Help with blood test results please: OK, having a... - Thyroid UK

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Help with blood test results please

OK, having a full thyriodectomy for ThyCan on Monday - got my full bloods done before, so i could see what my pre normal looks like. Views please, as I have no idea how to interpret them. Thank you. (Not on meds at the mo and have been prescribed 100mg of liquid Levothyroxine from Mon onwards). I always thought i had Hypo symptoms, always cold, constipated, brittle hair, tired, but i am slim.

FORGOT TO ADD TP 63 range is <60

Free T3 3.94 3.1 - 6.8

Free T4 12.7 11.0 - 23.0

TSH 1.85 0.2 - 4.2

Magnesium 0.84 0.7 - 1.1

Calcium 2.35 2.20 - 2.6

phosphate 1.2 0.8 - 1.5

C reactive protein less than 1, 0 - 5

ferritin 16 12 - 233

serum folate 8.2 3.9 - 27.0

serum ferritin 16 12 - 233

B12 746 ng/L 180 - 639

Vit D 84 nmol/L no ranges on the sheet?

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We need reference ranges please to be able to interpret your results as they vary from lab to lab.

Your Ferritin would appear to be very low.

You haven't given a result for Vit D, and can you also give the unit of measurement for that please.

You can be slim and be Hypo.

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Thank you - I have now added in the ranges on the sheet. It is all still so new to me.

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Vit D 84 nmol/L no ranges on the sheet?

Vit D - 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].

Are you supplementing? If not then improving to the recommended level is advised but your level isn't too bad and may increase naturally during the summer months.

ferritin 16 12 - 233

This very low. I would ask your GP to do an iron panel and full blood count to see if you have anaemia.

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. A level as low as yours is not a DIY fix so I would ask your GP to consider iron supplementation. An iron infusion would raise your level within 24-48 hours but you may not get one as you aren't below range. Iron tablets will take many months to raise your level, but if you are prescribed them then take each tablet with 1000mg Vit C to aid absorption and help prevent constipation. If you are prescribed iron tablets, then they must be kept away from Levo by 4 hours, and any other medication and supplements by 2 hours as iron affects their absorption.

B12 746 ng/L 180 - 639

This is good.

serum folate 8.2 3.9 - 27.0

A bit low, recommended is at least half way through range so 15.5+ with that range. Include lots of folate rich foods in your diet, you could look at a good B Complex such as Igennus Super B or Thorne Basic B.

Calcium, magnesium, phosphate, CRP all within range.

Free T3 3.94 3.1 - 6.8

Free T4 12.7 11.0 - 23.0

TSH 1.85 0.2 - 4.2

These are euthyroid (nomal) although FT4 and FT3 on the low side.

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Wow... many many thanks for this feedback. I forgot to put down my TP which is 63 range is <60. It was 83 before they removed the side with the tumour in it.

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Your FT4/3 were very low. And your TSH didn't reflect that, so probably why you never got diagnosed. Doctors only tend to look at the TSH. Your ferritin is much too low, there. You'll probably need to do something about that in order to be well on thyroid hormone replacement. Folate is a little low. B12 is high - do you supplement that?

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No i don't supplement B12. I eat lots of nuts?? I do supplement D3. Have read high B12 can be a cancer marker?? So what does low T3 and T4 indicate? TSH high as i have thyCan.

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Your TSH wasn't high, it was low compared to your Frees. Low T3 and low T4 mean you're hypo - or you were. So, you don't want to base your future levels on that test, you would be most unwell.

Not sure there is any B12 in nuts. It's in meat and eggs, which is why vegetarians and vegans are usually low in B12.

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Many thanks for that. I read the symptoms list for hypo and it is me to a tee bar the weight gain. I have felt rotten for years now.... Is 100mg going to do the trick? Could it be that i actually feel better on the new meds post op?

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You don't have to have all the symptoms to qualify. There are over 300 of them! :)

It could be that you will feel better if you are optimally medicated. And, that's the problem, doctors usually give to little thyroid hormone replacement. With no thyroid, it's very unlikely 100 mcg will be enough for you. You should be retested after six weeks and your dose increased by 25 mcg. Whatever you do, do not allow them to dose you by the TSH, that is a recipe for disaster. You need the FT4 and - preferably - the FT3 tested every time, and your dose altered accordingly. The TSH is a very bad indicator of thyroid status.

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Thank you. I knew I would be doomed to feeling so ill... I can see it happening. I had to bend his arm and cry in his office to beg to get my T3 done this time. I told him it was my last chance to find out the real me.....to see if i had been hypo all this time and what's going on before it is all removed. He said he will test again in 4 weeks time. Is it worth me paying to speak to a functional doctor and see what he says? Do i need T3 too? I can contest the dose tomorrow before my surgery on Monday? HELP please. Thank you.

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Hello Pinktijen

Wishing you well for next week.

The idea in theory makes sense :- check out thyroid performance now pre op, so you have a measure to work towards after surgery : but considering your comments and these blood tests confirming your suspicions, you are not with optimum results to dose back to.

Just as a point of reference a fully functioning thyroid would be drip feeding you in a day, as required, approximately 100 T4 and 10 T3.

I truly believe that if one has had medical intervention and had their thyroid removed or ablated it is only sensible to replace both these vital hormones on the prescription.

Some people can get by on T4 alone, some people stop converting T4 into T3 and some people need both hormones independently dosed and monitored in order to have a level of wellness acceptable to them.

It is essential that you are monitored on both T3 and T4 readings and not just the TSH.

It is essential that you also get your vitamins and minerals optimal to support your body.

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Getting yourself stable on 100 mag Levo and getting vitamins optimal is first step

Getting FULL Thyroid and vitamin testing again say 8 weeks after starting on Levothyroxine

Always take Levo on empty stomach and then nothing apart from water for at least an hour after. Many take early morning, on waking, but it may be more convenient and possibly more effective taken at bedtime.

verywell.com/should-i-take-...

Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription. Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients

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 all vitamins

thyroiduk.org.uk/tuk/testin...

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

Come back with new test results and members can advise

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

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Those aren't results from when you were healthy and just show that you are hypo, but TSH is much lower than you'd expect with those hormone levels so might be a problem with pituitary or hypothalamus rather than thyroid itself. Don't know if cancer affects TSH. Ferritin and folate are way too low.

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Thank you. According to the docs my half thryiod is working just fine!!! No wonder i have feeling like utter rubbish for years.

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I can't Thank you all enough. I have my bottles of oral levo in my hands now ready for Monday. I am 5ft9 and 55kg, what dose would you all recommend? I have never taken it before. My Endo recoms 100mg t4 only.

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