Advice please on latest Test Results

[Dotty1340]

Dear All,

I had a telephone consultation with my doctor recently as I have started to feel very tired again and not myself. He reluctantly agreed to the full range of tests including T3. I had to quote Thyroid UK in order to argue my case for testing T3. The results are as below...please can someone who can interpret these results provide me with any suggestions in what I can do to feel not as tired? I am seriously contemplating going along the T3 route to assist my conversion of T4. Interestingly, my T3 is as it was 12 months ago...3.9. The comments next to some of the results are a direct lift from my results...they are not my comments! As always, I am extremely grateful for all help and assistance you guys make to this forum.x

Serum free triiodothyronine level 3.9 pmol/L [3.1 - 6.8]

FT3 is of little additional value in patients on thyroxine.

Serum ferritin level 156 ug/L [30.0 - 150.0]

Above high reference limit

Refer to tinyurl.com/BiochemInfo for further

information about the investigation of hyperferritinaemia.

High ferritin - transferrin saturation to follow.

Iron & % Saturation

Serum iron level 18.5 umol/L [5.8 - 34.5]

Serum transferrin level 2.27 g/L [2.0 - 3.6]

Transferrin saturation index 33 % [15.0 - 50.0]

Serum vitamin B12 level 1399 ng/L [197.0 - 771.0]

Above high reference limit

Serum folate level 6.7 ug/L [> 3.9]

Fasting sample preferred. Recent folate intake may mask deficiency

Haemoglobin A1c level - IFCC standardised 30 mmol/mol [20.0 - 41.0]

Full blood count

Haemoglobin concentration 129 g/L [115.0 - 165.0]

Platelet count - observation 352 x10^9/L [150.0 - 450.0]

Red blood cell count 4.22 x10^12/L [3.9 - 5.4]

Haematocrit 0.385 L/L [0.36 - 0.47]

Mean cell volume 91 fL [79.0 - 101.0]

Mean cell haemoglobin level 30.6 pg [27.0 - 32.0]

Total white blood count 4.2 x10^9/L [4.0 - 11.0]

Neutrophil count 2.2 x10^9/L [2.0 - 8.0]

Lymphocyte count 1.5 x10^9/L [0.5 - 4.5]

Monocyte count - observation 0.5 x10^9/L [0.2 - 1.2]

Eosinophil count - observation 0.1 x10^9/L [0.1 - 0.7]

Basophil count 0.0 x10^9/L [0.0 - 0.2]

Serum sodium level 140 mmol/L [133.0 - 146.0]

Serum potassium level 4.2 mmol/L [3.5 - 5.3]

Serum urea level 3.7 mmol/L [2.5 - 7.8]

Serum creatinine level 75 umol/L [45.0 - 84.0]

GFR calculated abbreviated MDRD 73 mL/min/1.72m*2

Bone profile Please note new calcium adjustment equation in use from 5/7/18

Serum calcium level 2.37 mmol/L [2.2 - 2.6]

Serum inorganic phosphate level 0.93 mmol/L [0.8 - 1.5]

Serum alkaline phosphatase level 62 IU/L [30.0 - 130.0]

Serum albumin level 44 g/L [35.0 - 50.0]

Serum adjusted calcium concentration 2.38 mmol/L [2.2 - 2.6]

Serum total protein level 71 g/L [60.0 - 80.0]

Liver function tests

Serum alanine aminotransferase level 16 U/L [0.0 - 34.0]

Serum total bilirubin level 8 umol/L [< 21.0]

Serum C reactive protein level < 1 mg/L [0.0 - 5.0]

Serum TSH level 1.4 mU/L [0.27 - 4.2]

Aim for TSH towards the bottom of the reference range for T4

replacement in primary hypothyroidism, targeting to around

1.0mU/L for symptomatic patients.

I supplement with Selenium 100ug from Cytoplan, Jarrows B12 1000micrograms, and Holland & Barratt Vitamin D 25ug.

Many thanks.

[SeasideSusie Remembering]

Dotty1340

Serum free triiodothyronine level 3.9 pmol/L [3.1 - 6.8]

FT3 is of little additional value in patients on thyroxine.

Oh, that makes one want to weep, they just don't understand!

Serum TSH level 1.4 mU/L [0.27 - 4.2]

Where's your FT4 result, I can't see it there. You need it so we can see what your T4:T3 conversion is like.

I supplement with ..... Holland & Barratt Vitamin D 25ug.

What's your Vit D level? I see H&B Vit D is chock full of horrible unnecessary ingredients as usual. Do you take D3's important cofactors - magnesium and Vit K2-MK7?

There are important cofactors needed when taking D3 as recommended by the Vit D Council -

vitamindcouncil.org/about-v...

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

naturalnews.com/046401_magn...

Check out the other cofactors too.

D3 is best taken in softgel form, Doctors Best has only two ingredients - D3 and extra virgin olive oil to help with absorption. A far better buy than your current supplement.

Serum folate level 6.7 ug/L [> 3.9]

Even though there is no upper limit, your level is on the low side.

Serum vitamin B12 level 1399 ng/L [197.0 - 771.0]

You should stop supplementing B12. As you are taking B12 supplement, are you also taking a good B complex to balance all the B vitamins? If not then you should be, it will raise your folate level. If you get Thorne Basic B or Igennus Super B then they contain 400mcg methylfolate which will improve your folate level, and they also contain B12 which will maintain a good level now that yours is good.

