I am currently taking 50mg of levothyroxine and my results are listed below. The question I ask is, am I undermedicated still or these results ok. Advice would be greatly received.
TSH 2.47 (0.27-4.20)mlU/L
T4 Total 85.9 (66-181) nmol/L
Free T4 15.10 (12.0-22.0) pmol/L
Free T3 5.91 (3.1-6.8) pmol/L
Ferritin 52.7 (13-150 )ug/L
Vit B12 344 CONSIDER REDUCING DOSE >569
Folate 19.20 (8.83-60.8) nmol/L
Vit D 66 nmol/LConsider reducing dose >175
Anti-Throidperoxide abs <9.0 <34 klU/L
Anti-Thyroglobulin <10 <115 KU/L
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kaz90
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The question I ask is, am I undermedicated still or these results ok.
We have to ask you a question - how do you feel with these results?
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.
Your TSH is higher than most treated hypo patients would need. Your FT4 is 31% through range which would be too low for most treated hypo patients on Levo only, your FT3 is 76% through range. It's most unusual to have such a high FT3 with such a low FT4 and high TSH for a treated hypo patient.
Are you taking any supplements?
Ferritin 52.7 (13-150 )ug/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.
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
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."
Active B12 is the better test as it shows what's available to be taken up by the cells. Serum B12 (which is the test you've had) just shows total B12.
Folate 19.20 (8.83-60.8) nmol/L
Folate is recommended to be at least half way through range, which would be 35+ with that range.
Vit D 66 nmol/L = 26.4ng/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 the recommended level from your current level the Vit D Council recommends supplementing with 3,700iu D3 daily (nearest s 4,000iu).
Retest after 3 months.
When 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.
Thank you for replying, sorry for my late reply I had some issues to deal with the last couple of weeks. I did my test stopping the levo 24 hours before test, fasting and early morning blood draw. I do take supplements, I know my ferritin is not the best but I am now taking a different iron supplement which has brought it up to the present figure of 52.7.
I will get my b12 looked at as it has never been tested as b12 active.
I take these supplements daily:
1 x vitamin D3 4000ui/100ug
1 x magnesium 375mg
1 x folic acid 400ug
1 x iron bisglycinate 50mg
1x vitamin C 200mg
1 x b12 7.5ug
I do feel much better than I did, I am very interested in your comment on my high FT3 and low FT4, high TSH. I have tried researching my scenario but haven't found anything to explain why this is, could you offer any ideas to this?
That amount of B12 is not worth taking, presumably it is in a multivitamin supplement? If so, what else is in the supplement?
As for the folic acid, you might be better off with a good B complex containing 400mcg methylfolate and a decent amount of methylcobalamin (B12) as well. However, if you are going to test B12 (Active or otherwise) then don't supplement with folic acid or a B Complex until afterwards.
A couple of decent brands of B Complex are Thorne Basic B and Igennus Super B, both contain the bioactive forms of ingredients.
When taking a B complex containing Biotin (B7) or Biotin as a stand alone supplement, it should be left off for 7 days before any blood test because if biotin is used in the testing procedure it can give false results.
For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also extremely important to test vitamin D, folate, ferritin and B12
Have you had vitamins and antibodies tested
Ask GP to test if not been done yet
Low vitamin levels are extremely common, especially if Thyroid antibodies are raised
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).
Is this how you do your tests?
Private tests are available. Thousands on here forced to do this as NHS often refuses to test FT3 or antibodies or all vitamins
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
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
Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine
(Many of us need TSH nearer 0.2 than 2.0 to feel well)
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Re-posting - thyroid & vitamin test results
First Blue Horizon Tests since starting NDT - Expertise needed please!
Test results 
Help needed please interpreting Thyroid plus ten results 
Help with blood results
