Advice please on any action to take before a Medichecks blood test

[bristolboy]

Following Medichecks Ultra Vit test in Feb 2018, and advice from you kind people, I have been supplementing for the last 6-7 months. I've now ordered another Ultra Vit test and would appreciate advice on pre-test preparations.

My history is as follows:

Diagnosed hypothyroid approx. 10 years ago but without symptoms. Been on levothyroxine (T4) ever since. Approx 2 years ago (2016) symptoms started (extreme tiredness, unexplained weight gain, very "foggy" head and poor memory, tinnitus, minor (not age-related) hair loss). Scan showed thyroid gland was "moth eaten". Levothyroxine has been increased over past 2 years to 150mcg per day, but symptoms still persisted. So I had my first Medichecks Ultra Vit test in February 2018, and this showed Hashimoto's and low Vitamin D. Since that test (and with further advice from Thyroid UK) I have been supplementing daily with: 3000iu Vitamin D oral spray, 200ug Vitamin K2, 1000mcg Methylfolate, 200mcg Selenium, and 200mg Magnesium Glycinate (the Selenium and Magnesium to help with absorbsion of Levothyroxine/T4). I have not noticed any appreciable improvement in my symptoms, but I want this new test done to see if any of my levels have improved - then I intend to go Gluten Free to see if that helps with the gut damage from the Hashimoto's.

I know to have the blood taken first thing in the day, fasting (only water) beforehand, and not to take my daily morning Levo until after the blood has been taken. But should I continue to take my supplements as usual (I take them all in the evening)? Thanks in advance everyone!

[SeasideSusie Remembering]

Bristolboy

You can continue with your supplements, the advice is to not take them until after the blood draw but as you take them in the evening that's not a problem.

The exceptions to this are:

Iron - leave off for a week or don't eat liver, liver pate, black pudding for a week before the test

Biotin or B Complex containing Biotin - leave off for 3-5 days before test.

By the way, 100mcg K2 is enough for up to 10,000iu D3, so you are wasting money by taking 200mcg, also it's fat soluble so excess will be stored.

[Caroline888 in reply to SeasideSusie]

Hi Susie,

Can I just check something with you: what about iron-rich foods such as dark chocolate, prune juice etc? Is it ok to have that sort of thing in the week prior to a blood test for iron status?

(Sorry Bristolboy, hope you don't mind me having jumped in!)

Best wishes

Caroline

[SeasideSusie Remembering in reply to Caroline888]

I don't know how much iron will be in those but it depends on how much you take, although probably not as high in iron as liver.

[Caroline888 in reply to SeasideSusie]

Thanks Susie, I only take a little dark chocolate each day, about 1 oz. I also have half a pint of prune juice which I believe contains 6 to 10 mg iron each day. I was planning on doing a blood test for iron on Tuesday but have been eating/drinking the above each day. Should I delay doing the test and cut out the chocolate and juice for a week? I am a vegetarian so don't eat much else in the way of iron-rich foods.

What would you recommend? As I understand it, there is about 17 mg in 100 g of liver.

[SeasideSusie Remembering in reply to Caroline888]

To be honest I really don't know. I have only read about iron tablets and liver so can't say for sure.

[Caroline888 in reply to SeasideSusie]

Thanks Susie. If I find out anything significant i will pass it on!

Best wishes

Caroline

[radd in reply to Caroline888]

Caroline888,

Iron stores take ages & ages to accumulate. If you were wondering about reducing iron levels by the absence of chocolate, etc, it would take much longer than a week.

So keep enjoying ..... 🙂

[Caroline888 in reply to radd]

Thank you so much for that radd😊.

Best wishes

Caroline

[bristolboy in reply to Caroline888]

No problems, Caroline Nick x

[bristolboy in reply to SeasideSusie]

Hi Susie,

Thanks for the reply, and your tip on K2. Every little bit helps on this expensive journey!! Nick x

[MiniMum97 in reply to SeasideSusie]

Hi Why do you need to leave off iron for a week? Thanks

[SeasideSusie Remembering in reply to MiniMum97]

It's a bit like Levo, taking it too close to the test will give falsely elevated levels as it will measure what's recently been ingested, so for iron it's suggested to leave it off for a week. I don't have the link to where I read this.

[MiniMum97 in reply to SeasideSusie]

Presumably that’s for iron serum/iron status checks and does not apply if you are checking ferritin only?

[SeasideSusie Remembering in reply to MiniMum97]

As I said, I no longer have the link but I have notes which say about iron tests

FERRITIN

TRANSFERRIN

TIBC

SATURATION

Special Concerns about Iron Tests

•Taking iron supplements can affect the results of these tests.

So that tells me not to take iron before any of these tests.

As Ferritin is the iron store, presumably any iron we take goes to the store first, then the body takes it from the store when it needs it. Just my simple interpretation.

[MiniMum97 in reply to SeasideSusie]

Interesting. Just looked this up to get a better understanding of why this might be. Found this on “lab tests online”:

“Ferritin is a protein that contains iron and is the primary form of iron stored inside of cells. The small amount of ferritin that is released and circulates in the blood is a reflection of the total amount of iron stored in the body. This test measures the amount of ferritin in the blood.

Iron is an essential trace element and nutrient that, among other functions, is necessary for the production of healthy red blood cells (RBCs). The body cannot produce iron and must absorb it from the foods we eat or from supplements.

In healthy people, most of the iron absorbed by the body is incorporated into the hemoglobin of red blood cells. Most of the remaining is stored as ferritin or as hemosiderin, with additional small amounts used to produce other proteins such as myoglobin and some enzymes. Ferritin and hemosiderin are present primarily in the liver but also in the bone marrow, spleen, and skeletal muscles.”

So this seems to say that the ferritin test is an estimation of iron stores based on the small amount that circulates in the blood.

Seems to also say that iron absorbed goes to haemoglobin first, then to iron stores.

Still not sure therefore why taking iron before a test would affect results of ferritin test as if this above is correct then absorbed iron needs to get converted to ferritin of which some is released into the blood which is then measured by the test.

Interestingly this study (see link below) seems to imply that taking “normal” treatment for anaemia does not raise ferritin unless haemoglobin levels are normal. However they also found that taking a double dose does temporarily raise levels which then subside quickly when supplementation is stopped ...so perhaps leaving off iron supplements for a week ensures that if you have slipped into this “temporary storage” levels would then correct themselves prior to a ferritin blood test.

ncbi.nlm.nih.gov/m/pubmed/7...