Hi, I had some bloods done in September from Medichecks and recently had some results from my new doctor (apparently the ranges have changed), but I still don't know what they mean, so in simple "like I'm a 4 year old" terms can someone please explain if these are okay. Clearly, the Vitamin D isn't since the surgery phoned me straightaway and gave me a 3 month supply and even after a few days I do feel a little better, but not 100% and certainly all aches and pains are still present, along with tiredness etc. Any comments / advice would be greatly appreciated.
FREE T3 5.6 pmol/L (4.2 – 6.9) apparently there was a change in reference range on 13.10.18
VITAMIN D (AM1) - 35 - raised ALP <30 Deficiency: 30 – 50 Insufficiency: >50 Sufficiency
SERUM VITAMIN B12 175 ng/L (145 – 914)
SERUM FOLATE 3.57 ug/L (3.0 – 20.00)
SERUM FERRATIN 158 ug/L (11.0 – 307.0) (says normal no action)
I've not discussed results yet with Doctor as appointment is in four years time.. sorry I'm joking that's just what it feels like, I mean in a couple of weeks, but I'd like forum opinions, i.e. the truth!
What time did you take your last dose of Levo before both of these tests? There is quite a difference in your FT4 which could be explained by timing of Levo.
With your Medichecks test, FT4 is 63% through range, with your GP test it's 45% through range. [FT3 is 56% and 52% through range, not significant and wouldn't be affected by last dose of Levo like FT4 would be.]
VITAMIN D (AM1) - 35
What dose of D3 has your GP prescribed?
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L so that is the ultimate aim for optimal Vit D level. Once you have reached this you will then need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with City Assays vitamindtest.org.uk/
Your doctor wont know, because they are not taught nutrition, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -
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
I have read (but not researched so don't have links) that BCSH, UKNEQAS and NICE guidelines recommend:
"In the presence of discordance between test results and strong clinical features of deficiency, treatment should not be delayed to avoid neurological impairment."
And 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."
**
SERUM FOLATE 3.57 ug/L (3.0 – 20.00)
This is very low, folate should be at least half way through range. Ideally you need to raise this with folate rich food and probably folic acid or a good B Complex containing methylfolate. However, if you have any signs of B12 deficiency then you need that investigated further and testing for B12 deficiency/pernicious anaemia, you may need B12 injections or supplementation in which case that should be started before supplementing with folic acid or B Complex.
**
SERUM FERRATIN 158 ug/L (11.0 – 307.0) (says normal no action)
Ferritin is recommended to be half way through it's range so yours is good.
Hi SeasideSusie, thanks for your swift response. I took my Levo in the morning about 9am, after I’d done my blood test at about 8am for the Medichecks one.
After reading about taking Levo then waiting an hour before eating (which I’d not done previously) I’d taken the Levo the day before and then I didn’t take it in the morning because the appointment was at 11am and took it after so a longer period between. My Levo was also reduced between the blood tests from 125mcg to 100mcg.
The Vitamin D they’ve given me is Stexerol-D3 1,000 IU Colecalciferol (Vitamin D3) two to be taken daily for 3 months. I’ve been taken my Levo early morning about 7am and then one Vitamin D about 8.30 or 9am so I should be leaving a bit more time here, and one Vitamin D at tea time, but just read on the prescription “Two to be taken daily” so I could do both at the same time and remember to leave four hours between them. See if I didn’t ask not one doctor or pharmacist tells you about this kind of thing!
From the list on the B12 deficiency signs I’ve had for a long time: dizziness, cramps, weakness in arms, eyes not focusing properly, sleep problems, chronic fatigue, palpitations, totally grey hair now, skin pigmentation (for which I had Efudix to clear up), I had bronchitis last year and since 2010 I’ve had the flu really badly each year (I’ve just had the flu injection).
I think I need to get the timings right on all the vitamins and Levo.
After the B12 & folate figure it says “normal – no action”!
OK, so your FT4 is lower on the second test because of the reduction in your Levo, and you can see it made quite a big difference. However, the tests show that you have good T4 to T3 conversion. There was absolutely no need to reduce your Levo, your thyroid hormones were fine (FT4 and FT3) and well within their reference ranges.
The Vitamin D they’ve given me is Stexerol-D3 1,000 IU Colecalciferol (Vitamin D3) two to be taken daily for 3 months.
