My Background - 52 year old female. Menopause ongoing and without medicinal treatments or aids. Pituitary Adenoma diagnosed 2006. Current medication Cabergoline half tablet twice weekly. Levothyroxine 150mcg daily. Prozac 60mg daily.
Arthritis in both knees and both hands - medication prescribed - two Remedeine tablets 4 times daily. PRN 600 mg Ibuprofen.
Information overload leads me to seek help from you lovely people all fluent in layman’s terms language and with similar, personal experiences through sharing and caring that offers much needed support, advise and guidance to others like myself struggling badly as I stumble through each waking hour of what is the living nightmare that is my daily life.
Please, please share your thoughts, opinions and comments on my picture of my blood test results that I received today from Medichecks.
Many thanks in advance.
CoolCatCAP
Edited - Added picture showing test results.
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CoolCatCAP
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Can you please edit your opening post and add a photo of your Medichecks results because those ranges you've given are not Medichecks ranges. You will be given incorrect information based on the ranges you've given.
You can edit your first post by clicking on the down arrow V next to the word MORE, choose EDIT then choose ADD A PHOTO below the message box, then click SUBMIT.
I am absolutely appalled and flabbergasted that the bottom of the range for ferritin, Active B12 and folate is zero. This is what Medichecks is telling customers is healthy??!!??
We can now see that the reference ranges are the ones we normally see with Medichecks results. They are very different from the ones you typed into your post.
It would be best if you removed the typewritten results and ranges and replies will be based on the information in your picture.
I'm off to bed now but I will pop back tomorrow and see if there is any further information I can add to the replies received.
Ferritin is a big problem, B12 is also likely problem and you really Vit D tested as well.
I'll go through your results with my thoughts. I am not medically qualified so my reply is based on my own experience, research and reading.
TSH: 0.01 (0.27-4.20)
FT4: 27 (12-22)
FT3: 5.63 (3.1-6.8)
Taking 150mcg Levo daily
Your TSH is suppressed, your FT4 is over range and FT3 in a pretty good place at 68% through range.
Your FT4 being over range suggests you could be over medicated (you are not "hyper", hyper means overactive, you are taking Levo because your thyroid is underactive so it's not possible to be overactive but it is possible to be overmedicated which gives the over range FT4).
It may be a good idea to reduce your Levo by 25mcg and see how that affects your levels. It should bring your FT4 into range but it will most likely also lower FT3. Dose changes should only be 25mcg at a time, not more.
If you get your FT4 into the upper part of the range (say upper quarter) and your FT3 lowers too much then that could likely be that you don't convert T4 to T3 adequately.
As for your suppressed TSH, as you have a pituitary adenoma has Central Hypothyroidism been mentioned, has it been linked with a low TSH? Normally when taking adequate thyroid hormone replacement TSH is going to be low in range, maybe even suppressed is some people (for me to have adequate thyroid hormone replacement mine is always suppressed).
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors)
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You don't need Total T3 testing.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
**
Optimal nutrient levels are essential for thyroid hormone to work properly and good conversion of T4 to T3.
Active B12: 31.3 (37.5-188)
Active B12 below 70 can suggest B12 deficiency and further testing is advised.
If you have any then take these results and your list of symptoms to your GP and ask for testing for B12 deficiency/pernicious anaemia. Symptoms are more important than numbers where B12 deficiency is concerned.
*Do not supplement any B12 or B Complex until after further testing has been carried out*
**
Folate: 10.12 (3.89-26.8)
This isn't too bad although folate is recommended to be at least half way through range and that would be 15.5+ with that range. Eating folate rich foods will help, and once B12 injections or supplements started then you can add in a good B Complex containing methylfolate (not folic acid), eg Thorne Basic B or Igennus Super B which both contain bioavailable ingredients.
**
Ferritin: 12.4 (13-150)
This dire. You should ask your GP to do a full blood count (which will show if there's any iron deficiency anaemia) and an iron panel (shows other types of anaemia). Fast for 8 hours before an iron panel test.
You most likely need an iron supplement and as your level is so low you should ask for an iron infusion which will raise your level within 24-48 hours, tablets will take many months. If your GP suggests tablets, I would push for the infusion to get this level up quickly to start with. If you are prescribed tablets then take each iron tablet with 1000mg Vitamin C to aid absorption and help prevent constipaton. Always take iron 4 hours away from thyroid meds and two hours away from other medication and supplements as it will affect absorption.
You can also help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet apjcn.nhri.org.tw/server/in...
**
Don't take a multivitamin, they generally contain too low a dose of any active ingredient to be of help, they often contain vitamins/minerals that need testing and shouldn't be supplemented if not deficient - ie iodine, calcium - and they very often use the cheapest and least absorbable of active ingredients. If they contain iron then that affects the absorption of everything else so they are a waste of money. You now know where your deficiencies lie, these are what need to be addressed.
