Can someone please help me with the above test results. The presentation of the results above are rather muddled and limited (not an complete copy of the results I received).....!!! I am not very good with technology had to cut and paste the complete page of the lab results hence this is the way it turned out. Some data is missing such as NORMAL RANGE, UNITS but the important info, TEST and PATIENT RESULT are okay. Do hope what data is there is adequate.
Brief history: thyroidectomy due to cancer 1992. Since then levothyrozine medication. present dose 100mcg. Age 67.
My main reason for getting thyroid blood test via blue horizon was to try and get a bit more information about how my TSH levels are etc with a view to taking a natural dessicated hormone. Sad to say looking a results is quite mind boggling to me.
Any help would be much appreciated.
Thank you
Written by
dragon51
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It's easier for responders to read if you do a quick edit and space out the copy/paste results like this
HbA1c-(IFCC): 38 (20 - 42mmol/mol)
A healthy person without diabetes should have HbA1c less than 42 mmol/mol, so this appears to be OK.
hs-CRP: 1.16 (<5.0mg/L)
This is an inflammation marker and is low so is OK.
Ferritin: 72.8 (13 - 150ug/L)
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. Yours is at this level so it's OK but I'd make sure you eat iron rich foods to maintain the level apjcn.nhri.org.tw/server/in...
Magnesium: 0.86 (0.66 - 0.99mmol/L)
It's said that serum magnesium is an unreliable test
I don't know about this test but it appears to be well within the range.
TSH: 0.32 (0.27 - 4.20mIU/L)
T4 Total: 137.0 (66 - 181nmol/L)
Free T4: H 22.20 (12.0 - 22.0pmol/L)
Free T3: 5.35 (3.1 - 6.8pmol/L)
Taking 100mcg Levo
Your FT4 is top of range and your FT3 is 61% through range. TSH is where one would expect to see it when taking enough Levo to give these results.
Reverse T3*: 18.0 (10 - 24ng/dL)
Reverse T3 ratio: 19.35 (Normal >15Ratio)
These are within range but this test isn't all that useful because if your reverse T3 was high it doesn't tell you why it's high and there are many, many reasons for high rT3 that aren't connected with the thyroid.
Anti-Thyroidperoxidase abs: <9.0 (<34kIU/L)
Anti-Thyroglobulin Abs: 11 (<115kU/L)
Antibodies are low, no suggestion of autoimmune thyroid disease (Hashimoto's) with these results.
Vitamin D (25 OH): 81nmol/L= 32.4ng/ml
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 that level from your current level, the Vit D Council suggests supplementing with 2,500iu D3 daily
As you don't have Hashi's a good softgel such as Doctor's Best will be a good choice. It's a good supplement at a reasonable price. Check out Dolphin Fitness for best price.
Once you've 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:
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.
Check out the other cofactors too (some of which can be obtained from food).
Vitamin B12Deficient <145pmol/LNew range
Insufficient 145 - 300
L6.84Consider reducing dose >569
I can't actually see a B12 result in there, just the categories and ranges. Can you please check and add the result.
Serum Folate8.83 - 60.8nmol/L
Again, there seems to be only the range and no result, can you please add the result.
Cortisol (Saliva)
Unfortunately, Blue Horizon (and Medichecks) don't do the all important DHEA test along with the cortisol test so half the picture is missing. They also have ridiculous ranges for afternoon/bedtime samples that start at zero. If anyone did actually have a level of zero I expect they'd be very unwell, so I find it hard to take those ranges seriously. Regenerus and Genova Diagnostics offer a much better adrenal saliva test, details on ThyroidUK's website.
Optimal levels for cortisol are:
• Morning at the top of the range
• Noon approximately 75% of the range
• Evening close to 50% of the range
• Nighttime at the bottom of the range
Your levels are:
Waking: 15.40 (6.0 - 21.0nmol/L) = 63% through range, a little low.
12:00: 4.60 (1.5 - 7.6nmol/L) = 51% through range, a little low.
14:00: H 6.05 (0 - 5.5nmol/L) = over range
16:00: H 6.04 (0 - 5.5nmol/L) =over range
18:00: 3.84 (0 - 4.5nmol/L) = 85% through range
Before Bed: H 2.43 (0 - 2.0nmol/L) = over range
You have a mixture of low in the morning/noon and high for the rest of the day. I don't know how this is addressed.
My main reason for getting thyroid blood test via blue horizon was to try and get a bit more information about how my TSH levels are etc with a view to taking a natural dessicated hormone.
Why do you want to change over to NDT?
If you can provide the B12 and folate results that will help with your nutrient picture.
