Hi, I was wondering if anyone could advise me on my latest private results from Thriva please? Thank you
Total T 4 was 58.4 ref 66- 181
T4 was 12.4 ref 12 - 23
FT3 was 3.85 - ref 3.1 - 6.8
TPO antibodies was 11.3 - ref 0 - 34
TGAB was 10.9 ref 0- 115
Cahod6103
What thyroid meds are you taking?
How long before doing the test was last dose?
What's your TSH result?
Did you also have nutrients tested - Vit D, B12, folate, ferritin?
Thank you, sorry I hadn’t noticed I’d missed TSH, it was 4. 79 ref 0.27 - 4.3. The last dose would be Levo 75 with 10 T3 24 hrs before and 5 T3 about 13 hours before the test. I’m currently taking 75 Levo along with 10 T3 in am, then another 5mcg of T3 late afternoon. Yes I had the others done too, they were
Ferritin was 175 ref 13 - 150
Active b12 was 300 ref 25.1 - 165
Folate was 45 ref 8.83 - 60.8
Vitamin D was 71 ref 50- 100
Timing of your meds was OK, I split my T3 the day before my test and take the smaller dose 8-12 hours before test.
TSH: 4. 79 (0.27 - 4.3)
Total T4 :58.4 (66- 181)
FT4: 12.4 (12 - 23)
FT3: 3.85 (3.1 - 6.8)
Everything points to undermedication with TSH over range and FT3 so low in range.
FT4 will be low because you're taking T3 but that might be too low for you to feel well.
Looking at those results, if they were mine, I'd need more Levo to bring FT4 into range, see what that does to FT3 (it may increase). I'm on a Levo/T3 combination and I need both FT4 and FT3 to be around 75% through range, I am very unwell with a low FT4.
Ferritin was 175 ref 13 - 150
Are you supplementing? If so you could drop back, ferritin is recommended to be half way through range.
Active b12 was 300 ref 25.1 - 165
Presumably supplementing or on injections?
Folate was 45 ref 8.83 - 60.8
That's fine.
Vitamin D was 71 ref 50- 100
Assuming this is nmol/L and not ng/ml then the Vit D Council recommends a level of 125nmol/L [50ng/ml] and the Vit D Society recommends a level between 100-150nmol/L [40-60ng/ml].
Yes, vitamin D was nmol/L , so I should take more D3 then ? I was taking Ferrous Sulphate, but haven’t had any for about 3 months now, Ferritin level always seems to be above range. Yes, I have b12 injection every 10 weeks from the nurse. I definitely feel as if I’m being under medicated too, trouble is I had a letter from Endo end of Jan, he said I’d to stay on same dose and only get my TSH checked at beginning of March, I see him middle of March. I’m not happy with that as I feel awful, but how do I argue with a consultant ?
How much D3 are you currently taking?
Are you also taing D3's important cofactors - magnesium and Vit K2-MK7?
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.
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.
If your ferritin level has always been above range, why were you taking an iron supplement?
I definitely feel as if I’m being under medicated too, trouble is I had a letter from Endo end of Jan, he said I’d to stay on same dose and only get my TSH checked at beginning of March, I see him middle of March. I’m not happy with that as I feel awful, but how do I argue with a consultant ?
This the problem, most endos don't know much about treating hypothyroidism. Is yours a diabetes specialist (hospital website should tell you that)? I saw one nearly 20 years ago, I was already very unwell, he turned me into a zombie but he didn't care because he'd managed to get my TSH to scrape back into the bottom of the range, never mind the fact that my FT4 was very low in range and FT3 non existent, he was a happy bunny. I ditched him, with the agreement of my GP, and it took 2 years of being looked after before I could function properly again, and I'm still paying the price of him bowing to the god TSH and nothing else.
I’m taking d3 1000 IU every day, I don’t take magnesium though, I can’t take Vitamin K as I’m on Warfarin now. I took Ferrous Sulphate on GP advice as my serum iron panel results showed low, it was 11.3 ref 11- 29, also TIBC Saturation was 17% ref 20 - 50 % , she said she thought it would help these levels, but they have never been checked again that I know of, but I haven’t had any Ferrous Sulphate for about 3 months now.
