Blood test results advice sought.

[Hackedoff]

I wonder if any one can comment on my recent blood test results? My doctor’s advice is that this constitutes an improvement and is almost normal, so I should continue with 75mcg T4 and 12.5 mcg T3 daily. True, I feel less tired than I did, but he does not inspire much faith. Thank you in advance.

[SeasideSusie Remembering]

Hackedoff

As you are a new member and there is nothing in your profile, we know nothing about your thyroid journey, your past results, why you are on combination Levo plus T3, and having this information helps us to help you.

You appear undermedicated.

Your FT3 is only 15% through range, your FT4 is 22% through range.

You may be OK with that level of FT4, when on T3 it does tend to lower FT4 and some people are fine with a low level, others need it higher.

Your low FT3 will be causing symptoms. That needs to be higher in range.

If those were my results, I would increase my T3 now, retest in 6 weeks and see how I feel. Then if necessary tweak doses to find my sweet spot. Only change one thing at a time, don't change both Levo and T3 at the same time because you wont know which is helping you.

Increasing Levo can increase FT4 and may also increase FT3 depending on how well you convert T4 to T3.

However, optimal nutrient levels are essential for thyroid hormone to work properly, so you need the following tested if not already done and post the results for members to comment:

Vit D

B12

Folate

Ferritin

[Hackedoff in reply to SeasideSusie]

Dear Susie,

Thank you for your prompt reply! Sorry - my phone died back there...

My story is that my mother, sister and myself have thyroid disease. I had my antibodies checked this summer and it’s Hashimotos. I was diagnosed about 15 years ago and told 3 different GPS in the UK and abroad, that it made no difference to how I felt, whether I took the (up to 125mcg Levothyroxine) or not, but they did and said nothing, so I carried on dragging myself through my day and sleeping most afternoons for 1.5 hours plus, exhausted a lot of the time. A friend was diagnosed with a severely under active thyroid this year and her learning journey led me to begin researching my condition. I obtained T3 from Mexico this summer (I work in the Middle East) and under an endocrinologist started this treatment with a reduced amount of T4 - I had been taking 100mcg but halved this - and after some weeks found I had enough energy to get through the day without sleeping, for the first time. I also had a bone density scan and was found to have osteopenia although I am told it is reversible to some extent. My friend suggested that years of undermedicating may have caused my bones to become porous. I hope this is not the case. I still find it hard to concentrate and have a poor memory. For the first time ever, my hands are not constantly freezing. At the insistence of my friend I had the laboratory check vitamin D and so on as you suggested, in August.

Ferritin 73.75

Iron saturation 25.6

TIBC 278.1

Iron 71

UIBC 207

Vitamin B12 498.7

I have all the blood test results as a PDF file. I don’t know which shows vitamin D.

Many thanks.

[SeasideSusie Remembering in reply to Hackedoff]

Hackedoff

Can you add the reference ranges for those results please, also the units of measurement for B12.

Vit D should say something like 25OH Vit D and may say D3, D2 and TOTAL VIT D. The units of measurement will be either nmol/L or ng/ml

[Hackedoff in reply to SeasideSusie]

Ferritin 13.000-150.000

TIBC 250.000-450.000

Iron 33.000-193.000

UIBC 135.000-392.000

Vitamin B12 259.000-901.000

Vitamin D was tested in March; 41.29

range 30.000-75.000

It looks like the first time I ever saw an endocrinologist was in March. She was good but left soon after. The new guy doesn’t seem interested unless you have diabetes. I am 54, vegetarian, exercise and am fit and healthy apart from this. I’m menopausal and my gynecologist prescribed combined hrt, again unavailable here, so I’m sourcing from the UK and will begin taking at Christmas. In case this has any bearing - I told my endocrinologist but he ignored it. I take calcium and vitamin D prescribed supplements. I now take my T3&4 at around 3am with water.

I want to continue teaching for as long as possible (which can be into your 70’s in the Middle East). I feel very let down by the medical profession. So if you are able to help me to manage this condition I would be so grateful.

[SeasideSusie Remembering in reply to Hackedoff]

Hackedoff

I take calcium and vitamin D prescribed supplements

Was your calcium tested? We shouldn't supplement calcium unless tested and found to be deficient.

Vitamin D was tested in March; 41.29 range 30.000-75.000

You haven't given the units of measurement. Is that nmol/L or ng/ml?

