Hello .. I am new on here, please can someone help me to understand my latest blood results please .... I live in Spain and last April (2019) was prescribed 25 mg Levo as my TSH was 6.7 uUI/ml . I had another test in July TSH 4.8 ... no change to meds as in normal range!
After months of feeling constantly tired and low, very heavy periods, hair loss etc and hours of late night searches on the internet, I was chuffed to bits to find this community!!
I had my bloods done again yesterday, and results have just come back to say everything is normal! I would greatly appreciate some advice ....
TSH 4.533 uUI/ml ( 0.350 - 5.500)
T4 1.20 ng/dl ( 0.8 -1.9)
T3 2.93 pg/ml (1.4 -4.4)
Ferritin 16 ng/ml (10-291)
Transferrin 288 mg/ dl (200-360)
B12 531 pg/ml (211-911)
Vit D 25- Hidroxi 32.8 ng/ml
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last April (2019) was prescribed 25 mg Levo as my TSH was 6.7 uUI/ml . I had another test in July TSH 4.8 ... no change to meds as in normal range!
So the doctors in Spain seem to be as clueless as UK doctors about medicating to reach optimal levels. 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. So normal protocol is to retest every 6 weeks with an increase in dose of Levo of 25mcg each time until levels are where they need to be for you to feel well. It's not just a case of getting the patient's number back to anywhere within the range.
TSH 4.533 uUI/ml ( 0.350 - 5.500)
T4 1.20 ng/dl ( 0.8 -1.9)
T3 2.93 pg/ml (1.4 -4.4)
So your current results are far from normal, at least as far as TSH is concerned. Can you please clarify if T4 and T4 are Free T4/T3 or Total T4/T3.
It's Free T4/T3 that we need, Total T4/T3 doesn't really tell us anything.
Ferritin 16 ng/ml (10-291)
Transferrin 288 mg/ dl (200-360)
Although classed as "normal" because it's within range, this is extremely low (just 2% through the range) and you need to speak to your doctor. Don't be fobbed off with "it's in range so it's fine", there is a massive difference between your level being 2% through range - where you probably feel dreadful, to a level being over 50% and upwards through range.
This article has a list of symptoms that low ferritin can cause:
Low ferritin can suggest iron deficiency anaemia so you need more than just Transferrin tested. You need a full blood count and a full iron panel.
B12 531 pg/ml (211-911)
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."
So your level isn't bad but could be higher.
It's important to test Folate when testing B12 as they work together.
Vit D 25- Hidroxi 32.8 ng/ml
The Vit D Council recommends a level of 50ng/ml and the Vit D Society recommends a level of 40-60ng/ml so you're a little low there.
If you want to improve your level then the Vit D Council suggests supplementing with about 2,500iu D3 daily
Retest after 3 months and 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.
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.
Thankyou for your reply ...... what a lot of information!
I am finding it really hard work trying to get any answers over here ..... so you have been a huge help.
The T4 and T3 results are both free.
My blood test this time seems to have quite a lot on it, but I am struggling a bit because it is all in Spanish and I am trying to work my way through it with the translation! I am pretty sure my
My Iron result was 80 (49-151) , saturation of Fe 21.87% (16- ...)
I think the blood count is on there but I don’t know what any of it means 😊
I have contacted my doctor regarding the ferritin, but I don’t hold out much hope as after my last bloods I asked her to up my Levo dose, but she wasn’t having any of it, just kept saying my results “Es normal”!!
I think as a start I will buy myself some liquid iron, as suggested in your link and I am wondering if I should up my dose of levo to 50 .... we can buy it over the counter here for a couple of euros ... do you think that would be a good idea, if the doctor won’t prescribe it?
So those results show that you are undermedicated and in your shoes I would be adding 25mcg Levo now, retest in 6 weeks to check your levels. You will probably feel better with a much lower TSH and as long as FT3 stays in range then increase Levo every 6-8 weeks until your levels are where you need them to feel well.
My Iron result was 80 (49-151) , saturation of Fe 21.87% (16- ...)
