Hi came across this great site a few weeks ago & looking for some info/feedback on my test results please.
My GP carried out the standard thyroid test -returned normal. Still felt a bit “off” so paid for the rT3 test on Medichecks. Confused with the results & would appreciate someone breaking it down for me as I’m new to thyroid illnesses. Thank you so much
RH27
You have some problems here:
Vit D: 23.6nmol/L
This is Vit D deficiency. You should see your GP and show him this result.
NICE treatment summary for Vit D deficiency:
cks.nice.org.uk/vitamin-d-d...
"Treat for Vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 30 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU] given either as weekly or daily split doses, followed by lifelong maintenace treatment of about 800 IU a day. Higher doses of up to 2000IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders. Several treatment regims are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
Each Health Authority has their own guidelines but they will be very similar. Go and see your GP and ask that he treats you according to the local guidelines or this summary and prescribes the loading doses. Once these have been completed you will need a reduced amount (more than 800iu, which is what most GPs prescribe, so post your new result at the time for members to suggest a dose) to bring your level up to what's recommended by the Vit D Council - which is 100-150nmol/L - and then you'll need a maintenance dose which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Your doctor wont know, because they are not taught nutrition, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -
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).
Come back and say what your GP is going to do and how much D3 has been prescribed.
**
Ferritin: 28 (13-150)
This is low and for thyroid hormone to work (that's our own as well as replacement hormone) it's said that ferritin needs to be at least 70, preferably half way through range.
You can ask your GP to do a full blood count and iron panel to see if any anaemia is suggested. Come back and say what GP is going to do.
Iron is not something that's easy to self supplement as iron is complicated and an iron panel may show adequate serum iron, in which case supplementing with iron tablets wouldn't be the correct thing to do.
You can 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...
**
Active B12: 57 (37.5-188)
This is low. Anything below 70 indicates testing for B12 deficiency according to viapath.co.uk/our-tests/act...
You can check for signs of B12 deficiency here:
b12deficiency.info/signs-an...
If you have any, list them to discuss with your GP and ask for testing for B12 deficiency/pernicious anaemia. Do not supplement B12 or B Complex before further testing as this will mask signs of B12 defiency and skew results.
Come back and say what GP is going to do.
**
Folate: 5.72 (>3.89)
This is above the low limit but still on the low side. Not low enough for GP to do anything about it. You can supplement with a good B Complex containing 400mcg methylfolate but only after further testing for B12 deficiency/pernicious anaemia and B12 injections or supplementation started.
**
CRP is high, this may be due to inflammation somewhere, it is non-specific. I imagine Medichecks has commented on this.
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Reverse T3 and ratio
Don't worry about this. There are many reasons for high reverse T3 and the test can't tell us what that reason is, therefore the ratio doesn't have much meaning.
**
Your TSH, FT4 and FT3 results are euthyroid (normal). TSH is where one would expect to see it in a normal healthy person (below 2) although your FT4 is quite low in range. This could be because your vitamins and minerals are so poor, these need to be optimal for thyroid hormone to work. So optimising your nutrient levels is your first step, then have a look at the whole panel again in a few months' time.
Thank you so much for the detailed reply I am so grateful.
My issue is I have been to my GP numerous times who run standard bloods and always come back saying they are "normal". How do I get them to listen to me? I feel like I am not myself health wise & nobody can help. I am so tired, moody, depressed, gaining weight & feel like I'm in a constant hangover state.
Funnily enough 2 years ago my Vitamin B12 levels were low and was asked to repeat the blood test 2 weeks later but advised it was normal.
I am now worrying also about the CRP level being high as it can indicate increased inflammation and/or infection. How do I go about following this up with my GP? I get the impression they think I am a hypochondriac.
RH27
My issue is I have been to my GP numerous times who run standard bloods and always come back saying they are "normal"
From now on, any tests that are done (not just thyroid, but any), always ask at the reception desk for a print out of the results. Any that are out of range you can then make an appointment to discuss with your GP. Don't ask the GP for results, they don't like it and will fob you off, but it's always best to know yourself where your results lie within a range.
I am now worrying also about the CRP level being high as it can indicate increased inflammation and/or infection.
That can be as simple as a cold or a virus, and will pass. If test is repeated and it remains high then GP should look for the source of inflammation.
I get the impression they think I am a hypochondriac.
Don't worry about that, it's your health. If results are out of range there's a reason, that may be temporary, as with CRP, but as for your current B12 level, I've given you a link to signs and symptoms, have you checked it, do you have any - if so then list them and discuss with your GP.
As for ferritin, point out how wide the range is, your level is 11% through the range. If your level was 148 the you'd be 99% through the range. You would feel very different with a level of 148 than you would with a level of 28, yet they're both classed as "normal". Point this out, say you understand that low ferritin can sometimes suggest iron deficiency anaemia, so can you have a full blood count.
There is no denying that your Vit D level indicates deficiency.
Your GP is your partner in your health, not there to fob you off and ignore symptoms and dodgy test results.
Thank you again for the info/advice you are a great help.
I totally agree about the GP not fobbing people off but from experience if they tell me one thing, and I disagree and provide evidence to the contrary, they do not take kindly to it. I certainly have a lot of the B12 deficiency symptoms which I will ask my GP about.
