A bit of background - my GP has referred me to a rheumatologist with possible fibromyalgia, as we have done all sorts of tests and all results come back ‘normal’. A friend suggested doing a thyroid check, which I did through Medicheck.
The results came back this morning, they are as follows (range shown in brackets):
You're being told everything is "normal" purely because your results fall within the range, the problem is they're not in a particularly good place in the range.
Taking your vitamins and minerals first:
Active B12: 69.600 pmol/L (25.10 - 165.00)
This is just below the limit that this site recommends testing for B12 deficiency (they say <70)
and if you have any then list then to discuss with your GP and ask for further tests.
Folate (Serum): 3.78 ug/L (2.91 - 50.00)
Folate and B12 work together and yours is very low in range. It's recommended that folate be at least half way through range. Your GP may prescribe folic acid but if not then you can buy your own methylfolate/B Complex BUT don't start supplementing until further testing for B12 deficiency has been carried out if you have symptoms.
If you have no signs/symptoms of B12 deficiency that it would be OK to supplement with a sublingual methylcobalamin lozenge plus a good B Complex (such as Thorne Basic B or Igennus Super B) to balance all the B vitamins.
Ferritin 16.5 ug/L (13.00 - 150.00)
Your Ferritin is dreadfully low and this will be causing problems - see this article
For thyroid hormone to work (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range. With a level as low as yours it can suggest iron deficiency anaemia so I would ask your GP to do an iron panel and full blood count.
After those tests then you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
CRP - High Sensitivity: 1.54 mg/l (0.00 - 5.00)
This is fine.
Vit D - this really needs testing, especially as your other levels are poor. If this wasn't the UltraVit test, which includes Vit D, you could either ask your GP (may not be done) or do a home fingerprick blood spot test with City Assays vitamindtest.org.uk/
This is on the high side and shows your thyroid is starting to struggle.
Free Thyroxine: 13.200 pmol/L (12.00 - 22.00)
Free T3: 4.7 pmol/L (3.10 - 6.80)
FT4 (free thyroxine) is on the low side, again shows your thyroid is struggling and your FT3 is holding up at the moment, your body is doing it's best, despite a very low level of thyroxine, to push out enough T3 which is the active hormone.
No sign of autoimmune thyroid disease with these results.
So at the moment your thyroid results aren't enough to get you a diagnosis.
What you need to do now is optimise all your nutrient levels as mentioned above and retest in, say, 4-5 months and see where all your levels lie then (thyroid and vitamins again).
I started looking at vitamin D deficiency symptoms last year and then started looking at B12, as I have several symptoms which overlap. I have already pushed for B12 testing after finding an amazing group on Facebook who gave me a lot of information. I had homocysteine and MMA tests in June, both in ‘normal’ range:
Homocysteine 14.3 umol/L [< 15.0]
Methylmalonic Acid 172 nmol/L [0.0 - 280.0]
I wanted to check my thyroid as I understood that B12 is linked to other minerals and vitamins so before I started self injecting I wanted to make sure there were no other issues.
My vitamin D level was tested by my GP in August, when it was 83 nmol/L [50 - 100]. This is a vast improvement on the test last autumn when it was around 40, but we have had weeks of sunshine.
My GP recently tested my blood count but ferritin wasn’t part of that. It was last checked in October last year and it was 10.6 ng/ml [10 - 291]. GP didn’t flag that up as an issue, and I did ask again recently if I could be anaemic and he said it was unlikely.
My vitamin D level was tested by my GP in August, when it was 83 nmol/L [50 - 100]. This is a vast improvement on the test last autumn when it was around 40, but we have had weeks of sunshine.
You've done well to raise it that much naturally but it's not enough, certainly now that we are approaching winter and we can't make Vit D from the sun during the winter months.
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L. As your original level was 40, that was extremely low.
If it was me I would start supplementing now and throughout the winter, retesting in April.
As there is no sign of Hashi's (autoimmune thyroid disease) you will be fine with a D3 softgel along with it's important cofactors magnesium and Vit K2-MK7.
With your current level, the Vit D Council recommends the following
To achieve 125nmol/L take 2500 IU D3 daily
To achieve 150nmol/L take 4600 IU D3 daily
The cheapest way to raise your level is with 5000iu D3 softgels and take 1 alternate days, if you want to achieve the higher recommended level you could take 5000iu a few days a week and 2500iu the other days.
I find this brand excellent and good value, it only has 2 ingredients
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
My GP recently tested my blood count but ferritin wasn’t part of that. It was last checked in October last year and it was 10.6 ng/ml [10 - 291]. GP didn’t flag that up as an issue, and I did ask again recently if I could be anaemic and he said it was unlikely.
Ferritin isn't part of a full blood count, it would be part of an iron panel or stand alone. If your ferritin level last October was 10.6 and your GP ignored that he needs shooting! Low ferritin can suggest iron deficiency anaemia. I would ask again for an iron panel and full blood count, get the results and pop them on the forum. If your GP says you've already had them done, then point out your ferritin level last October was a mere 0.6 into the range, and you feel that it should have warranted further investigation. And because he says it's unlikely that your anaemic doesn't mean that you aren't. You need testing with those levels.
