I posted a little while ago and was asked by all for the ranges which I now have.
Im currently on 150 levothyroxine, but beyond tired and struggling with weight loss. Doctor has said results all fine, had to demand a full count as usualy only do TSH.
Any ideas?
TSH- 0.63 mu/L (0.27 - 4.20)
Free T4 - 14.5 pmol/L (11 - 25)
T3 - 4.5 (havent had print out for this just told on phone.)
B12 - 308ng/L (180 - 900)
Serum Folate - 4 ug/L (>3.0)
Serum ferritin - 20 ug/L (15 - 300)
Thyroid Peroxidase - 13.6 U/ml (<34)
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daftbat1987
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T3 - 4.5 (havent had print out for this just told on phone.)
Your TSH is in a good place, most of us Hypo patients feel best when it's 1 or below. However, your FT4 is very low in it's range - just 25% through it's range. This very unusual with such a low TSH. It's not possible to comment on your T3 - we need a range to interpret it and also to know if it's Free T3 or Total T3.
Always get a print out of your results, mistakes can be made when given verbally or hand written by a receptionist.
B12 - 308ng/L (180 - 900)
ng/L is the same as pg/ml mentioned below:
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."
Do you have any signs of B12 deficiency - check here:
If you do then list any to discuss with your GP and ask for testing for B12 deficiency/pernicious anaemia. Many people with B12 in the 300s have needed to be started on b12 injections.
Serum Folate - 4 ug/L (>3.0)
Although this is over the low limit this is very low. I'd want mine in double figures. You GP wont do anythig about this because it's in range.
If you don't have any signs of B12 deficiency - and only if you don't - then you could take a B12 supplement - buy some sublingual methylcobalamin 1000mcg and use one bottle. Also, because all B vitamins need to be in balance, you should take a good B Complex and this will increase your folate level. Make sure your B Complex contains methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). A couple of good brands, which have bioavailable ingredients, are Igennus Super B and Thorne Basic B. Either of those would be suitable. Once the bottle of sublingual methylcobalamin is finished, it should be OK to just continue with the B Complex to maintain levels.
If you do have signs of B12 deficiency then don't take the B Complex before any further testing as it will mask signs of B12 deficiency.
Serum ferritin - 20 ug/L (15 - 300)
This is very low. Low ferritin can suggest iron deficiency anaemia. Although your GP will say it's within range so it's fine, push for a full blood count and an iron panel to see if you have anaemia.
For thyroid hormone to work properly, it's said that ferritin needs to be 70+, and I've read that for females a good level is 100-130.
Because your level is so low, I wouldn't suggest self supplementing, you need to see if there is any anaemia first.
I think your low nutrient levels may be part of your problem, but your very low FT4 is also a problem. Optimising nutrient levels may help.
Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the magazine for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.
You can obtain a copy of the article by emailing Dionne at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor.
Thyroid Peroxidase - 13.6 U/ml (<34)
Your thyroid peroxidase antibodies are negative for autoimmune thyroid disease (Hashimoto's) but one negative doesn't mean you don't have Hashi's. Antibodies fluctuate so it could be they were tested when low and another test might see them high. Also, there are Thyroglobulin antibodies and you can be negative for Thyroid Peroxidase but positive for Thyroglobulin. Thyroglobulin antibodies aren't normally tested at primary level, it's usually an endocrinologist who tests that. Also, it's possible to have Hashi's without raised antibodies. Hashi's can cause low nutrient levels.
You also need both TPO and TG thyroid antibodies tested. Sadly NHS refuses to test TG antibodies if TPO antibodies are negative (as your are)
If antibodies are high this is Hashimoto's, (also known by medics here in UK more commonly as autoimmune thyroid disease).
Most Hashimoto's patients have high TPO or high TPO and high TG antibodies......but a significant number only have high TG antibodies and can struggle to get diagnosed
One in five Hashimoto's patients never have raised Thyroid antibodies. Getting thyroid ultrasound can help get Hashimoto's diagnosed
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 BOTH TPO and TG thyroid antibodies tested at least once .
B vitamins best taken in the morning after breakfast
Recommended brands on here are Igennus Super B complex. (Often only need one tablet per day, not two. Certainly only start with one tablet per day after breakfast. Retesting levels in 6-8 weeks ).
Or Jarrow B-right is popular choice, but is large capsule
If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results
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 did the last test?
Ideally you need 25mcg dose increase in Levothyroxine
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.
Other medication at least 2 hours away, some like HRT, iron, calcium, vitamin D or magnesium at least four hours away from Levothyroxine
Many people find Levothyroxine brands are not interchangeable.
Once you find a brand that suits you, best to make sure to only get that one at each prescription.
Watch out for brand change when dose is increased or at repeat prescription.
Many patients do NOT get on well with Teva brand of Levothyroxine. Though it is the only one for lactose intolerant patients. Teva is the only brand that makes 75mcg tablet.
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