Please can I have your thoughts regarding my results. The test was done first thing in the morning on an empty stomach with no meds for 24 hours.
I seem to be experiencing flare ups more often in the last 6 months with very achy muscles especially in the arms ,neck and side of body together with dizziness and feeling unsteady together with extreme tiredness but It's not all the time.
I am taking 150mg daily of T4 , should I be reducing this? I have been taking this for about 10 years now.
Serum free T3 level 4.4 (3.5-6.5)
Serum TSH 0.18 (0.55-4.78)
Vit D 53 (50-374)
Ferritin 92 (10-291)
Serum c reactive protein level 13 (0-5)??
Potassium 4.7 (3.5-5.3)
Vit B12 595 (211-911)
Bone profile normal
Liver function normal
Full blood count ok except
Percentage hypochromic cells 5.8% (0.0-2.5) ??
I would appreciate your thoughts.
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Jlml
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Have you ever had TPO and TG thyroid antibodies tested? . If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
About 90% of all hypothyroidism in Uk is due to Hashimoto's.
Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .
You may benefit from a good quality daily vitamin B complex, one with folate in not folic acid
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two). Or Jarrow B-right
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 3-5 days before any blood tests, as biotin can falsely affect test results
Only add one supplement at a time and wait at least ten days to assess before adding another
Improving vitamin D, can mean you also need to supplement magnesium. Loads of posts about magnesium on here
Unless you test TSH, FT3 and FT4 together, you won't know if you have low enough FT4 to just increase dose of Levothyroxine. Or if FT4 is high in range you may need addition of small dose of T3
Improving vitamin levels can help improve conversion of FT4 to FT3
Selenium supplements can help improve conversion too
Suggest you get private testing 6-8 weeks after added vitamin D and vitamin B complex
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Do not take Levothyroxine dose in the 24 hours prior to test, delay and take immediately after blood draw. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or vitamins
Medichecks Thyroid plus ultra vitamin or Blue Horizon Thyroid plus eleven are the most popular choice. DIY finger prick test or option to pay extra for private blood draw. Both companies often have special offers, Medichecks usually have offers on Thursdays, Blue Horizon its more random
High percentage of hypochromic cells
I think this mean Anaemia
humanbean or SeasideSusie may be able to comment, they are iron experts
B12 and folate deficiency gives rise to over-sized red blood cells. Iron deficiency gives rise to under-size red blood cells. If you have both, the mean cell size might be right in the middle of the range. But add in Red Cell Distribution Width (RDW) and we can have a much better idea as to whether there is a problem or not.
Hypochromic red blood cells can occur in several circumstances - iron deficiency anaemia, thalassemia, and in some cases of Anaemia of Chronic Disease, plus a few other conditions.
Your ferritin (iron stores) are lower than ideal but not catastrophic - we see lower levels a lot on this forum. An optimal level is round about mid-range or a little bit over, i.e. with the range you've been given this would be roughly 150 - 170.
A high CRP is common in Anaemia of Chronic Disease (ACD).
Unfortunately you don't have enough information to determine which condition(s) you actually have.
Thalassemia - I mentioned this above because of the hypochromic cells, but it usually presents with high ferritin, so I would dismiss this as a possibility.
Iron deficiency anaemia (IDA) - this is very common, but apart from your ferritin level, which isn't outrageously bad, you don't have the appropriate evidence required to say you have this condition or don't have this condition.
Anaemia of Chronic Disease - this is also common. Your high CRP would suggest this might be an issue for you. But ferritin is usually high in ACD and yours isn't.
Basically, I would suggest that you have IDA, ACD, or possibly both. There is nothing to suggest (at the moment) that you either of these conditions very severely. But another complication is that if you had both conditions it makes it harder to work it out. For example, ferritin is low in IDA and high in ACD. Put both conditions in the same body and the ferritin might appear fairly normal.
Don't supplement iron on the basis of the information you've given here. It is a very bad idea for anyone with ACD.
I should also have said that I have never seen anyone quote a hypochromia % before. I have no idea if yours is bad or only minor. In someone with severe IDA the level might reach 70% or more for all I know, or might never get higher than 10% - I don't have the necessary knowledge on this.
If you have the results of a Full Blood Count (or Complete Blood Count) then you could post that too. If you haven't had an iron panel done, then it would be essential I think.
A GP should do an iron panel, but if you live in the UK I wouldn't hold my breath on the subject. You can order one privately :
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