potassium? Are you eating more potassium rich foods eg a banana every morning, then retesting in a while?

Your TSH is a higher than ideal. What is your target therapeutic level? Is it 2?

Ask GP to test Vitamin D level.

SlowDragon profile image
SlowDragonAdministrator

Push your GP to increase dose of Levothyroxine by 25mcg

Always make sure you get same brand of Levothyroxine at each prescription and with the 25mcg dose increase

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...

your vitamins are low because you are under medicated.

Just dosing according to TSH is completely inadequate

Essential to test FT3 and FT4 and vitamin D

Suggest you get dose increase, vitamin D tested and improve vitamin levels. Then get full private testing 8 weeks after dose increase in Levothyroxine

Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins

thyroiduk.org.uk/tuk/testin...

Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have money off offers.

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

TSH should be around one and FT4 towards top of range and FT3 at least half way in range

Fanfeck profile image
Fanfeck

Thanks for all the advice. I do manual work and get very fatigued, and very sore calf muscles, and Achilles' tendon problems. He's giving me potassium tablets to take for two weeks and then blood test. I've seen a consultant at the beginning of the year with regards to this, but he found no causes

waynewal profile image
waynewal

Am not a doctor but you might check out stopthethyroidmadness.com and see a different story on what tests are necessary to determine correct thyroid tests

It will be a shocker. Seasides comment is on the mark.

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