Third Blue Horizon blood report.

[Ballito]

I have just received the latest report from Blue Horizon, but don't know what to make of it. The doctors comment thinks I am hyperthyroid, but I am not as my body is not capable of sweating, I do not have rapid heart rate either. My body is so itchy as it is very dry and I am always cold. As well as an itchy back , scalp and neck, I have two spots just below the navel and midway to the hips each side, which are always itching?? I think that possibly my rhianitis is a little better as I don't have so much rubbish in my throat every morning. I self medicate on NDT and started on half a tablet, then one, then one and half and I was on 2 tabs when the blood was taken. Any help would be welcome especially from @reallyfedup123 and@seasidesusie. Thank you for your kindness.

HbA1c-(IFCC) H 42 20 - 42 mmol/mol

hs-CRP 0.62 <5,0 mg/L

Ferritin H 180.0 13 - 150 ug/L

Magnesium 0.87 0.66 - 0.99 mmol/L

Insulin 54.8 <173(Fasting) pmol/L

TSH L <0.005 0.27 - 4.20 mlU/L

T4 Total 98.4 66 - 181 nmol/L

Free T4 H 24.70 12.0 - 22.0 pmol/L

Free T3 H 12.80 3.1 - 6.8 pmol/L

Reverse T3 20.0 10 - 24 ng/dL

Reverse T3 ratio 41.67 Normal >15 Ratio

Boarderline 12 - 15 Low <12

Anti-Thyroidperoxidase abs <9.0 <34 klU/L

Anti-Thyroglobulin Abs <10 <115 kU/L

Vitamin D (25 OH) 118 Deficient <30 nmol/L

Insufficient 30 - 50 Consider reducing dose >175

Vitamin B12 538 Deficient <145, Insufficient 145 - 250. pmol/L

Consider reducing dose >569

Serum Folate 39.50 8.83 - 60.8 nmol/L

[Jazzw]

Hidden and SeasideSusie

[Jazzw]

You do look a little overmedicated - but before I go any further, how long a gap did you leave between taking your 2 grains of NDT and having your bloods taken?

[Ballito in reply to Jazzw]

Hello Jazzw. My bloods were taken 9 a.m and I took the last two tablets at 10.15 p.m the previous night.

[Angel_of_the_North]

I would worry about that high ferritin and HbA1c at top of range (might be on the way to type 2 diabetes). Other than that, if you left 24 hours between last dose of NDT and test, I'd say you were overmedicated.

[Ballito in reply to Angel_of_the_North]

Hello Angel of the North. I do not know why the ferritin is so high or the HbA1c. I left approximately 11 hours between taking last tabs and the blood test. Should I have left it for 24 hours? Thanks for your help.

[Angel_of_the_North in reply to Ballito]

Generally, 24 hours for things containing T4 and 12 hours for T3 only. The two I mentioned aren't affected by when you last took your meds.

[Ballito in reply to Angel_of_the_North]

Thank you, I will leave 24 hours the next blood test. So I am now on a mission to lower my ferritin and blood sugar - I think I will be living on porridge oats!

[SeasideSusie Remembering in reply to Ballito]

It's 24 hours for Levo and 8-12 hours for NDT and T3. NDT because of the T3 element it, so if you leave 24 hours you will get a false low FT3, and FT3 is the most important result when on NDT (and T3).

[Ballito in reply to SeasideSusie]

Thank you SeasideSusie for making that clear.

[humanbean]

How quickly did you go up in dose of NDT? It is so easy to miss your sweet spot if you go up in dose too fast.

[Ballito in reply to humanbean]

Hello humanbean. I went from half a tab to 2 tabs in 9 weeks. Is that too fast? I haven't really felt any different since I started with the NDT.

[humanbean in reply to Ballito]

Yes, I would say that is too fast.

This is a protocol recommended on another site :

tpauk.com/main/article/how-...

The actual instructions are abut 2/3 down the page but read all of it anyway.

[Ballito in reply to humanbean]

Thank you for the information. I think I have been a little hasty, but to be honest I haven't felt anything to be worried about so far - apart from the blood report. I will take it slowly and see how I go. Thank you.

[SeasideSusie Remembering]

Ballito

Before we can make sense of your thyroid results, as already mentioned we need to know when your last dose of NDT was taken. At the moment, your results do look like overmedication.

