Latest blood results

[Pinkberr42]

Hi. It's been a year since I was diagnosed with hashimotos following private blood tests. Here are my latest results but as you can see only the TSH has been tested. I've attached previous results, there's an obvious slope here, what does it mean? My ferretin is still low, are my other results all OK? I am self injecting B12 and vit D was good in previous test as I'm ongoing supplements. My last three periods were every two months and I'm experiencing a very sore tongue and dryness around my body following the end of the last period. Would really appreciate it if anyone could help me understand my results before I see the gp on Monday. Oh and I'm also on 50mg levo.

[Pinkberr42]

I don't know how to upload multiple images

[MaisieGray in reply to Pinkberr42]

Unfortunately only one image can be uploaded.

[Pinkberr42]

Basically my tsh was 4.82 April 2018, 2.87 October 2018 and now 1.67 May 2019.

[SeasideSusie Remembering]

Pinkberr42

My ferretin is still low

19.3 (30-400)

That's a very wide range, for females it's usually 13-150 or 13-300.

So, as it's below range, what's your GP doing about this?

Low ferritin can suggest iron deficiency anaemia. There are no red flags in your full blood count which would support this, but what about an iron panel? That should be done. We can have iron deficiency without it being anaemia, so we can have normal haemoglobin level and full blood count results but still have iron deficiency. So maybe discuss with your GP, maybe he should be contacting a haematologist or referring you.

Basically my tsh was 4.82 April 2018, 2.87 October 2018 and now 1.67 May 2019.

TSH alone is not enough to monitor hypothyroidism.

Were all these tests done under exactly the same conditions, i.e. early morning blood draw after an overnight fast, drinking water only until after the test, and leaving off Levo for 24 hours (12 hours for T3 and NDT)? That's the only way to accurately compare results.

As you have Hashi's, because of the natural fluctuations associated with it then you can expect your results to fluctuate (and symptoms).

[Pinkberr42 in reply to SeasideSusie]

Thank you for replying. Yes tests were done in similar conditions.

I will speak to my gp about checking my iron. I'm taking tablets at the moment but it's not moving up quite as quickly as I'd like it to.

[SeasideSusie Remembering in reply to Pinkberr42]

I'm taking tablets at the moment but it's not moving up quite as quickly as I'd like it to.

Tablets can take many months to make a difference. However, with a below range ferritin level I'd ask for an iron infusion, that will raise your ferritin level within 24-48 hours.

[SlowDragon Administrator]

50mcg Levothyroxine is only a starter dose

TSH over one is often too high for many people on Levothyroxine

You need FT3 and FT4 tested

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and fasting. This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

Last Levothyroxine dose should be 24 hours prior to test, (taking delayed dose immediately after blood draw).

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

Medichecks currently have an offer on until end of May - 20% off

thyroiduk.org.uk/index.html

Ferritin is absolutely terrible

Ask GP to do full iron panel test for Anaemia

Likely to need iron infusion. Referral to haematology perhaps

How many ferrous fumerate are you taking per day?

It doesn't seem to be improving levels

Iron infusion would give dramatic improvement

Are you on strictly gluten free diet?

Are you also taking a good quality daily vitamin B complex to support all B vitamins?

Important to have good folate too

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...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

NHS guidelines on Levothyroxine including that most patients need somewhere between 100mcg and 200mcg Levothyroxine. Also what foods to avoid (note recommended to avoid calcium rich foods at least four hours away from Levo)

nhs.uk/medicines/levothyrox...

just testing TSH is completely inadequate, essential to test FT3 and FT4

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH under one) and FT4 in top third of range and FT3 at least half way in range

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

NICE guidelines

cks.nice.org.uk/hypothyroid...

The initial recommended dose is:

For most people: 50–100 micrograms once daily, preferably taken at least 30 minutes before breakfast, caffeine-containing liquids (such as coffee or tea), or other drugs.

This should be adjusted in increments of 25–50 micrograms every 3–4 weeks according to response. The usual maintenance dose is 100–200 micrograms once daily.

[Pinkberr42 in reply to SlowDragon]

GP won't do a thing because haemoglobin levels are fine

[Pinkberr42]

I went to the GP who won't consider transfusion because my haemoglobin levels are fine. I'm thinking maybe I should go private?

[SlowDragon Administrator in reply to Pinkberr42]

OK iron is complex

Eating liver or liver pate once a week, plus other iron rich foods like black pudding, prawns, spinach, pumpkin seeds and dark chocolate, plus daily vitamin C can help improve iron absorption

FERRITIN and hypothyroidism

healthunlocked.com/thyroidu...

Post about iron supplements

healthunlocked.com/thyroidu...

First step is to test TsH , FT3 and FT4 privately

Just testing TSH is completely inadequate