I have had a private blood test, which showed far more information than any that have been requested by my GP.
Free T3 3.7 range 3.1-6.8 pmol/L
Thyroid Peroxidase antibody 8.0 range 0-24 IU/ml
TSH 3.380 range 0.27-4.20 mlU/L
Free T4 10.82 range 12-22 pmol/L
Iron 5.7 range 5.83-34.5 µmol/L
Transferrin saturation 9.1 range 15-45%
Ferritin 5.66 range 13-150 µg/L
Serum Folate 5.60 range 3.89-26.80 ng/ml
Vitamin B12 347.2 range 197-771 pg/ml
Vitamin D 50 range 75-200 nmol/L
I have been taking 125mg Levothyroxine daily, for last 6 years and took last dose 24hrs before blood test.
I had the blood test after 10 hour fasting and at 8:30am.
I'm 58 and feel more like 108! Constantly tired, depressed, breathless after the smallest task - like walking up a flight of stairs - resting pulse is around 55, but huge spikes on moving about.
All help and advice is extremely welcome.
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Littleshopofhorrors
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Well, kiddo. No wonder you feel awful. Your B 12 and D 3 are low. Your Iron looks okay but I am no expert at iron readings or treatments. Your T 3 and T 4 are too low and your TSH is too high.
Your T 3 levels should be in the upper 1/3 - 1/4 of range and T 4 should be mid-range. TSH should be much lower. The TSH numbers aren't any test of thyroid hormone.... just reflect the body demanding that the thyroid gland produce more thyroid hormone. So, you are woefully under-treated.
It is helpful to start supplementing with D 3 and B 12. D 3 --- 1000 to 5000 mg per day and 1000 mcgs of B 12. Then test levels again in six weeks or so, see how you are doing.
I hope your doc is agreeable to increasing your dose of levo a little. If not you may need to supplement with what I call a 'whole glandular' like Thyroid Gold. Just small amounts to start with. Remember, those D 3 and B 12 levels need to be increased as well 'cause it is hard to optimize your thyroid medications otherwise.
It is always a good idea to start keeping a daily log/record of your body temp and heart rate, thyroid doses, other supplements, symptoms and how you are feeling. Take readings about 3 - 5 pm when readings are at their highest. This will be helpful to you down the road when you may need to increase/decrease dosages.
ps.... if you can't tolerate increases in thyroid medications/supplements, it might be time to see if there is adrenal insufficiency or adrenal exhaustion. stopthethyroidmadness.com/a...
Strange to have such a very low, under-range FT4 on 125 mcg levo a day. How do you take your levo? Do you take it on an empty stomach, and wait at least one hour before eating or drinking anything other than water? Do you take any other medication or supplements at the same time?
FT4 under range , FT3 low in range and TSH high in range. No TPO antibodies but you also need to have TGAb tested to rule out Hashimotos.
I agree with greygoose about possible absorption issues of Levo because it is strange to be medicating quite a standard dose and have FT4 under range, as it should be evident in the blood stream , and what little you are absorbing probably won't be properly utilised because you have big iron & nutrient deficiencies.
You iron levels are very deficient and Vit B12 low. Both of these as well as insufficient working thyroid hormone would be contributing to your breathlessness. Vit D is under range and folate low. You may not be under medicated but just need to supplement iron/nutrient deficiencies in order to get thyroid hormone working well, and address gut issues to overcome absorption problems.
Are you diagnosed with celiac or anything ?
It seems that you require more medication, first improve your B12 someone else should be able to help with that your folate is low too.
You should take a Vitamin D supplement to improve your level take this with K2 these two work together to send your calcium to your bones and teeth and not into your soft tissues. You should aim for a level of around 100. Take 5000iu soft gel everyday for 3 months and then retest your Vitamin D. You can buy K2 online take these with the fattest meal of the day.
With these improvements you should find a difference, at the moment your FT3 and FT4 are too low, your TSH is too high.
A diagnosis of iron deficiency can be made when a person has both low hemoglobin and hematocrit and low serum ferritin. Serum iron and, transferrin-iron saturation percentage will also be low in a person who is iron deficient. Iron deficiency without anemia can occur when a person has a normal hemoglobin, but below normal serum ferritin and/or transferrin saturation. Iron deficiency with anemia can occur when a person has low values of both serum ferritin and hemoglobin.
Iron-deficiency anemia is diagnosed by blood tests that should include a complete blood count (CBC). Additional tests may be ordered to evaluate the levels of serum ferritin, iron, total iron-binding capacity, and/or transferrin. In an individual who is anemic from iron deficiency, these tests usually show the following results:
•Low hemoglobin (Hg) and hematocrit (Hct)
•Low mean cellular volume (MCV)
•Low ferritin
•Low serum iron (FE)
•High transferrin or total iron-binding capacity (TIBC)
•Low iron saturation
Your GP should do further tests to see if you have iron deficiency anaemia:
Haemoglobin
Haematocrit
MCV
which are part of a full blood count.