If it's nmol/L the Vit D Council recommend a level of 125nmol and if it's ng/ml the recommended level is 50ng/ml.

Are you taking D3's important cofactors

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 if taking tablets/capsules/softgels, no necessity if using an oral spray

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 if taking tablets/capsules, no necessity if using topical forms of magnesium.

naturalnews.com/046401_magn...

Check out the other cofactors too (some of which can be obtained from food).

Vitamin B12 498.7 (259.000-901.000)

You haven't given the units of measurement. Is that pmol/L or pg/ml or ng/L (pg/nl and ng/L are the same).

If it's pg/ml then the following applies:

According to 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."

So increasing to above 550pg/ml is recommended and I think you may be in the older age group so nearer 1000 is recommended.

If it's pmol/L that equals 675.7pg/ml so it's not a bad result but you still may want to increase it.

If we take B12 then we need a good B Complex to balance all the B vitamins. With your result I think a good B Complex containing a decent amount of B12 as well might be sufficient. Look at Thorne Basic B which has 400mcg B12 as methylcobalamin at the suggested dose, and Igennus Super B which has 900mcg methylcobalamin at the suggested dose.

Optimal levels for an iron panel according to rt3-adrenals.org/Iron_test_... :

Iron 71 (33.000-193.000)

Serum iron should be 55% through range for females (70% for males) - Yours is 23% through range

TIBC 278.1 (250.000-450.000)

Low in range indicates lack of capacity for additional iron and high in range indicates body's need for supplemental iron - yours is low in range

Iron saturation 25.6

Optimal is 35 to 45% with the higher end for men

Ferritin 73.75 (13.000-150.000)

Low level virtually always indicates need for iron supplementation and high level with low serum iron/low saturation indicates inflammation

or infection

Yours is just about OK at 44% through range as it needs to be 70 for thyroid hormone to work, recommended is half way through range.

So your nutrient levels aren't dire apart from your iron panel could be better.

I now take my T3&4 at around 3am with water.

How long did you leave between your last doses and the blood draw? For the results to show the normal circulating leve of hormones then for Levo T4 it should be 24 hours, and for T3 it should be 12 hours. Any longer and the results show a false low, too close to the blood draw and the results measure what you've recently taken and show a false high.

I mentioned in my previous post that you appear to be undermedicated but if you didn't take your last doses of Levo and T3 at the right times your results might not be accurate. Some people find they are better splitting their dose of T3, others are fine with it being taken all in one go.

[Hackedoff in reply to SeasideSusie]

Hi,

Sorry for my late reply and thank you so much for your detailed response (although I have to say that I find the intricacies of managing this condition rather baffling...). I have tried on two previous occasions to reply, but each time the post disappeared when I tried to send it. I've resorted to a PC, in the hope this will work better.

I will take your advice and will seek out the B complex and an iron supplement, although the pharmaceutical choices are extremely limited here.

Yes, I fasted before my blood test and didn't take T3 or T4 for 24 hours plus beforehand (I deliberately missed one dose and had the blood test in the afternoon). The doctor told me I had no need to fast, but I ignored him.

My calcium was tested in August and was 9.5 with a range 8.600-10.000. I was prescribed the daily supplement called "Osteocare" which contains 800mg calcium, 300mg magnesium, 10mg zinc & 5ug vitamin D (as D3 2001U).

Thank you again for taking all this time and trouble to help me

Much appreciated.

[SeasideSusie Remembering in reply to Hackedoff]

Hackedoff

You calcium isn't deficient, it's a bit closer to the top of the range than the bottom so I don't know why you were prescribed Osteocare. It's D3 you *might* need (along with it's important cofactors) as I mentioned above. The small amount of D3 is the Osteocare won't do anything to help raise your Vit D level but I don't know if your level needs improving because you haven't said what the unit of measurement is.

I haven't said that you need an iron supplement. Read through the breakdown of your iron panel again. Your TIBC is low in range and "Low in range indicates lack of capacity for additional iron" which basically translates to "you don't need extra iron". Your serum iron is low but your Ferritin is 44% through range. Take an iron supplement and it may raise your Ferritin too high as half way through range is recommended. Iron is complicated which is why you won't see me suggest taking an iron supplement.

You left too long between last dose of T3 and blood draw, it's 12 hours for T3 and 24 hours for Levo. So you have a false low FT3 and your normal circulating FT3 will be higher than shown in that test. The fact that you had a had an afternoon blood test has gi en a lower TSH than if you'd had an early morning blood test.