Latest Blood results.

[Ballito]

Hello everyone. Once again I am asking the forum for help to interpret my new blood results. I see I have to cut down on the Vit B12 and also the Magnesium oil I am using. I have an appointment with the dr. in two days time to discuss if she has found a sympathetic endo, so would appreciate any comments. Thank you so much.

HbA1c-(IFCC) 38 20-42 mmol/mol

hs-CRP 0.72 <5.0 mg/L

Ferritin 98.9 13 - 150 ug/L

Magnesium H 1.11 0.66 - 0.99 mmol/L

Insulin 39.3 < 173 (Fasting) pmol/L

TSH 0.71 0.27 - 4.20 mlU/L

T4 Total 74.9 66 - 181 nmol/L

Free T4 14.00 12.0 - 22.0 pmol/L

Free T3 4.11 3.1 - 6.8 pmol/L

Reverse T3 14.0 10 - 24 ng/dL

Reverse T3 ratio 19.11 Normal <15 Boarderline 12-15 Low <12 Ratio

Anti-Thyroidperoxidase abs 11.6 <34 kIU/L

Anti-Thyroglobulin Abs <10 <115 kU/L

Vitamin D (25 OH) 76 nmol/L

Vitamin B12 H 609 pmol/L

Serum Folate 42.70 8.83 - 60.8 nmol/L

These bloods were taken by the nurse from Blue Horizon at 10.10 am on 13th Aug. which was the earliest I could get. My husband went straight to the post office when they were done, but I notice that they were not received by BH until the 15th Aug. at 1.34 pm. Would this alter any readings? Thanks for reading.

[SeasideSusie Remembering]

Ballito

These bloods were taken by the nurse from Blue Horizon at 10.10 am on 13th Aug. which was the earliest I could get. My husband went straight to the post office when they were done, but I notice that they were not received by BH until the 15th Aug. at 1.34 pm

Which is why it's suggested in their Terms and Conditions to get samples there the next day and use Royal Mail's Special Delivery Guaranteed Next Day by 1pm.

"Return Sample Postage

You should aim to get your pathology sample back to the Laboratory in the provided envelope as soon as possible. Although we have restricted a number of profiles that are likely to haemolyse we do suggest that the best course of action to take is to get the sample back to the laboratory the next day by attending your post office and upgrading to Royal Mail next day delivery with consequential loss cover.

If you do not use a guaranteed next day service, with consequential loss cover, back to the laboratory (With you posting Monday to Thursday and the sample arriving at the laboratory (Tuesday to Friday) then we cannot guarantee that the blood will be testable due to clotting of the sample."

However, I'm sure if there was a problem BH would have contacted you.

**

Are you taking any thyroid meds?

TSH 0.71 0.27 - 4.20 mlU/L

T4 Total 74.9 66 - 181 nmol/L

Free T4 14.00 12.0 - 22.0 pmol/L

Free T3 4.11 3.1 - 6.8 pmol/L

Your Total T4 is on the low side which is reflected in the Free T4 and your Free T3 is where one would expect to see it with your FT4 level.

If taking no thyroid meds then low or normal TSH with low FT4 can suggest Central Hypothyroidism where the problem lies with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).

Vitamin D (25 OH) 76 nmol/L

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L so your level is on the low side.

Vitamin B12 H 609 pmol/L

This works out at 825pg/ml. 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."

I am 70 and keep mine around the 1000pg/ml level. Personally I don't think you need to lower your dose.

Serum Folate 42.70 8.83 - 60.8 nmol/L

This is fine. At least half way through range is recommended so your level is good.

Ferritin 98.9 13 - 150 ug/L

This is also a decent level.

Apart from your slightly high magnesium level there doesn't seem to be any problem with any of the other results.

[Ballito in reply to SeasideSusie]

Thank you SeasideSusie. We were under the impression that the envelope supplied by BH would get there as quickly as possible. Thank you for pointing out that we should have upgraded to Royal Mail next day delivery. Lesson learned!