Your ferritin is slightly high, are you supplementing? If not then keep an eye on it.

I can't see any red flags with any of your other results.

[Dotty1340 in reply to SeasideSusie]

Hi Seaside Susie, many th asks for taking the time to reply. I have re looked at my test reposts and can’t find any mention of FT4, I am assuming they did not test for it.

I will amend my supplements and no, apart from what I listed above, I have not taken any other form of vitamin.

So I guess I’m a bit stuck regarding the conversion levels because they didn’t test for the FT4...

My plan is to go and see the doctor who does not think T3 has any bearing on the thyroid and see If he will give me a private prescription. Trying to get my T3 tested was like trying to get blood out of a stone so I guess I should be pleased I got this far.

I cannot understand why I am feeling so tired, especially in the afternoon.

I have a stressful job and I need to feel on top of my game if you know what I mean, so I am starting to get desperate to rid myself of this fatigue. X

[SeasideSusie Remembering in reply to Dotty1340]

Dotty

I cannot understand why I am feeling so tired, especially in the afternoon.

That will be because of your very low FT3. It's the active hormone that every cell in our bodies need.

What you really need is to FT4 and FT3 tested at the same time to see what your T4 to T3 conversion is like. If conversion is poor there are things to help it, supplementing selenium, zinc, magnesium, optimal nutrient levels, good gut health

restartmed.com/increase-fre...

If you can't get FT4 and FT3 done together with your GP, you could do a private test with Medichecks who have 20% off this month with code MED99. You'd only need the basic Thyroid Monitoring, or if you want to include antibodies it's the Thyroid Check Plus.

[Dotty1340 in reply to SeasideSusie]

Thank you, much appreciated.

[Dotty1340 in reply to SeasideSusie]

Hi SeasideSusie,

The below results were from December 2017 -

Serum free T4 level 22 pmol/L [11 - 22]

Coded entrySerum TSH level 0.55 miu/L [0.27 - 4.2]

I have sent off for a Medicheck test kit this afternoon.

[SeasideSusie Remembering in reply to Dotty1340]

Dotty

Are you on the same dose of Levo now as you were back in December when that test was done?

I hope you used the 20% off code at Medichecks

[Dotty1340 in reply to SeasideSusie]

Hi, yes same dose and used the code for medichecks!

[SeasideSusie Remembering in reply to Dotty1340]

Dotty

So as you're on the same dose, it's quite feasible that your FT4 could still be high in range like before, and with FT3 as low as recently tested then conversion could be your problem. But let's see when you get your new test results.

Don't forget to do the test early in the morning, fast overnight (delay breakfast but you can drink water) and don't take Levo until after the blood draw - there should be a gap of 24 hours since last dose of Levo and blood draw.

[Dotty1340 in reply to SeasideSusie]

That’s great, thank you. I just hope the finger prick test is going to be easier than Friday at the doctors when they couldn’t find a vein!! Never ever had that issue before and with my needle phobia you can just imagine the performance I did fast prior to the test and the usual 24 hours, appointment first thing etc. Thank you so much for your time.

[SeasideSusie Remembering in reply to Dotty1340]

Dotty

I find them easy, but I've done lots.

I stand on a small stool so that I am higher than the worktop where the microtainer is and my arm is as near straight as possible for the blood to drip into the microtainer.

Whizz arm round in a circle, windmill style, before pricking to get blood flowing (some people run up and down stairs but that's not possible for me).

Have a bowl of hot water ready to swish hand in, until hand goes red.

I use my middle finger first, if necessary go onto my ring finger, prick on the side nearer to the base of the nail than the finger tip.

If flow stops, dunk hand in hot water again and swish around, make sure it goes red.

youtube.com/watch?v=InHBLT-...(Not working as expected?)

[Wildbird]

FT3 is of little additional value in patients on thyroxine. Is this the start of a new policy by the labs in respect of t3? Even the NHS choices website acknowledges that t4 i.e thyroxine has to be converted into t3 to be active in the body. How can it ever be claimed that Levo converts to free t3 in the body, if labs see no value in the results. As t3 is now so costly, it seems as if there is a deliberate attempt to minimise it’s importance to hypothyroid patients. As SeasideSusie has said, without your free t4, it’s difficult to know what your conversion is like. I would think that low t3 will be a factor in you becoming so fatigued. Yours is at the very bottom of the range and as you are still symptomatic, this cannot be right for you.

[Dotty1340 in reply to Wildbird]

Thank you Wildbird, yes...isn’t the T3 rhetoric disheartening!

[silverfox7]

Can I just ask about the T3 comment? Like SS I'm horrified re the comment about T3. Is the comment from the doctor or the labs? If it's the doctor then that bad enough but if it's from the labs it is shocking!

[Dotty1340 in reply to silverfox7]

Hi, the comments were all contained on the Report from the laboratory so I am assuming it is a comment from the lab for the doctor to see. I access my results online so I can see all the comments which also contain explanations about what each different test is checking for. It must be fairly recently they have out this comment on as certainly at the end of December 2017, this comment was not there.

[silverfox7]

That is really shocking as that mention is going out to all GP's in the area! They really don't want to do the tests do they!

They will be saying we don't need oxygen next.