**
There is no problem with thyroid antibodies, they are low and don't suggest any autoimmune thyroid disease.
CRP is nice and low so no problem there.
**
I have no knowledge of your other medication so you should check for interactions with Levo and it's always best to keep them as far away from Levo as possible, minimum is 2 hours but some do need longer.
**
Don't start supplements all at the same time, stagger them. Start with one, give it a week or two and if no adverse reaction then add in the second one, give it another week or two and if no reaction add in the next one, etc. By doing it this way, if you do have any reaction you will know what caused it.
Thank you for your very informative and detailed response Seaside Susie. I have my first appointment with new GP on Tuesday (4 week registration waiting period for new patients)....you have given great advice - I have a growing list of questions for Tuesdays appointment. I shall keep you posted.
Long story with understaffed GP surgery (resulting in long process to change GP surgeries and 4 week appointment system for new patients at my new GP surgery) as well as various A&E visits the past few months has left me practically bedridden and suicidal.
Looks like I have a long, long road to recovery ahead.
you are deficient in b12 and iron so no wonder your feeling very ill research all the symptoms it's can cause and you probably will relate to them, are you eating a clean diet do you have any gut issues ?
Why were you prescribed 150 levo ?
As your are to me hyper with a 0.01 tsh
I would reduce your levo to 100 for a few days till you see the doctor and see if it reduces any of your symptoms If you feel ok to do so or is there a reason it is so suppressed ??
On thyroid UK Dr Toft states:
Dr Toft states in Pulse Magazine, "The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l.
In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance.
But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l.
This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l)."
I would pay private for T3 tests to cover the serum total T3 test Dr Toft mentions above so you can check your level and whether it's within range then it will also confirm your too hyper if not and the need to reduce levo also
This is why your T4 free thyroxine is high at 27 above the range your suppressing your tsh way to much so my advice would be to reduce your levo for a few days and see if it helps with symptoms till you see the gp and address your diet reduce or cut out sugar, cut out gluten and dairy and eat more foods rich in b12 and iron and look into probiotics and a good high dose multivitamin until you visit your gp as they may well give u b12 injections and high strength iron to increase your levels and see if these things help your mood and reduce any of your symptoms.
You really need to address your B12, Folate and ferritin levels. Why are you taking Prozac?
Did you have test done when your pituitary adenoma was discovered? Have they done any further MRI's to see if it has grown at all? TSH is often suppressed when there is a pituitary issues so it would be worth asking for all pituitary hormones to be tested, especially cortisol. Quite often adenomas are incidental causing no issues but that can change & they can be secreting excess or very little hormones. My pituitary adenoma wasn't secreting any excess hormones but that changed within a couple of years & started to produce excess ACTH which is the hormone that stimulates the adrenal glands to produce cortisol. I was diagnosed with Cushing's disease so the adenoma had to be removed. It is worth getting a visual fields eye test with your optician to see if the adenoma is impacting the optic nerves.
Thank you so so much for all replies....I am so overwhelmed to receive such kindness shown in all your detailed and informative responses. I shall post an update on after my first GP appointment at my new GP surgery on Tuesday.
I am running on empty. My whole body sweats as my heart, glands and pulses pound in tune to the very fast paced brass band that continually marches through it.
Breakdown of today’s appointment with new GP;
Called 40 mins after scheduled appointment time, show my Medichecks blood tests results, informed it is a ‘registration appointment’ only, I point out the areas of concern on the test whilst trying to get across to this man how desperately ill I am, he ‘notes’ thyroid levels and replies he ‘wants a full blood screening done’, adds this to my notes on the computer, tells me to make an appointment at reception for blood tests and a follow up appointment with him a week after my blood tests appointment ‘and we’ll take it from there’. End of GP appointment. Relay DR’s instructions to appointments receptionist who informs me next available appointment for blood tests is 18/2/19!!!!! I honestly don’t think I will live that long.....my body is imploding more and more each passing day. I really am 100% done. 😢💔
So sorry your appointment went badly. Not sure what you can do really other than wait it out and be prepared for next time.
What time is your appointment on the 18th?
Always recommended here when booking thyroid tests:
* Book the first appointment of the morning. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.
* Leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.
These are patient to patient tips which we don't discuss with doctors or phlebotomists.
I hope you can hold out until the 18th, come back and let us know what happens.
Thank you SeasideSusie. Right now, I feel my whole body is in some form of serious crisis....I am sweating profusely and my whole body is pounding all over with palpitations....I am seriously considering a trip to A&E very shortly.....my gut instincts are screaming at me that something is not quite right.....😢💔
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