Here are some recent blood results, can anyone have a look over before my next GP appt in a week?
Thyroid Peroxidase Antibody
4 iu/mL (range 0-24)
Serum TSH
2.33 miu/L (range 0.3-5.0)
Serum B12
279ng/L (range 170-730)
Serum Cortisol
215nmol/L (range unknown)
Serum 25-HO vit D3
28.0nmol/L (range 50-250)
As you can see I’m “normal” apart from vit d which I’ve got weekly supplements for.
I am still exhausted. Losing my memory. Experiencing more strange symptoms, like dizziness, poor balance and spacial awareness, headaches, stiff neck, loss of focus, feeling like I’m outside my own body, feeling a vibration/shaking of my head, trembling hands, I’m on sertraline for depression that hit me early this year. I just wish I could feel well. I’m 36 yr old mum to four kids, have a loving and supportive husband, and all I want is the energy to enjoy this time of my life.
Have other blood results too, but it’s not easy to keep typing them all out, I can post any you think are relevant.
Thank you xxx
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samimanf83
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They may be in the so-called 'normal' range, but that does not make them normal for you. Your TSH says that your thyroid is struggling a bit, but it's not a reliable test on its own. You need the FT4 and FT3 to see what's really going on.
Your B12 is too low, and low B12 can cause hypo-like symptoms. So, your really need to raise that a bit. Low B12 is probably responsible for your dizziness and poor balance and spacial awareness.
Your vit D is also much too low, and could be causing all sorts of aches and pains.
You really need your folate and ferritin tested, too.
Thank you for your reply. I did get T3 &T4 bloods but no results yet in my records, bloods done 16 May. But it was hand written on my printed blood form by nurse. Also got these results done:
Folate 5.7 (range 3-19)
Ferritin 124 (range 10-291)
I’m halfway into a 7 week loading dose of vit d, so far not feeling any benefit but I’ll be on standard vit d all the time after this is complete.
Just not sure how I sit and tell my GP I may be in a normal range bracket but I’m far from right!
Sorry, are you already on thyroid hormone replacement - levo, or whatever? If so, your TSH is too high. The aim of taking levo is to bring it down to 1 or under, so you are under-medicated. Obviously your doctor doesn't know that. Maybe, if you get FT4/3 results, they will bear this out by being too low. The trouble is, of course, doctors don't really know how to interpret blood test results for thyroid. I'm not sure how you would explain that to your doctor. I just used to say something like 'I feel almost well on this dose, but I think I would feel even better with an increase'. It's difficult to know what to say without actually knowing the doctor himself, and how he's likely to react.
Well, that's little more than a starter dose, and should have been increased six weeks after you started taking it. You shouldn't have been left on it for 5 years! Your doctor is ignorant and negligent.
It was 50mcg when diagnosed in sept, by Dec the retested my bloods, value was just over 5, so it went up to 75mcg. I have been back to the doctor many times, and always because my bloods are neatly in range they leave my dose the same, despite the fact I have so many symptoms as though I’m not being treated. Recently I had to move surgeries so I’m trying my luck with a new doctor. Met him in early May, he seemed to listen to me, but all I’ve seen back are blood results on my health app so I’ve booked back to see him next thur. I’m going to have to write down all that I am experiencing because when I get in the room my mind is blank. I think it’s just awful this condition is not better supported. All I know is some bloods were out of range, got told hypothyroid and put on levo. Why? No idea. How? No idea. Ever seen an endo...only once when I was pregnant and he did not change anything either and discharged me saying my pregnancy would not affect my thyroid.
OK, so I imagine you now understand why you're probably better off without an endo! They know next to nothing about thyroid. And, very, very few doctors know anything about symptoms. They just don't learn about them in med school. So, they tend to ignore them, or attribute them to 'something else'. They are taught to just look at the TSH.
Unless people have positive antibodies, they rarely find out why they are hypo. And even if you do have positive antibodies, so you know it's Hashi's making you hypo, it's rare to find out what caused the Hashi's. Even if the doctors were willing, there's no real way to find out. But, you should have your antibodies tested to know if you have Hashi's, because it's important to know that much.
This is too high for a treated hypo patient and you need an increase in your dose of Levo. You also need FT4 and FT3 tested.
