Blood results - Advice please

[sonyap83]

Can anyone advise on my latest bloods please , seeing a consultant tomorrow.

Serum Calcium - 2.28 (2.20 - 2.60)

Serum adjusted Calcium Conc - 2.29 (2.20 - 2.60)

Total Alkaline Phosphatase - 46 (30-130)

Serum total protein - 68 (60 - 80)

Serum Albumin - 42 (35-50)

Serum Globulin - 26 (18-36)

Serum TSH 1.3 (0.30 - 6.00)

Serum Vitamin B12 - 300 (160-1000)

Serum Folate - 12.1 (3.0 -20.0)

Serum Cortisol - 593 (145 - 619)

Notes 9am fasting cortisol.......................

[SlowDragon Administrator]

Previous post with more results....but these are difficult to interpret without ranges

healthunlocked.com/thyroidu...

Just testing TSH is completely inadequate. Endocrinologist should test TSH, FT3 and FT4 plus both TPO and TG thyroid antibodies

What time is your appointment?

Bloods are often done immediately after appointment

Which brand of Levothyroxine are you currently taking? Do you always get same brand?

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

Low vitamin levels are extremely common, especially if Thyroid antibodies are raised

Has GP ever tested Thyroid antibodies?

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

thyroiduk.org.uk/tuk/testin...

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

If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).

About 90% of all Primary hypothyroidism in Uk is due to Hashimoto's.

Low vitamins are especially common with Hashimoto's. Food intolerances are very common too, especially gluten. So it's important to get TPO and TG thyroid antibodies tested at least once .

Link about thyroid blood tests

thyroiduk.org/tuk/testing/t...

Link about antibodies and Hashimoto's

thyroiduk.org.uk/tuk/about_...

thyroiduk.org.uk/tuk/about_...

List of hypothyroid symptoms

thyroiduk.org.uk/tuk/about_...

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many need TSH significantly under one) and most important is that 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

NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.

nhs.uk/medicines/levothyrox...

Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)

[SlowDragon Administrator]

It's common to need higher dose of Levothyroxine if on the pill as oestrogen affects thyroid

What vitamin supplements do you take?

Calcium looks a bit low, common when vitamin D is low. You don't need calcium supplements. Calcium naturally rises as vitamin D improves

B12 looks low

Do you have any low B12 symptoms

b12deficiency.info/signs-an...

Ask endocrinologist to test both thyroid antibodies, TSH, FT3 and FT4 and coeliac blood test, vitamin D and iron and ferritin

You might Ask for DIO2 gene test. They won't be able to offer it. May not have even heard of it

It is available on NHS in Kent. Everyone else has to get test privately

thyroiduk.org.uk/tuk/testin...