How long had you been on 2 tablets of NDT before the blood test?

Do you take a B Complex or Biotin? If so, did you leave it off for 3-5 days before the test?

HbA1c-(IFCC) H 42 20 - 42 mmol/mol

I would mention this to your doctor, it needs keeping an eye on at the very least.

Ferritin H 180.0 13 - 150 ug/L

Are you supplementing?

Vitamin D (25 OH) 118 Deficient <30 nmol/L

This is good, the Vit D Council recommends 125nmol/L and the Vit D Society recommends 100-150nmol/L so your result falls in with those recommendations. If you are supplementing, the dose would appear to be just about right.

Vitamin B12 538 Deficient <145, Insufficient 145 - 250. pmol/L = 728pg/ml

An extract from the book, "Could it be B12?" by Sally M. Pacholok says:

"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."

So your B12 level is fine. If you are in the older age group, you might want to nudge it up a bit more.

Serum Folate 39.50 8.83 - 60.8 nmol/L

This is fine. Recommended is at least half way through range and you've achieved that.

[Ballito in reply to SeasideSusie]

Hello SeasideSusie. I was on 2 tabs of NDT for 18 days before I had the blood test. Yes I take Igennus Super B complex tablet which I left off for 5 days before the blood test. No I am not supplementing ferritin. I have no idea why it is so high. No one has mentioned the high Free T4 and High T3, or are they o.k.? Thanks for your help.

[SeasideSusie Remembering in reply to Ballito]

Ballito

I think no-one has specifically mentioned your FT4 and FT3 results because we needed to know when you took your last dose of NDT.

I see from another reply that you took your last dose of NDT 11 hours before the blood draw which is perfect (8-12 hours is the right amount of time to leave). In that case your high FT4 and FT3 show considerable overmedication. Normally, when on NDT then TSH and FT4 can be low and it's the FT3 result that is important and that should stay in range. Yours is very high over range.

Sometimes ferritin is high due to infection or inflammation, in which case CRP would be raised as well, your CRP is nice and low in range so I would mention your ferritin level to your GP, he may want to keep an eye on it.

The Igennus Super B seems to be keeping your B12 and folate at a good level.

[Ballito in reply to SeasideSusie]

Thank you SeasideSusie. I will come off NDT for a few days and start again - going very slowly. I would have thought I would have had palpitations or hot flushes if I was very overmedicated - although as my husband says it would be impossible with my sluggish metabolism, as I have never had a hot flush in my life! Thank you for your encouraging reply.

[humanbean]

Can I suggest that while you are trying to find the correct dose of NDT for you, that you could save money by doing less comprehensive blood tests, but perhaps more frequently. Do a test before you change dose, and then act on the results when you get them. You should aim to only change dose once every 6 - 8 weeks. And when you get close to your ideal dose only make changes in quarter tablet amounts, not half tablet amounts.

medichecks.com/thyroid-func...

And you can get 10% off the price of that test with this discount code :

healthunlocked.com/thyroidu...

[Ballito in reply to humanbean]

Thank you. That is a good suggestion. I think I have been too impatient as I didn't feel any different really. Is it o.k. if I stick to 2 tablets and see how it goes or would you recommend that I take a little less? Thanks for your help.

[humanbean in reply to Ballito]

Since your Free T3 is just about double the top of the range I would suggest coming off it for a few days - perhaps 5 days or so. Then start on the protocol suggested in the link I gave above.

tpauk.com/main/article/how-...

I know it is very slow, and the idea of spending weeks feeling dreadful makes people impatient, but it often backfires on people if they try and push the pace.

[Ballito in reply to humanbean]

Thank you for the article. Yes, I think I will come off of it for a few days, and then start again slowly. Appreciate your advice.

[humanbean in reply to Ballito]

You might find this link interesting :

stopthethyroidmadness.com/m...

I know there is a less cautious protocol for going onto NDT on the STTM website but I can't find it! Perhaps you can take a look :

stopthethyroidmadness.com/s...

[Ballito in reply to humanbean]

Thanks again for this article. I think I need to read up on this site more often. Yes, they are less cautious and they seem to advise not to stay on a small dose too often. Very confusing, but with the help from HU I'm sure I'll find my sweet spot and hopefully everything else will fall into place! Thanks again.