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.
Serum B12 279ng/L (range 170-730)
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."
An Active B12 test will tell you how much B12 is available to be taken up by the cells (the serum B12 tests the total amount of b12), but still doesn't tell you what is in the cells, only what is in the blood. If you want to do an Active B12 test then you can do a fingerprick test with Medichecks.
If you have any you should discuss with your GP, they are supposed to go by symptoms rather than numbers. If you do an Active B12 test and it is below 70 that suggests testing for B12 deficiency.
Folate and B12 work together, so you should have folate tested.
Serum 25-HO vit D3 28.0nmol/L (range 50-250)
What exactly have you been prescribed for this?
You should also have Ferritin tested.
Sorry, I can't help with cortisol unless it's a saliva test.
Thank you for your reply as well. I did get T3 &T4 bloods but no results yet in my records, bloods done 16 May. I’m ok HUX D3 20,000 unit 2weekly for 7 weeks (taken for 2 weeks so far)
Folate 5.7 (range 3-19)
Ferritin 124 (range 10-291)
What happens with medicheks, can you present their findings to the GP for consideration?
I don’t really understand the cortisol, doctor requested it, but then it just comes back with a value and no range, so how does it relate?!
I’m ok HUX D3 20,000 unit 2weekly for 7 weeks (taken for 2 weeks so far)
So your loading doses will total 280,000iu which is about the norm. After that I expect your GP may prescribe just 800iu. That is unlikely to be enough. Doctors have little to no training in nutrients so they are happy to just see something within the reference range or just follow guidelines.
However, it is vitally important to know your level after the loading doses have finished so that you know what dose to continue with. You GP may not retest and if that is the case then I would do it yourself privately.
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).
Once you know your new level after the loading doses have finished, you can then visit the Vit D Council's website and work out how much you should take to reach their recommended level (or I can do it for you)
Once you've reached the recommended dose 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:
Your GP won't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3 as recommended by the Vit D Council -
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).
Folate 5.7 (range 3-19)
This is in range so wont be a problem for your GP. However, we Hypos need optimal nutrient levels and it's recommended for Folate to be at least half way through it's range, which would be 11+ with that range.
I wouldn't recommend doing anything about your folate level at this stage until you have cleared up about your low B12. Taking something to raise your folate (eg methylfolate or a B Complex) will mask signs of B12 deficiency, so you need to sort out your B12 first as mentioned above.
Ferritin is OK, I've seen it said that 100-130 is a good level for females and 150 is a good level for males.
What happens with medicheks, can you present their findings to the GP for consideration?
Some doctors will accept Medichecks results, some wont. If you mean about the Active B12, this is a test that isn't normally offered by the NHS so your GP probably wont be on board with that anyway. You would have to go by whether you have any symptoms of B12 deficiency if you want to get anywhere with your doctor, unless your Active B12 comes back less than 70 then we have a link to what St Thomas' Hospital says about further testing which you could use.
I don’t really understand the cortisol, doctor requested it, but then it just comes back with a value and no range, so how does it relate?!
Cortisol is produced by the adrenal glands, and the adrenals are part of the endocrine system so we need adrenals to function well or it can affect the thyroid. I don't know why your GP did the cortisol test, mine has never been done by my GP and I was diagnosed hypothyroid 44 years ago. But as I say, I don't know anything about serum cortisol results, only saliva test results, so you can either put up a new post asking what your result means (which is probably the better option and you'd get more information here) or you could ask your GP.
Thanks again, really helpful before I go back to see him next week. In our area, after finishing the loading dose you are told to purchased OTC vit d supplements. Would I need to check with my chemist to make sure I get sufficient dose? I’ve had a loading dose before last year and used multivitamins because I didn’t really understand its importance, would like to make the effort now as I feel so unwell.
Being told to purchase your own supplement after loading doses is common. Doctors are really only obliged to get you out of the deficiency category.
So it's important to retest after the loading doses and if your GP won't do it then do a private one - £29 with the company I linked to, it's just an easy blood spot fingerprick test.
Once you have your new level then post on here again, tag me if you want, and I will work out the dose you need next and suggest a good brand. Better brands tend to be sourced on the Internet, my pharmacy tends to sell cheap own brands.
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