Medicheck results in. Now what?

[Kandahar]

No meds for 24 hours and blood taken fasting at 9am. Had been on t4 100 and t3 3x 5mcg over day, starting at 7.30am with t4 and 5mcg.

TSH 0.017 (0.27 - 42), Free t3 5.26 (3.11–6.8), free t4 15.3 (12-22).

Serum folate 16.81 (-3.9)

Active B12 152 (37.5-188)

Vit D 60.3 (50-175)

Ferritin 220 (13-150)

Mcheck says need to see GP re: dangerously high ferritin and to reduce if taking iron. I'm not!

Re: thyroid, think will reduce t4 to 75mcg until see endo. What do people think? Have been hyped up and angry and some fast heart beating. But pleased to have lost about 5lb of 2st 5lb gAined over time on Levo - about 12 years. But also developed osteoporosis after having had bones 20%. higher than others my age.

Working life spent stressed as journalist and editor meeting print deadlines and last 13 years coping with husband becoming increasingly mentally and physically wheelchair-bound. Wonder if adrenal system is shot due to this. Having adrenal check soon. What this space. Would really love some views please!

[SeasideSusie Remembering]

"No meds for 24 hours"

Did you leave T3 off for 24 hours as well as Levo?

If so then your have a false low FT3 result, the last dose of T3 should be 8-12 hours before blood draw. If this is the case then your FT3 will be higher in range, maybe even over range, and this may be causing you to be hyped up, etc. Rather than lowering your dose of Levo, which will lower your FT4 (it's currently only 33% through it's range) and possibly take it too low, a reduction in dose of T3 might be the answer.

[Kandahar in reply to SeasideSusie]

Thanks for comments Susie. Trust me to get it wrong. However, because I hadn't felt well until had t3, I’d be reluctant to reduce it. And the Levo hasn’t ever helped me.

What would your thoughts be about the adrenals, please?

[SeasideSusie Remembering in reply to Kandahar]

Stress can affect adrenals so if you're doing a private test go for one that tests cortisol plus DHEA, Regenerus or Genova Diagnostics include both, Medichecks and Blue Horizon don't, details on how to order are on ThyroidUK's main website under Private Testing.

[JumpJiving]

I am curious about the normal range shown for your ferritin result. I had a Medichecks test done less than a month ago, and mine shows a completely different range to the one that you have shown.

As for how to bring your ferritin back within range - if you go to my.medichecks.com/results/view and expand out the "Learn More" section under ferritin, it will give you some general things to do. Typically that means reducing iron in your diet, not taking iron supplements (I know you said that you are not, but check any multi-vitamins etc as well), not taking vitamin C with iron-rich foods etc. However, you should see your GP, and I suspect after more tests your GP, if your result is still high, may refer you to haematology, who may then arrange for venesections (basically another form of having blood taken).

[SeasideSusie Remembering in reply to JumpJiving]

I have done a few iron deficiency checks with Medichecks which includes ferritin, the range 13-150 is always quoted. Maybe it's related to age - I'm post menopause. And I believe the range for males goes higher.

[JumpJiving in reply to SeasideSusie]

Thanks SeasideSusie . For me (male in 50's) it shows 30 - 400 for the range. Hadn't occurred to me that the range would vary based on gender

[Kandahar in reply to JumpJiving]

I’m like SUSIE - that’s to say 74 in my case! Interesting that we all work to different levels.

[Kandahar in reply to JumpJiving]

Than, but. I’ve read that, but I always want to know more!

[MaisieGray]

Did they actually use the phrase "dangerously high levels of ferritin"? In a paper entitied Management of Elevated Serum Fertitin Levels, the author wrote

Q. At what point should patients be treated for elevated ferritin levels? What are the usual treatment options?

A. This raises an important question regarding the appropriate normal range for serum ferritin levels. Many laboratories consider serum ferritin levels greater than 200 ng/mL in women and greater than 300 ng/mL in men to be abnormal. However, a large percentage of the general population has a serum ferritin level between 200 and 1,000 ng/mL. This may be related to the epidemic of obesity and fatty liver, which may elevate ferritin levels on the basis of inflammation rather than iron overload.

So levels greater than 200 ng/mL are considered abnormal, but commonly abnormal; with no reference to "dangerous". The author wrote that in patients with mild elevations of ferritin, observation alone might be appropriate; with a level of 1,000 ng/mL being the point at which a liver biopsy might be considered. So I don't think you need to think in terms of dangerous at this stage.

[Kandahar in reply to MaisieGray]

No, Maisie, now I’ve reread. But someone did in an earlier post. Before that I wasn’t aware of an relevance of higher levels. Of ferritin, and neither does my GP apparently!

[Elainemawby]

You would need to have your serum iron checked (preferably 4 point iron test) before taking any action on iron in your diet. Ferritin can be elevated due to infection or inflammation with normal iron levels.

[Mozzymoo22]

High ferritin can be due to inflammation.

[beh1]

I agree with MaisieGray re ferritin levels. Mine were similar a couple of years ago, and doctor said he wasn’t concerned, but if it got above 1000 he’d take action. In the event, I found out that by giving blood regularly I can keep my ferritin levels in range. High levels could be inflammation (although my crp is always low), or maybe genetic, and no bleeding if menopausal!

[Kandahar in reply to beh1]

Yes, used to give blood but they don’t want it now that I’m over 70. Ridiculous when they need blood!

[Kandahar]

Interesting! Think it’s my brain that’s inflamed!

[shaws]

Your doctor may not like your very low TSH but both your Frees are good. I wouldn't adjust dose if you're feeling well. TSH is from the pituitary gland and not the thyroid gland, and it rises when we're lacking thyroid hormones.

thyroiduk.org.uk/tuk/thyroi...

If our TSH is very low some professionals seem to believe (wrongly) that we've become hyPERthyroid but that's not the case if thyroid hormones are good.

[Kandahar]

But I have been rather aggressive and heart racing. But otherwise better than for years with t3. Because that has been done by t3. So would prefer to reduce Levo to 75 from 100 and see how I feel. Although now starting to feel lethargic again (before reducing Levo). Views very gratefully received!

[Tilleg]

Hi there, I’ve just read your post & noticed that you are on exactly the same dose of T3 & T4 as myself. I too started experiencing some of the awful symptoms like yourself. I rang my endo’s receptionist as she said that he advised me to drop one of the T3 doses from 3 to 2 per day. I did feel reluctant to do this however as soon as I did the palpitations and extreme anxiety eased as did the nausea and several other horrible symptoms. I’m still taking my 100 levo along with T3 twice a day and now find I’m also sleeping much better too. Everyone is different but I just wanted to share with you that’s what worked for me. Hope you are feeling better soon, take care x

[Kandahar]

Dear Susie

Rather late in the day but going for latest blood test at GP’s in morning and rereading the above. Had bit of hiccup in June when spent week in Portugal without t3 by mistake. Hit me following week and had to recover!

Currently on 30mcg in three doses starting at 7.30am when also have 25mcg of Levothyroxine. Was feeling good but not so much now and put back on 5lb.

Is this usual? And I suppose I’m asking what do I do next? After the results of test, of course?

Finding hard to speak to endo and not sure if he has endorsed upping t3 until feel better, as suggested here. He’s happy to continue writing prescriptions for me to use and to see me if vital, but has referred me back to gp for ‘shared care’. Will ask gp about this when get results. Gp is also writing prescriptions, so OK in that respect...