What do I do now?

[jankei]

Just lost what I was typing so have to start again!! Just got my latest blood test results printed. This was a six weekly test to see how I am getting on with 50 levo, increased from starting dose of 25 (age for low start). I also asked the doc to test the vitamin levels you recommend and bless him he asked for those too.

So all you very kind experts out there these are the results.

Serum total 0H vit D 61 range 75.00-200.00 nmol/L adequate-borderline insufficient. Only advise supplement if clinically indicated.

Plasma vit B12 level 206 200.00-900.00 ng/L

Serum folate 2.2 2.00-17.00 ug/L

Serum Ferritin 129 15-250.00 ug/L

But, and a big but, either he didn't request or they didn't test Serum T4. My TSH started at 9.9, went to 7.3 six weeks later and now is 3.2 normal no action! On my last blood test before this one when it was 7.3 I went for the test in the afternoon and had eaten and had my thyroxine. This time I complied with what you say and went first thing without tablet or eating!

I am assuming that the doc will not increase my dose? How am I feeling? Well, actually not too bad. I have a telephone appointment tomorrow with him, any suggestions as to what to say would be appreciated. He has helped me and my family over the years with our problems and we all think highly of him so I don't want to go at him all guns blazing. Do you think if I had the vit D supplement it would be enough to bring me up to feeling 100%? Do I need anything else from the results?

Thank you so much for reading all this. x

[SlowDragon Administrator]

You B12 and folate are both extremely low. You need full testing for Pernicious Anaemia before starting B12 injections. Or at least daily B12 supplements if GP won't give B12 injections

If he prescribes folic acid this should not be started until 48 hours after first B12 injection

Vitamin D. GP only likely to say you can self supplement. Aim to increase vitamin D to around 100nmol

On Levothyroxine dose should be increased in 25mcg steps until TSH is under 2

(Many of us need it under one )

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...

Have you had both TPO and TG thyroid antibodies tested ? If high this confirms cause of being hypothyroid is due to autoimmune thyroid disease also called Hashimoto's

[jankei in reply to SlowDragon]

Thanks for your reply. Yes tpo and was 254 autoimmune thyroid disease. I think I have had everything tested recently. What does the anaemia test consist of?

[jankei]

Probably a question for seasidesusie! Please see my results as above. Spoke to doctor this morning. He has given me a script for Vit D for 3 months. He said everything else was fine. I queried folate and B12 being on the low side, and he said that was fine, it was within range. So I though I might buy my own B12, and wonder if you could tell what is best to get. My blood count,, blood film microscopy and ferritin were all good. I asked if I should change my dose of Levo, currently 50 and he said no tsh dropped from 9.9 to 3.2 was good. I said I thought it should go down to 1.00 and he said no, fine as it is. I didn't feel I could contradict him, as he has been so lovely to me over the years, and I am feeling quite good at the moment. Anyway see how it goes, and thanks in advance to Susie, or indeed anyone else who can advise.