Your Vit D level of 71nmol/L = 28.4ng/ml.
For this level, the Vit D Council suggests, to raise it to their recommended level of 125nmol/L, taking 3,700iu daily (nearest equivalent 4,000iu). As 1000iu is a maintenace dose for a level that's good already, you may want to consider raising your dose.
vitamindcouncil.org/i-teste...
Retest after 3 months and once you've reached the recommended level then adjust dose to a maintenance level. Vit D should be tested once or twice (ideally) a year to check level.
It would be a good idea to take magnesium as this is needed for D3 to work.
I took Ferrous Sulphate on GP advice as my serum iron panel results showed low, it was 11.3 ref 11- 29, also TIBC Saturation was 17% ref 20 - 50 % , she said she thought it would help these levels, but they have never been checked again that I know of
OK, iron is complicated, I don't know how you raise serum iron without raising ferritin where iron tablets is concerned. Maybe your GP should be getting guidance on this and I would ask for levels to be checked.
Oh thank you, I will take more then and in Magnesium in too. The iron panel does seem complicated, I couldn’t understand why Ferritin was high but iron and Saturation levels were low. GP mentioned that Ferritin can be raised due to inflammation in the body, something like that anyway. I will ask about getting the full Iron panel getting checked again though. Thanks.
Yes, ferritin can be raised when there is inflammation or infection. If it stays raised perhaps your GP could investigate.
Yes, she should. I have been taking a lot of chest infections lately, seems to be every couple of months, I’ve had a chest x - ray, nothing showing up to give an explanation.
Did you do blood test only 8-12 hours after taking T3 and 24 hours after taking Levothyroxine
Add you still taking steroids?
How much was Levo reduced from, when T3 added?
Your current dose is 75mcg Levothyroxine plus split dose of 10mcg T3 plus 5mcg T3?
Yes, that is my current dose, Levothyroxine was reduced from 125mcg to 75 when T3 was added, it was 10 T3 at first in am with Levo, then after first results increased T3 by another 5 to be taken around 5pm. Yes I had Levo 75 and 10 T3 24 hours before and also T3 5mcg 13 hrs before. I am still taking 10mg of Prednisolone, I’ve to go down to 5mg next week, then taper it off .
Looks like another endo who reduced Levo too much then
I would agree with SeasideSusie and suggest you increase Levo to 100mcg and retest in 6-8 weeks
When I had T3 added my Levo was reduced by 25mcg. I found even that was too much. More on my profile
Thanks. Yes, I don’t think my Levo dose is enough, I feel far worse now since he started me on the T3, even though T3 was below range when he did add it in. I don’t see him until March, but in the letter I got from him in Jan, he said he was leaving me on same dose and I’d only to get my TSH tested at beginning of March. I don’t agree with that, but how do I argue with a consultant ?
clearly your results show under medicated
Email them to consultant and say you will be increasing Levothyroxine by 25mcg and retesting in 6 weeks
This is combined care, its as much your decision as theirs
That’s very true, they just seem to see you are in range so you are fine, whether you are right at the bottom of the range or not, surely they should listen to how you feel first, not just go by levels.
I don’t agree with that, but how do I argue with a consultant ?
Well, if it was me I'd increase the Levo by 25mcg now. You're not seeing him until March so you have a few weeks to see if the increase in Levo makes a difference. Get blood tests done just before your appointment, present him with a fait accompli - "I know you said to stay on the same dose but I felt so ill that I had a thyroid function test done and these are my results .............. and because my FT4 was so low I increased my Levo dose. I think it was the right thing to do because I have started to improve and my FT4 has increased to ..........." sort of thing.
But I'm a bit of a rebel after years of doctors keeping me ill.
Ha ha, I’m a coward. I might speak to my GP about it and ask her to email him to say about these private results looking as if I’m being undermedicated, or be a bit braver and phone his secretary to pass all this on and get him to phone me, I could probably do it better over the phone than face to face, lol. He never even asked how was feeling after last results, just sent the letter that I’ve already said about. Doesn’t sound great care when I read that back .
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