Do not leave your GP's surgery until you have either a diagnosis or further tests have been ordered. I would hope that an iron infusion is seriously considered by your GP.
**
Vitamin B12 347.2 range 197-771 pg/ml
This 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."
An Active B12 test tells us what is available to the cells if you wish to do that test with Medichecks and a result below 70 suggests testing for B12 deficiency.
If you have any then list them to discuss with your GP and ask for testing for B12 deficiency/Pernicious Anaemia.
Serum Folate 5.60 range 3.89-26.80 ng/ml
This is low and ideally should be at least half way through range. Folate and B12 work together. You can eat more folate rich foods and a good B Complex containing methylfolate (not folic acid) will help raise your level. Good brands are Thorne Basic B and Igennus Super B. However, if you have signs of B12 deficiency then don't start supplementing until further testing of B12 has been carried out.
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Vitamin D 50 range 75-200 nmol/L = 20ng/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 suggests supplementing with 4,900iu D3 daily (nearest is 5,000iu)
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.
Check out the other cofactors too (some of which can be obtained from food).
**
Thyroid Peroxidase antibody 8.0 range 0-24 IU/ml
TPO antibody result is negative. However, I'm wondering if your low nutrient levels are caused by Hashimoto's, which is confirmed by raised antibodies (although you can have Hashi's without raised antibodies). Sometimes TPO antibodies can be negative but raised Tg (Thyroglobulin) antibodies can be positive. It might be worth getting those tested but I doubt your GP can do it.
TSH 3.380 range 0.27-4.20 mlU/L
Free T4 10.82 range 12-22 pmol/L
Free T3 3.7 range 3.1-6.8 pmol/L
The aim of a treated hypo patient generally is for TSH to be 1 or below or wherever it needs to be for FT4 and FT3 to be in the upper part of their reference ranges, if that is where you feel well. These results show undermedication but Greygoose and Radd make good points so definitely get your nutrients sorted.
Free T3 3.7 range 3.1-6.8 pmol/L Much too low needs to be at lest 50% of range (at least 5)
TSH 3.380 range 0.27-4.20 mlU/L Too high, shows you are undermedicated - should be under 1 when on meds - most healthy peopel have a TSH of around 1.2
Free T4 10.82 range 12-22 pmol/L Under range - shows undermedication
Iron 5.7 range 5.83-34.5 µmol/L Under range - what is GP doing about this?
Ferritin 5.66 range 13-150 µg/L GP should be prescribing iron infusion (preferably) or at least 3 x 210 ferrous fumarate a day
Serum Folate 5.60 range 3.89-26.80 ng/ml - too low needs to be in double figures
Vitamin B12 347.2 range 197-771 pg/ml Needs to be over 500 to prevent neurological problems
Vitamin D 50 range 75-200 nmol/L Under range (but range is unusual for UK) at least high 90s in recommended
It's all so bad that I'd request a referral to gastroenterology to find out why you are absorbing so little from your food and meds.
Are you taking an anti acid such as zantac, or omprezole and this combined with being hypo could explain your poor absorbtion. You might also want to take some vitamin C and try some digestive enzymes. I use 'super enzymes' by 'NOW' and buy from Amazon. Everything is in your boots. As far as B12 goes not a lot of point taking tablets so would be better if patches or under the tounge lozenges. Sack your GP
Thank you all for your really helpful comments and suggestions. I have managed to get an appointment with a gastroenterologist for next week - GP referral at my insistance for anaemia, as I had been taking 2 different kinds of iron tablets and there was little improvement in my levels. I think that there is a problem with absorption of pretty much everything! I will take my blood test results with me and show him the whole issue, then maybe I can start to address some of the causes of my total exhaustion. I am currently finding that I can pass out when sitting down, I'm used to fainting when standing, but sitting down is a new thing.
I have been taking 125mg Levothyroxine daily, for last 6 years and took last dose 24hrs before blood test.
I had the blood test after 10 hour fasting and at 8:30am
Thanks for the advice! I saw a gastroenterologist for anaemia, who was about as much use as a chocolate teapot! Told me I wasn't very anaemic and to take a different form of iron tablet. Said that the B12, THS, and 'other thyroid bits' were fine. He reckoned vit D was low, 'as we haven't had summer yet'. God give me strength!! He did request a test for Coeliacs, but I am pretty sure I have had one before, which was negative.
I am going to get vit C, vit D, B12, but try to get easily absorbed forms. I will try his iron tablets, but if I get any more constipated.... I am also contemplating taking T3 - self medicating - but am not sure how to go about this. Any advice on what to get and where, will be gratefully received.
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