No, I am not taking any thyroid meds. I have bought NDT but not taken any as didn't want results to be altered before blood tests and doctor wants to see me on Friday. She was writing to a Consultant to ask what course of action (if any) she should take re my thyroid. If nothing comes of this visit, I will self medicate, as I am already feeling the cold and to me it is 'bed socks weather' already!

Thank you for putting my mind at rest re the other results. Your input is most appreciated and I will take your comments with me on Friday.

[SeasideSusie Remembering in reply to Ballito]

Ballito

The envelope is just standard 1st class delivery. I do actually think they could make it clearer about their recommendation for getting it there next day and using Special Delivery rather than it being buried in their Ts and Cs as not everyone reads them.

If I remember correctly, there is an option at checkout to add Special Delivery (I've used it in the past, but not used BH lately) and it's something like £4.something pence extra, whereas over the counter at the post office it's about £6.50, so there's a bit of saving there.

If nothing comes of this visit, I will self medicate, as I am already feeling the cold and to me it is 'bed socks weather' already!

I actually can't get into a cold bed. I have good quality thick flannelette sheets all year round, and I also have an all night electric underblanket and that's on all year round too, I lower the heat in hot weather but can't do without it completely, I just can't sleep if the bed's not warm.

No, I am not taking any thyroid meds.

So you might want to mention Central Hypothyroidism. The signal (TSH - thyroid stimulating hormone) from the pituitary or hypothalamus doesn't seem to be reaching your thyroid to stimulate it to produce thyroid hormone (T4). Central Hypothyroidism is nowhere near as common as Primary Hypothyroidism so many doctors don't know about it.

Some reading for your GP, you can read part of it but GP will be a member of BMJ I expect and will be able to read it all, you can read the Summary, click on READ MORE:

bestpractice.bmj.com/topics...

Also:

ncbi.nlm.nih.gov/pmc/articl...

I have an appointment with the dr. in two days time to discuss if she has found a sympathetic endo

Make absolutely sure that it is a thyroid specialist that you see, but they are very few and far between and may not know about Central Hypothyroidsm. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them).

[Ballito in reply to SeasideSusie]

Hi. My heart goes out to you. I am so uncomfortable being cold and not having an inbuilt radiator, but you are far, far worse than myself. 'Normal' people just do not understand how you feel. Thank you for the articles which I shall read and also take with me. The thyroid is very complicated I know, but the doctors do not seem to make any effort to understand. Unless it is a thyroid specialist, then I will not waste my time going. Also, I will mention Central Hypothyroidism to my dr, but from our last discussion, it will not mean anything to her, so will I be o.k. to take the NDT or do I need other medication? Thank goodness for HU and the people of the forum as I do not have any faith in my doctors unfortunately.

[SeasideSusie Remembering in reply to Ballito]

Ballito

so will I be o.k. to take the NDT or do I need other medication?

I don't know, to be honest. If it could possibly be Central Hypothyroidism, I think there might have to be some investigation of the pituitary/hypothalamus (scan perhaps?). Might be worth either doing some research or asking on the forum if anyone has CH and how it was diagnosed.

'Normal' people just do not understand how you feel

That's true. My late hubby understood, but whenever we went to visit anyone, I generally kept my coat on, or had more layers than anyone else. Nobody's heating was ever warm enough for me. Hubby used to walk around our house in short sleeved shirt and I would have thermal vest, top, plus jumper. When we used to go on holiday (I don't now, not worth the hassle), we often had a few weeks in January/February in Cyprus and I used to take one of those simulated sheepskin mattress covers, cut out the sheepskin bit, and lay that over the sheets to sleep on. Plus pyjamas and bedsocks. We went to Australia in their summer too and was still cold in bed there.

[Ballito in reply to SeasideSusie]

Lets hope the sun decides to shine again and then perhaps we can feel a bit warmer! We are having fun here as I cannot get those articles to print for some reason. I cannot even find how to send them to my husbands laptop so that he can have a try. Hey ho, what would we be doing with our time, if it wasn't trying to figure out why we don't feel 100 percent. Thanks for your support. I will ask the forum if anyone has CH and how it was diagnosed as you suggested. You are a Godsend.