Test results include lab concerns: help with Bloods interpretation please. Thanks!

[ChronicTonic]

Hi All,

I enclose my blood test results from Wednesday morning.

The results have flagged up the following, which I would appreciate help interpreting:

> TSH

> Lymphocyte Count

Frustratingly, there’s no T3 or FT3 - which my GP agreed I needed testing and meant to include. I normally check when the blood’s being taken, but I didn’t that day - so obviously they weren’t done. Argh!

> However, I’m pleased my ferritin levels have improved with the ferrous fumerate I’ve been taking, but am guessing my ferritin still needs more work?

> And what about the folate?

> Or the serum urea levels (what does that even mean?!)

> And is my low MCV corpuscular volume an issue?

These results are all the more relevant as I was admitted to hospital in an ambulance on Saturday with a temperature, body spasms and a blood pressure of 210/100.

This is very unlike me, as over the years I’ve suffered from very low blood pressure and have even been rushed to hospital in an ambulance twice due to it being exceedingly low to the point of losing consciousness.

Similarly, on top of all the weird Fibro and ME/ CFS symptoms I have, I’ve not been feeling right for a year or more now, since a 3 day fever - ie: a suspected attack of Transverse Myelitis (like polio crossed with MS) - left me semi-paralysed in my neck and shoulders and also from the waist down.

Since last year my legs have slowly become better, but I still suffer from muscle weakness in my legs and arms too. In fact, my health has really deteriorated - along with what feels like inflammation in my neck and lower skull, leftover from the Transverse Myelitis. The TM symptoms seem to fluctuate as much as my Fibro and ME symptoms

I’m currently waiting for a brain MRI scan result (as the spine MRI showed nothing particularly unusual), and from what the radiologist secretary let slip when I called the hospital, there’s nothing really showing.

However, this doesn’t really surprise me since I was OK the day of the brain MRI but had a huge Transverse Myelitis flare-up a few days later. Typical!

Either way the hospital couldn’t explain my crazy high blood pressure (especially for me!) - or me slipping in and out of consciousness at the weekend - or anything else I experienced. I ended up being discharged 12 hours later with no treatment or explanation for my episode. Again, typical!

Anyway. Any help with deciphering my blood test results from this week gratefully received.

Could I be overmedicating with T3? It didn’t cross my mind ‘til my recent post inspired some research - and interesting answers from you guys.

I don’t feel hyperthyroid, but I don’t feel great either. I put my muscle weakness and tingly physical symptoms down to the Transverse Myelitis, but maybe it’s also from me self-mismanaging my thyroid?

I have been on the following for a year: 75mcg levothyroxine in the morning and also 25mcg Liothyronine twice daily.

Thanks in advance for your input: I know it’s pretty useless looking at my results with T3 and RT3 unexpectedly missing, but any help at this stage gratefully received.

Cheers,

Abi.

[ChronicTonic]

Thanks ReallyFedUp my B12 result is the second down and doesn’t look bad actually:

416 guidelines (180 - 640)

What do you think?

No idea what could be blocking thyroid med absorption: I make sure I leave an hour before breakfast and a cuppa, and take my iron waaaaaay after my afternoon dose of T3.

Hmm....

[ChronicTonic]

Is anyone else able to add their tuppence here? I’m going to have to face my (already unimpressed at my self-medicating) GP after Easter, and need all the thyroid knowledge I can muster to defend my use of T3 *and* to know what to request in terms of T4 treatment?

SeasideSusie SlowDragon shaws sorry to single you out but I really need help deciphering the blood results I’ve received so far. Any input gratefully received - apart from anything I really don’t feel too well.

And as I said I’m feeling more than a little trepidation about my upcoming GP appointment. Especially as I still have to request a T3 and FT3 blood test from him (which I think he did try to include for me, but didn’t happen for some unknown reason).

Thanks for your time,

Abi.