Oh good grief! Seriously?!! 2000iu daily to try and raise your level from 35nmol/L. That is just 5 points away from the level where you would be given loading doses for deficiency (30nmol/L) which would total 300,000iu over a number of weeks. See cks.nice.org.uk/vitamin-d-d...
I seriously think you should take over your own supplementation here, and be guided by what the Vit D Council says.
Your level of 35nmol/L is equal to 14ng/ml and the Vit D Council recommends here
To achieve this level ..…. Take this much supplement per day:
40 ng/ml (100nmol/L) ...... 3200 IU
50 ng/ml (125nmol/L) ...... 4900 IU
60 ng/ml (150nmol/L) ...... 7000 IU
so you can see your 2000iu isn't likely to raise your level any time soon.
As you don't appear to have autoimmune thyroid disease (Hashimoto's) then you should be fine with a D3 softgel (eg Doctor's Best) or you could go for BetterYou oral spray which gives better absorption for some people as it bypasses the stomach. Personally I would aim for the upper end of the range as it is winter and we can't make Vit D naturally from the sun now and we draw on what store of Vit D we already have.
Don't forget the important cofactors mentioned above and make sure you stick to the very important timing - both D3 and magnesium should be taken 4 hours away from Levo.
After the B12 & folate figure it says “normal – no action”!
That's purely because they're within the range, it doesn't matter to doctors where in range - it could be one point up from the bottom or one point down from the top, to them that's normal. But us Hypos need "optimal".
As you have symptoms of B12 deficiency, you should list them and ask your GP for further testing, if necessary print off the full list from the B12 deficiency site, any other relevant information and even get a copy of the book mentioned so that you have some back up to discuss this. Don't take any B12 or folic acid/folate/B Complex until further testing has been carried out.
thanks SeasideSusie, I'll make sure I'm armed up when I go back. Its such a shame that doctors are not taking something so serious for so many people as lightly as this and are not informed enough. I am also taking a tablet for high blood pressure as this was off the chart (my fault I had stopped taking it previously because of an annoying cough and the dizzy spells) and I'm on one 5mg of Amiodipine a day which I avoid taking with anything else to be on the safe side! I'm printing off various docs to take to my next appointment. Many thanks for your help and advice.
It doesn't matter if the range has changed, you need to read results with the range that was used when the blood was analysed. The range is fixed by the machine on which the analysis is done, so this varies from lab to lab, and does not change the level of your result. If a result is 50% through one range, it will be 50% through another range. Example:
FT4 17 (12-22) is 50% through the range.
FT4 16.5 (10-25) is 50% through the range.
So, the result will change according to the range, if you see what I mean. There are no standard ranges.
Free Thyroxine (FT4) is the thyroid storage hormone. It has to be converted to the active hormone Free T3.
TSH is a pituitary hormone. When the pituitary senses that there is not enough thyroid hormone circulation in the blood, it increases its output of TSH - Thyroid Stimulating Hormone - which stimulates the thyroid to make more hormone. If you are hypo, and your thyroid cannot respond, the TSH gets higher, and higher and higher. When decent levels are restored, the pituitary makes less TSH, so the level drops.
Your pituitary believes there is enough thyroid hormone in your blood, because your FT4 is almost at the top of the range, and the FT3 is well over mid-range.
However, the pituitary isn't always right, so along with blood tests, we have to take into account how you feel. Do you feel well with these results? If so, they are good.
Thanks greygoose. I don't feel as bad as when I first posted on the site a couple of months ago, but I can't say I feel terrific. It feels like its a cycle, some weeks I feel okay, others I am so tired I can't stay awake in the afternoon and have a nap, my joints don't feel good but I believe the Vitamin D will sort that out, but again over the years I've had the same thing. The Doctors don't keep up the checks and put all the dizziness, palpitations, poor sleep, cramps etc. together and build a picture of unhealthy thyroid so I, like many others, struggle on and I'm very pleased I found this website and the forum for advice and help. I'm due to see doctor soon (another new one!) and hopefully she'll be a little more sympathetic. I did say I wouldn't try T3 but I did buy some from abroad and was thinking of trying this. Do you think a good idea or, like seasidesusie, should look into sorting out my vitamin deficiencies first and see if that route is more suitable?
I think you should sort out your vitamin deficiencies first. Thyroid hormone works better when your nutrients are optimal. So, even if they aren't the complete answer, it would be better to optimise them before trying T3.
You also need to be sure that you have a sustainable supply of T3 - which is so difficult, these days! No point in starting it if you cannot continue it.
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