New here - pls can I have help with test results?

[Keto4Me]

B12 + FOLATE

Serum folate level 3.3 ug/L [3.0 - 20.0]

Serum vitamin B12 level 295 ng/L [180.0 - 640.0]

Serum ferritin level

Serum ferritin level 52 ug/L [15.0 - 200.0]

Serum TSH level

Serum TSH level 0.41 mu/L [0.35 - 4.94]

Serum vitamin D level

Serum vitamin D level 50.3 nmol/L

30-70 nmol/l Insufficiency

Thanks

[SeasideSusie Remembering]

I see from your other post that you are on 150mcg Levo.

We always advise here, when doing thyroid tests, we advise:

* Book the first appointment of the morning if test is with GP, or do as early as possible if doing a private test, test no later tghan 9am. This is because TSH is highest early morning and lowers throughout the day. If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.

* Fast overnight - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Eating may lower TSH, caffeine containing drinks affect TSH.

* If taking thyroid hormone replacement, leave off Levo for 24 hours before blood draw, if taking NDT or T3 then leave that off for 8-12 hours. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it will give false results (Medichecks definitely use Biotin, they have confirmed this and the amount of time to leave the supplement off).

These are patient to patient tips which we don't discuss with doctors or phlebotomists.

Serum TSH level 0.41 mu/L [0.35 - 4.94]

This is a good level for someone on Levo. However, TSH is not the whole picture, you also need FT4 and FT3 tested to see where your actual thyroid hormone levels lie. When on Levo only, the aim of a treated hypo patient generally is for TSH to be 1 or lower with FT4 and FT3 in the upper part of their ranges if that is where you feel well.

If not already done thyroid antibodies should be tested to see if you have autoimmune thyroid disease aka Hashimoto's. Your nutrient levels aren't particularly good and that is common with Hashimoto's.

Serum vitamin B12 level 295 ng/L [180.0 - 640.0] ng/L is the same as pg/nl

Although this is in range, it is low. 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."

Do you have any signs of B12 deficiency - check here

b12deficiency.info/signs-an...

If so then list any that you are experiencing to discuss with your doctor and ask for further testing for B12 deficiency/pernicious anaemia. Many people with B12 level in the 300s have been started on B12 injections, it's the symptoms that count rather than the number.

Serum folate level 3.3 ug/L [3.0 - 20.0]

This is very low, if it was 2.9 you'd technically be "folate deficient". Ideally, folate should be at least half way through it's range. It's worth discussing with your GP, you may be able to get folic acid prescribed. Do not start supplementing for this before further testing of B12 is carried out if necessary, folic acid supplements will mask signs of B12 deficiency. Folic acid should be started after B12 injections or supplementation.

Serum ferritin level 52 ug/L [15.0 - 200.0]

This is on the low side. It's said that for thyroid hormone to work properly (that's our own as well as replacement hormone) ferritin needs to be at least 70, preferably half way through range.

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...

Serum vitamin D level 50.3 nmol/L = 20.12ng/ml

As you can see this is in the Insufficiency category and you may not get anything prescribed. However, you will probably do better to buy your own supplements.

The Vit D Council recommends a level of 125nmol/L (50ng/ml) and the Vit D Society recommends a level of 100-150nmol/L (40-60ng/ml).

To reach the recommended level from your current level, the Vit D Council suggests supplementing with 3,700iu D3 daily (nearest is 4,000iu).

vitamindcouncil.org/i-teste...

Retest after 3 months.

When you have reached the recommended level then you'll need a maintenance dose to keep it there, 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:

vitamindtest.org.uk/

Good supplements are BetterYou oral spray (gives best absorption when Hashi's is present), sublingual drops, eg Vitabay Organics (also good when Hashi's present) or where no Hashi's is present then a good oil based softgel, eg Doctor's Best.

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).

So to sum up, you need to improve your nutrient levels and have TSH, FT4 and FT3 all tested at the same time, plus thyroid antibodies if not already tested and found to be positive.

[Keto4Me in reply to SeasideSusie]

Thank you SeasideSusie! An amazing reply and so much to digest. I really appreciate the time you've taken here (and with the numerous other posts from people you've replied to). I actually feel I may have taken my first step back to feeling "normal"!

I was going to get the following tests done privately: TSH, FT3, FT4, rT3, TGAb, TPOAb,

Vitamin B12 (active), Folate, Vitamin D, CRP-hs, Ferritin. Do you think that's a good start? And I will heed your advice re fasting, taking levo after and having bloods drawn as early as possible.

Thanks again. I actually feel a bit emotional!!

[SeasideSusie Remembering in reply to Keto4Me]

I really don't think it's worth testing rT3, it's expensive and really doesn't tell us much.

If your level came back high, you wont know what's causing it. There are many reasons for high rT3. It can be caused by excess T4 producing rT3 rather than FT3 but other causes of high reverse T3 include selenium or zinc deficiency, cortisol issues, stress, dieting, chronic illness, inadequate or low iron, chronic inflammation, high cortisol, or liver issues and any other chronic health issues. and probably several more things.

Conditions that contribute to increased Reverse T3 levels include: Chronic fatigue, Acute illness and injury, Chronic disease, Increased cortisol (stress), Low cortisol (adrenal fatigue), Low iron, Lyme disease, Chronic inflammation. Also selenium deficiency, excess physical, mental and environmental stresses. Also Beta-blocker long-term use such as propranolol, metoprolol, etc. Physical injury is a common cause of increased RT3, also illnesses like the flu. Starvation/severe calorie restriction is known to raise RT3. Diabetes when poorly treated is known to increase RT3. Lyme disease. Cirrhosis of the liver. Fatty liver disease. Any other liver stress Renal Failure. A fever of unknown cause. Detoxing of high heavy metals.

So save a bit of money (put it towards some supplements!), do the Medichecks UltraVit test - 20% off until the end of May with code TUK20 - or Blue Horizon Thyroid Check Plus Elelven (sorry, no code for that one), post results/ranges here and we can help