Ferritin 16 ng/ml (10-291)
Transferrin 288 mg/ dl (200-360)
I think as a start I will buy myself some liquid iron, as suggested in your link
Which link suggests this? I'm not one for recommending taking iron supplements. Iron is complicated and I'm not an expert. All I can say is that your ferritin level is very low but I don't know if you have iron deficiency anaemia, your full blood count would show that.
Ok, I will take two levo tomorrow morning .... only problem is I doubt if will be able to have my bloods checked again in 6 weeks ...
Is there any way I can upload a picture of my results to you, if you know what you are looking for then I expect it all looks pretty obvious ... even in Spanish!
I clicked on the ferritin link and as I scrolled down, there was a liquid iron suggestion of where to buy ... it did state only suggested if you had a blood test showing low ferritin levels, not to take just on symptoms alone?!
I only give that link to show symptoms of low ferritin, not to suggest supplements
"This article has a list of symptoms that low ferritin can cause:"
I will have to reword my comment in future to make it clear that further investigation may be required before considering self supplementing. I never suggest iron supplements, iron is complicalted and I only ever suggest eating liver and other iron rich foods when it's obvious that anaemia is not indicated.
It’s probably just me, a little over enthusiastic after being given such helpful advice .... I have also looked online at which foods to add to my diet, and also if it’s worth getting a breakfast cereal fortified with iron ... I will start on the levo tomorrow and make an appointment to see if my doctor has any recommendations for iron!
I really appreciate your advice ... the information you have given me has been really helpful and I now feel that there are a few things I can tackle myself to try and get things back on track!
( sorry to be a pain, but one more thing, which reading on a blood test indicates that you have anaemia ..... was my iron ok?)
Hello, thankyou for your last reply .... lots more reading!
I contacted my doctor about the my low ferritin result, I could weep, she sent me a message this evening ( on a Saturday!!!) saying that she has reviewed my results again and everything is with in the normal ranges, TSH and anaemia! I had made an appointment to see her on Monday, but not sure if should cancel, I think I am wasting my time, she won’t budge even though I pointed the reasons I went to see her last week are still there ... very heavy periods, extreme tiredness and generally feeling low.
Yesterday I upped my dose 50 mcg as you suggested, but my head is swimming with what to do about the supplements. I have now gone off the idea of the iron as I was hoping for some advice from the doctor ... so will go down the route of improving my diet, I have bought some chicken livers and spinach!!
Do you think the Betteryou sprays B12 and vitamin D with k2 would be a good start and maybe some magnesium?
You shouldn't take B12 on it's own, it needs a B Complex as well to balance all the B vitamins. If I were you I would just take a good quality B Complex containing methylcobalamin and methylfolate. The methylcobalamin will be enough improve your B12 level, the methylfolate will help your Folate level if necessary. Good ones are Thorne Basic B and igennus Super B which contain bioactive forms of ingredients.
For Vit D you need what I suggested but what form is your choice. I don't use the oral sprays there are too many unnecessary ingredients for me, I like as few ingredients as possible so I prefer Doctor's Best D3 softgels which contain only D3 and extra virgin olive oil. There are also oil based liquids such as Vitabay Organics. There are also K2 softgels and oil based liquids. And, of course, magnesium is important.
Don't start all suplements at the same time, start with one, if no adverse reaction then add a second one two weeks later. Continue like that and if you do have a reaction you will know what caused it.
It's very disappointing that your doctor is dismissing concerns about your low Ferritin. Is there another doctor you can see?
That’s super helpful .... I will get some ordered. Great advice about starting them a couple of weeks apart, something I didn't think of!!!
Unfortunately there is only one doctor that I can see at the surgery, the other one is for children! I have decided to still go along to my appointment tomorrow, as my other half says, I have nothing to lose and she might listen if we are sitting face to face. The fact is all the symptoms are still there, so surely she needs to find an answer as to why!!
Thank you again for taking the time to help ...... this website is a godsend!
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