Your T4 to T3 conversion could be a bit better, supplementing with selenium and zinc can help there (you might want to test first, especially as zinc and copper should be balanced) and optimal nutrient levels helps too.
Hi Susie thank you for such informative and helpful advice. Fully intend to follow your suggestions. So grateful!!!!
Here is the missing bits of report: B12 result H 618
FOLATE: L 6.84
Would like to convert to NDH due to feeling quite depressed, lethagic and fatigued. Worse still is the persistent brain fog that appeared about 6 weeks after thyroid surgery. My mental cognition has never been the same since then. Furthermore, over time I seem to have hypothyroid symptoms or hyperthyroid ones. Seems to fluctuate.....! According to the doctor,s accompanying analyse with the lab results he/she says I am borderline hyperthyroid!!!
Its a work in progress so I going to get supplements to suggested and monitor any changes. If all goes well I maynot need to convert to using NDH
So this is folate deficiency. You should see your GP about this and should really be prescribed folic acid. Not everyone gets on with folic acid and need the converted form - methylfolate - which you may not be able to get on prescription.
Folate is B9 and helps produce red blood cells. We don't store B9 and need to keep topping it up with folate rich foods (or a supplement). Signs of deficiency include
This is a good serum level as 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."
However, this test measures total B12. You can have a good total B12 result but a poor Active B12 result when that is tested. Active B12 is what is available to be taken up by the cells, it is the preferred test but the NHS doesn't normally do it. If this was me, due to the folate deficiency, I would do a private Active B12 test with Medichecks
Normally £39 but until the end of May using code TUK20 gives 20% discount, thereafter code THYROIDUK gives 10% discount on any test not on special offer. If the result comes back less than 70 then this suggests testing for B12 deficiency. It is, of course, your choice if you want to do this. Don't take anything yet for the folate deficiency if you are considering the Active B12 test as it masks signs of B12 deficiency. Folic acid/folate is started after any B12 injections or supplements.
Furthermore, over time I seem to have hypothyroid symptoms or hyperthyroid ones. Seems to fluctuate.....!
This is indicative of Hashimoto's. Although your antibodies are very low, you can have Hashi's without raised antibodies.
According to the doctor,s accompanying analyse with the lab results he/she says I am borderline hyperthyroid!!!
That's simply because your TSH is low and your FT4 is over range. That is not hyperthyroidism - impossible when you're hypothyroid - but it can be a sign of overmedication. Did you give details of your condition to Blue Horizon? My understanding is when thyroid cancer has been present then it's usual to keep TSH suppressed.
I would hang fire on doing anything about NDT at the moment, your nutrient levels need sorting out, you can try to improve your conversion of T4 to T3 as mentioned above. Once your nutrient levels are optimal I would reassess and go from there.
I am not medically trained, my response is based on my own experience, reading and research.
Hi I so appreciate your help. Would be lost without it. Yes you are not a doctor but your information is much more valuable to me because it is gives me information that I understand and can work with considering my limited comprehension. How you explain things in simple terms takes away the feeling of being "blinded by science"!!! Will remain eternally grateful!!!
So out of my muddled mind I now have a plan based on your suggestions.
First: Getting active B12 blood test done via medicheck then taking it from there.
Could you please advise me regarding preparation for this test ie vitamins I am taking now, magnesium, b12 and D3. Should I stop taking these vitamins because I was not taking them when I got the initial blood tests with Blue Horizon which you have been helping me with? Can these vitamins distort the Active B12 blood test in any way?
Furthermore have ordered selenium and zinc supplements. Is it best to hold back on taking these until after Active B12 blood test is done?
Regarding folate deficiency issue: Is it ok to buy these online...converted form METHYLFOLATE?
Sorry for bombarding you with these questions. Once again sincere thanks Susie.
Could you please advise me regarding preparation for this test ie vitamins I am taking now, magnesium, b12 and D3.
Leave off the B12 for 7 days before doing the Active B12 test. Medichecks should advise you of this when sending the kit.
Any other vitamins, just take after the test on the day.
Furthermore have ordered selenium and zinc supplements
Hopefully you've ordered selenium l-selenomethionine or a yeast bound selenium and not selenite or selenate. As for zinc, I mentioned that zinc and copper should be balanced. It might be an idea to test first.
Regarding folate deficiency issue: Is it ok to buy these online...converted form METHYLFOLATE?
You could, but you have folate deficiency and I really think your first step should be to discuss this with your GP. He may wish to do further investigation, he may just prescribe folic acid. You could try the folic acid, it's fine for many people and if it's prescribed you wont have to pay for them. If the folic acid doesn't suit then you could look into a good quality methylfolate supplement, or even a good B Complex if you need to supplement B12 as well. You can always ask for suggestions for good quality supplements.
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