HELP with test results 🙏🏾💜

[Piggyoink]

Hi everyone! I would be very grateful for your advice on the below. The following are bloods after 6 weeks on 15mcg Liothyronine and 50mcg levothyroxine in the morning, then a further 5mcg liothyronine in the afternoon. I knew I wasn’t on the right dose but here I am ‘playing the bloods game’ with my GP so that he can see where I am and continue to prescribe necessary meds. There are quite a few below range blood related markers.. he’s offered no diagnostics/ solution other than to increase Levo by 25mcg but I’m also going to take an extra 5mcg liothironine as I think I need to go a little higher. I’m pretty lethargic, light headed and blood pressure pretty low. Any advice or suggestions would be very welcomed. Wishing you all improved health 💜🙏🏾

Serum FT4: 9.4 ( 10-20) low

Serum TSH: 0.11 ( 0.5-4.4) low

Serum FT3: 4.6 ( 3.5-6.5)

Serum thyroid peroxidase antibody: 28 ( 0-60)

Serum B12: 727 (190- 800)

Serum Folate: 20.7 ( 3-17) over range

Serum Ferritin: 81 (12-300)

Vit D: 219 (50-200) over range

Haemoglobin concentration: 113 ( 115-165) low

Total white blood count. 4.54 ( 4-11)

Platelet count: 216 ( 150-450)

Red blood cell count: 3.69 ( 3.8- 5.8) low

Haematocrit 0.35 ( 0.37-0.47) low

Neutrophil count: 1.48 ( 2-7.5) low

Lymphocyte count: 2.50 ( 1-4)

Monocyte count: 0.38 ( 0.1-1.5)

Eosinophil count: 0.15 ( 0.04- 0.4)

Basophils count: 0.03 (<0.15)

Blood film microscopy: mild neutropenia? Viral? Ethnic? Drugs? (These were the comments on the results!)

BONE PROFILE:

Serum alkaline phosphate level: 36 ( 40-130) low

Serum inorganic phosphate level: 1.08 (0.8-1.45)

Serum albumin level: 43 (35-52)

Calcium adjusted level: 2.29 (2.2-2.6)

IMMUNOGLOBULIN LEVELS:

Serum total protein level: 66 (60-80)

Serum albumin level: 43 (35-52)

Immunoglobulin G level: 10.9 (5.3-16.5)

Immunoglobulin A level: 2 (0.7-4)

Immunoglobulin M level: 1.7 (0.5-1.9)

Protein electrophoresis - no serum paraprotein detected

[SeasideSusie Remembering]

Piggyoink

Serum FT4: 9.4 ( 10-20) low

Serum TSH: 0.11 ( 0.5-4.4) low

Serum FT3: 4.6 ( 3.5-6.5)

he’s offered no diagnostics/ solution other than to increase Levo by 25mcg but I’m also going to take an extra 5mcg liothironine as I think I need to go a little higher.

I would only change one at a time.

We all have individual needs of where our levels are best for us when taking a combination of Levo and T3. I couldn't possibly function with a low FT4, yet others can. But if you change both together you wont know which you are benefitting from.

If those were my results, I would increase Levo now, that may increase your FT3 as well as FT4, depending on how much natural conversion you have. Retest in 6-8 weeks. See what difference it has made then decide on your next step.

It took me many, many months of tweaking doses to discover my optimal doses.

What supplements are you taking?

Serum B12: 727 (190- 800)

This is fine.

Serum Folate: 20.7 ( 3-17) over range

I wouldn't worry about this, high folate is apparently OK when B12 is high.

If you are supplementing B12/B Complex it may require adjustment because you could be wasting money.

Serum Ferritin: 81 (12-300)

This is OK. I've seen it said 100-130 is a good level for females, so eating liver occasionally will maintain, maybe even slightly increase, your level, or black pudding, liver pate, etc.

Vit D: 219 (50-200) over range

This is very surprising considering your level was 81nmol/L 2 months ago.

If you are supplementing then stop, you are heading into toxicity territory. Retest in 3 months. The recommended level is 100-150nmol/L, but over 200 is too high. Excess Vit D is stored, it's a fat soluble vitamin and can't be excreted like a water soluble vitamin.

Haemoglobin concentration: 113 ( 115-165) low

Red blood cell count: 3.69 ( 3.8- 5.8) low

Haematocrit 0.35 ( 0.37-0.47) low

Even though your ferritin is OK, these can suggest anaemia and you should discuss with your GP.

[Piggyoink in reply to SeasideSusie]

Thank you so much SeasideSusie super helpful. I have conversion issues so unlikely that by taking thyroxine it will have any significant effect on T3...and genetic issues with regards to Vit D so I need to reduce my supplementation, I think I got abit carried away! Other supps I’m taking are Vit A & D3, Zinc, curcumin, magnesium, active b12 &l-5-mthf, liver nutrients. Other than that really good gluten free diet, back to being sporty after barely being able to get out of bed last year and good rest/ little stress living. Not sure why anaemic though? 🙏🏾

[SeasideSusie Remembering in reply to Piggyoink]

I have conversion issues so unlikely that by taking thyroxine it will have any significant effect on T3

I also have poor conversion but I find that adjusting Levo does make a difference to both FT4 and FT3 so I still have some natural conversion. And some of us do need a decent level of FT4 as well as FT3 to feel well. I need both at around 75% through range, SlowDragon is similar to me too. You may find that you need an in-range FT4.

Not sure why anaemic though?

Those results suggest it, not necessarily confirm it, which is why you should discuss with your GP. Any out of range result should be investigated.

active b12 &l-5-mthf

You could cut back on these as your folate is over range and B12 high in range. In fact a good B Complex a few times a week is probably all you need (such as Igennus Super B or Thorne Basic B as these have the bioavailable forms of ingredients).

With the D3, are you taking Vit K2-MK7, one of the important cofactors? 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.

Be careful with the amount of Vit A, as it is fat soluble it can build up to toxicity level like D3.

[Piggyoink in reply to SeasideSusie]

Thank you again so much. I will just increase thyroxine and reduce supplements as you’ve suggested. My FM doctor will hopefully advice on the low blood thing... all of this is certainly a journey huh? But really I’m so much better than I was before... and mostly through the help of this amazing community! 💜🙏🏾🤗

[shaws Administrator in reply to Piggyoink]

One of our Advisers (now deceased) stated that FM was due to thyroid hormone resisistance and that only T3 could relieve symptoms and a higher dose than what would be 'normal' for others.

[Piggyoink in reply to shaws]

Hi shaws i meant functional medicine, not as I think you mean... fibromyalgia but thank you for taking the time to write. Every bit of information is super useful 🙏🏾💜

[SlowDragon Administrator]

Would agree with SeasideSusie that you try increase Levothyroxine by 25mcg and retest in 6-8 weeks. You should see FT4 and FT3 rise

I am Heterozygous DIO2 and find taking T3 as three split doses 8 hours apart works best. (T3 doses - 10mcg 7am, 5mcg at 3pm and 5mcg at 11pm ) Levothyroxine at 11pm.

.....but we are all individual on what works for us

[Piggyoink in reply to SlowDragon]

Thanks so much SlowDragon ill update in some weeks to see where I am 🙏🏾💜