Can I be a pest and also ask about the rT3 result ? The Dr's comments on my medichecks test stated this:-
"Your FT3/rT3 ratio is slightly low which could suggest that you are not getting sufficient free triiodothyronine (FT3) into your cells. Other conditions can cause difficulties converting thyroxine to T3 and cause rT3 to rise. These include COPD, liver disease, diabetes, heart failure and low calorie diets"
I don't honestly think anyone knows enough about rT3 ratio to give an accurate explanation. And so many things cause rT3, much more than Medichecks has listed, and yours is in range anyway. Testing rT3 is a bit of a red herring, the test can tell you if there is a problem but it can't tell you what has caused the problem - thyroid or otherwise, so there's not much point in testing really.
As for their comment
"Your FT3/rT3 ratio is slightly low which could suggest that you are not getting sufficient free triiodothyronine (FT3) into your cells."
Your FT4 is 25% through range and your FT3 is 42% through range, so your FT3 is actually better than your FT4 so you can see from those figures that there is a fair amount of FT3 available to get into your cells at the moment. I did mention that your FT4 was low and that optimising your nutrient levels - especially ferritin - may help increase your levels. As your FT4 increases it's likely that your FT3 will as well.
Presumably you are not on Levothyroxine?
If you are on Levothyroxine then dose needs increasing.
Thank you for replying SlowDragon. I am not on any meds at all - I had a standard Thyroid test carried out with my Dr which came back normal but proceeded to go ahead with the advanced test on Medichecks as I felt something wasn't quite right.
I totally sympathise for those suffering with thyroid conditions but strangely feel disappointed mine is "normal" as I was hoping I would have a diagnosis and could start treatment for it
Well actually you do have a diagnosis and can start treatment right away. You have vitamin and iron deficiencies. These are serious. Believe me, there are any number of people on here that would love to have your vitamin deficiencies but a normal thyroid because you can get your levels up much easier with these than with thyroid which is a lifetime hinderance. So do take the advice you have been given here. Address all the issues and retest in the 2-3 months suggested.
I struggle with ferritin and I hate liver, but I do love pate and black pudding so I eat those. You need to stick at it.
Thanks and I apologise if I offended anyone with my comment - please excuse my ignorance as this is all new & confusing to me.
I certainly am taking the great advice on board and will follow up with my GP
It didn't come across as offensive no. I just wanted to make the point that it's important. Many people just sort of dismiss vitamins and minerals.
Hi after all the great advice and printing off the links provided I visited my GP & showed him my active B12 results.
He agreed to test my bloods but when I mentioned the total serum B12 test not being as effective, he stated even if my active levels are low this should show up in the test. I do not understand how this would show a true reflection of my levels & feel disappointed with his response.
I showed him the Viapath info regarding the active test result being the best method of testing low B12 but to no avail, still going ahead with the total serum test.
Can anyone advise what I can say/show when my results come back as being in their "normal range"?
Please let me know if I should post in another forum?
Many thanks
The latest BMJ research document (summary only) is given below but, hopefully, GP will be able to access full document - behind a paywall. It confirms that, as there is no completely reliable test, the patient's history/symptoms are paramount and any neurological symptoms should be treated with injections 'every other day until no improvement' to avoid permanent damage :
pernicious-anaemia-society....
As it's generally so misunderstood by GPs and specialists who are not up to date with latest research, it's important to know that vitamin B12 is a primordial molecule we can't do without.
Two experts in the field, Sally Pacholok, "Could it Be B12?" and Dr Ch.... have been studying and treating patients with PA/B12 deficiency for years, both describing how under diagnosis is causing severe and permanent neurological/psychological damage if not treated early and adequately.
It can sometimes help to write to the surgery with detailed history/symptoms and latest research before requesting a trial of B12 injections and another appointment, taking someone close with you for extra support/witness.
Good luck RH27 and, above all, don't worry. If all else fails, many of us source B12 and self inject successfully.
Thank you Polaris that’s very kind of you to reply & with links & agree about bringing someone with me as I find it all a bit overwhelming trying to explain to my GP when I don’t know enough myself.
I posted on the Pernicious Anaemia forum about my follow up appointment with my GP & was advised my levels don’t show a B12 deficiency so I feel I’m back to square one & confused!
I'm so sorry RH27 - it is confusingly complex and doesn't follow the usual test based practice of medicine these days, which is just one reason why it's often misdiagnosed - ME/CFS, MS, Parkinson's, ALS/MND etc. with most of us having to research and become our own advocate.......
The third link above is to Tracey Whitty's B12def. website, which has many links to really helpful information on neurological symptoms and more research, films, videos, templates for writing, etc. - it will gradually become clearer......
Your active B12 appears low/borderline but, in any case, is not a completely reliable indicator, especially if you already have history/symptoms. I noticed that you'd already been tested B12 deficient before - surely a red flag which GP should have investigated further ?
Four in my family have Hashimoto's and PA (40% with thyroid disease go on to have PA and vice versa). We've all had difficulties around diagnosis as have many members of the PAS, including Martyn Hooper, the chairman, who tested at least twice for Intrinisic Factor, before finally diagnosed, by which time he had suffered permanent damage........
I imagine this is why the BMJ document states :
"Vitamin B12 deficiency is a common but serious condition
Clinical presentation may not be obvious thus leading to complex issues around diagnosis and treatment
There is no ideal test to define deficiency and therefore the clinical condition of patients is of the utmost importance."
Sally Pacholok and Martyn Hooper's books are also good sources of excellent information and advice written in layman's language.
Don't give up finding answers RH27 🙂🤞
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