Do you have a print out of any of those tests done by your GP? If so, post the results here, if not ask your surgery's reception if you can have a print out for your own records, you are legally entitled to them.
I have had a look at the link you posted, and wondered if I had an issue with low stomach acid, as I do suffer from heartburn and until recently was taking Omeprazole (a PPI). Looking at the range of symptoms of low stomach acid and I can tick off most of these:
"Symptoms of low stomach acid are related to impaired digestion, increased susceptibility to infection, and reduced absorption of nutrients from food. Symptoms may include:
bloating
burping
upset stomach
nausea when taking vitamins and supplements
heartburn
diarrhea
gas
desire to eat when not hungry
indigestion
hair loss
undigested food in stool
weak, brittle fingernails
fatigue
GI infections
iron deficiency anemia
deficiencies of other minerals, such as vitamin B-12, calcium, and magnesium
protein deficiency
neurological issues, such as numbness, tingling, and vision changes"
And while this can cause deficiencies in various nutrients, it is also caused by deficiencies: "Deficiency of zinc or B vitamins may also lead to low stomach acid." So this could just keep going round and round in circles.
Vit D supplements vary. I mentioned softgels because you can get excellent quality for possibly the best price. There are tablets but of course they wont contain any oil to help with absorption, and there are oral sprays which bypass the stomach so are absorbed differently.
Some D3 is made from lanolin from sheep's wool.
A couple of vegetarian D3 supplements below but if no oil is in the ingredients then they must be taken with the fattiest meal of the day if in tablet form.
The typical change in the blood count is a microcytic anaemia with a low MCV and a low mean corpuscular haemoglobin. The MCV drops once iron stores have been depleted. The WCC should be normal, while the platelet count is frequently raised.
Your platelet count isn't raised but is near the top of the range and your white cell count is normal.
Have a read through the article, but like I say I'm no expert when it comes to iron.
Low stomach acid is typical in hypo patients, it has similar symptoms as high stomach acid but a lot of doctors don't agree there is such a thing.
There is an easy home test you can do for low stomach acid
Scroll down to "The Baking Soda Stomach Acid Test"
Betaine HCl with Pepsin or Raw Organic Apple Cider Vinegar with Mother (look at Biona brand) can help here.
You might find that working on optimising your nutrient can help, so once you've started the B12 injections, add in a good B complex such as Thorne Basic B or Igennus Super B. Then add in Vit D and it's cofactors. And very important to sort out the iron problem but that might not be easy, depends on your GP and how far you can push for further testing.
Don't start supplements all at the same time, stagger them. Start with one, give it a week or two and if no adverse reaction then add in the second one, give it another week or two and if no reaction add in the next one, etc. By doing it this way, if you do have any reaction you will know what caused it.
I was diagnosed with fibromyalgia 18 months ago by a rheumatologist but been hypothyroid with Hashimoto's disease for over 12 years. Now going down route that fibromyalgia might be caused in my case by undermedication of thyroid hormones ( see Dr Lowe's archive and Q&As on Thyroid Uk website), and got a lot better with upping levothyroxin then adding T3. But having had hard emotional and physical past 5 weeks following death of my father...it has returned a bit. Looking at your thyroid blood results....if you had already been on levothyroxin I would have confidently said you need to raise your dose, but as you are not you do appear to be struggling with low free thyroxin. Unfortunately your doctor will probably say you are ok as your TSH at 2.53 is well within range( in GB they believe 10 or above is treatable!), but your norm might have been much lower. What is notable are your poor vitamin/mineral levels: for good thyroid health forum members try to get folate, ferritin, Vit D and B12 at optimum levels...in upper end of ranges. Folate and ferritin should be at least half way thru range, ferritin if still menstruating better at 100-130ug/L. B12 should be at top of range. You didn't get Vit D done thru Medichecks unfortunately, it might be low too if others low (might be worth getting tested too, should be 100-150). I doubt your doctor will give you any supplements to improve these 4 nutrients, so suggest you look up previous SeasideSusie replies to posts on supplements: doses, brands etc. Most of us go for online quality ones- avoid most supermarket types - look good value but often cheap or mixed ingredients that body can't absorb properly. I take these supplements daily ( plus magnesium, selenium and zinc) ... they might have contributed to lessening of fibromyalgia symptoms too...so certainly worth doing.
Thank you, Judith, and I am so sorry for your loss.
I should have mentioned earlier that I am a vegetarian - I do eat dairy and eggs - which probably isn’t helping my symptoms. I assume it will be possible to improve my levels without having to start eating meat again, but I am keeping an open mind. I have been feeling so awful that I just want to start feeling well again.
Glad I was telling you same info as SeasideSusie, and that she confirmed at least get your vits/ mins up...it's a slow process ...but you will be used to that as doctors exclude everything else before giving you a dead-end diagnosis of fibromyalgia. Trying to be proactive with your health is a good idea I believe ( I have had to self medicate with T3 as well as supplements). Good luck
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Thyroid results, FT4 over range. Tension and Panic attacks.
Thyroid Check Ultravit
Finger prick Thyroid test results??
Thyroid check . Please have alook at the results and comment .
Medicheck results advice/help