[SeasideSusie Remembering in reply to ChronicTonic]

Abi

You can't really defend your use of T3 without proper testing of TSH, FT4 and FT3 done at the same time. It's not possible to really say what's going on. The T3 will be lowering your TSH and your FT4, but we need to see if your FT3 is in range. If your GP can't get get this done then you should consider doing what hundreds of us here who self source T3 do and that is private testing with Medichecks or Blue Horizon. It's essential to know when you are taking T3.

You may also need more Levo. I take a combination of Levo and self sourced T3 and I can't function with a low FT4, I need both FT4 and FT3 around 75% through range.

416ng/L (180 - 640) - ng/L is the same as pg/ml

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

If that was my result I would be wanting to improve it. I would even do an Active B12 test (Medichecks do a fingerprick test) to see what amount of B12 is available to be taken up by the cells.

[ChronicTonic in reply to SeasideSusie]

Thank you SeasideSusie for your response.

I have used medichecks in the past a few times, using their Thyroid Thursday sale day until I ran out of money.

I also then realised that if I just scribbled + T3 + FT3 on my blood test request like a forgetful GP, then the hospital phlebotomists (take a ticket, queue) who cover all the surgeries in the area would do these for me. I always get there first thing.

This time I had my bloods done at the surgery as I’ve been really unwell and wobbly, and could make an appointment with less hanging about - again first thing in the morning.

From your recommendations I will work on:

improving my B12 and Folate

Consider asking my GP for more T4 once my T3 FT3 results are in: I already suspected I might need more T4 so it’s interesting you should say this.

What is the benefit of the B12 prick test? Is it more accurate than the blood results, or does it show what’s/ not being absorbed?

Thank you so much for taking the time to reply: it’s hugely appreciated.

[SeasideSusie Remembering in reply to ChronicTonic]

What is the benefit of the B12 prick test? Is it more accurate than the blood results, or does it show what’s/ not being absorbed?

What you have had done already is a serum B12 test and that tests the total amount of B12. The Active B12 tests shows what is available to be taken up by the cells. You can have a good level of serum B12 but a low level of Active B12, a bit like Total T4 and Free T4 - total doesn't tell us what's available for the cells to use, only the Free test tells us that.

[ChronicTonic in reply to SeasideSusie]

Fantastic explanation. Thank you SeasideSusie for taking the time to explain to me x

[SlowDragon Administrator]

You need vitamin D tested

Obviously essential to test FT3

Personally I think your FT4 is too low. Many of us find we need good levels of FT4 as well as FT3

TSH is completely irrelevant on any dose of T3

How do you take your T3 ? Some can take once a day, others need it split 2 or 3 times per day

Twice per day - 12 hours gap

Three times per day at 8 hour gap

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose 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)

If/when also on T3, make sure to take last dose 8-12 hours prior to test

Is this how you do your tests?

Folate is far too low

B12 on the low side. Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

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. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).

Or Jarrow B-right is popular choice, but is large capsule

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

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

endocrinenews.endocrine.org...

Ferritin still not brilliant

[ChronicTonic in reply to SlowDragon]

Thanks SlowDragon Yes it’s how I do my blood tests: I always follow all the vitamin, mineral and medication intake recommendations you wonderful folk suggest on here - as I did in this instance - but it’s still very much worth repeating just in case we’ve missed something.

B vits I always take in the morning after breakfast, but I could take them more regularly every single day - as yourself and SeasideSusie recommend - rather than a few days a week at present. It’s just that good quality vitamins are so expensive! I’ll look into the B Vits you suggest: capsule size isn’t a problem.

I take my second 25mcg T3 about 10 hours later than my morning 25mcg T3 dose. Would those additional 2 hours (‘til a gap of 12 hours) make a difference?

Thanks again for your thoughts. As always!

[ChronicTonic in reply to ChronicTonic]

PS: Would you suggest Igennus Super B complex or Jarrow B-right for my current circumstances, please? Any preference?

Thanks again x

[SlowDragon Administrator in reply to ChronicTonic]

Personally I like Igennus

I only ever needed one per day, now successfully on T3 I have cut it back to just 1/2 tablet per day

I can only tolerate T3 as 3 doses per day. But if my FT4 was that low I would feel terrible

Getting TSH, FT4 and FT3 tested together is next step, before changing anything