This was my first time having these test, thanks to the helpful advice I received from you all. I am relieved to see that my anti bodies are normal.
I have spoken to my pharmacist and been given supplements and dietary advice to raise my Vit D level.
I am still unsure what to make of my TSH T3 & T4 results. I have booked an appointment with my GP to discuss.
Any advice on how to approach my GP with this would be greatly received.
I have spoken to my Gran and been informed that on my mothers paternal side of the family there is a family history of Hyperthyroidism which I was unaware of until a few days ago.
My symptoms are:
Increased sweating, over-sensitivity to heat, palpitations, increased appetite/cravings, dry skin, hair loss, shortness of breath, tiredness/exhaustion, dry/gritty eyes, painful eyes, loss of muscular strength, aches and pains, irregular menstrual cycle, mood changes, nervousness, anxiety, insomnia, high resting heart rate, disturbed/broken sleep. scalloped tongue, jumpy legs, shaky/trembling.
I understand that a few of these symptoms can be cause by low Vit D.
My biggest fear is that because my blood results are borderline and not out of "normal" range i am going to be dismissed about it all.
CRP HS = 1.25mg/l Range <5
Ferritin = 73ug/L Range 13 - 150
Folate Serum = 4.66 ug/L Range > 3.89
Vit B12 = 79.4 pmol/L Range 37.5 - 188
Vit D = 46.1 nmol/L Range 50 - 175
TSH = 0.403 Range 0.27 - 4.2
Free T3 = 4.17 Range 3.1 - 6.8
Free Thyroxine = 13.2 Range 12 - 22
Thyroglobulin antibodies = 10 Range <115
Throid Peroxidase Antibodies = 9 Range < 34
Any advice would be really appreciated. Thank you xxx
I have spoken to my pharmacist and been given supplements and dietary advice to raise my Vit D level.
What has your pharmacist advised?
What dose of D3 are you taking and in what form - tablets, capsules, softgel?
Were you given advice about what level of Vit D to aim for and continued monitoring thereafter?
Were you given advice about D3's important cofactors?
Folate Serum = 4.66 ug/L Range > 3.89
Although this is above the low limit, it is still low. Some labs give proper ranges for Folate and I think it's rather strange that some have gone over to this type of "range", but I would definitely want my folate level in double figures.
Vit B12 = 79.4 pmol/L Range 37.5 - 188
As this is the Active B12 test, and anything below 70 would suggest testing for B12 deficiency, I would want my level higher and I'd aim for over 100.
You could check signs/symptoms of B12/folate deficiency here:
and if you think this is what is indicated then discuss with your GP.
If your B12 and folate results were mine, but no obvious signs of deficiency, then I'd be supplementing with a good B Complex such as Thorne Basic B or Igennus Super B to bring both levels up.
Some of your symptoms could be both hyper/hypo and it is possible to have autoimmune thyroid disease (Hashimoto's) without raised antibodies.
Also, it is unusual to have such a low FT4 with such a low TSH. For primary hypothyroidism the TSH is high and the FT4 low. I'm not diagnosing but it could be that the pituitary is not signalling the thyroid to make thyroid hormone - the signal being TSH which would be high when there's not enough hormone. This could possibly point to Central Hypothyroidism which is diagnosed when TSH is normal, low or slightly elevated and FT4 is low.
Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed
You could do some more research, print out anything that may help and show your GP.
As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before. You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at tukadmin@thyroiduk.org for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.
As I said, I'm not diagnosing (I'm not medically qualified) but just pointing out the possibility.
My Pharmacist advised me to take a multi-vitamin with Iron in tablet form. I'm sure on the dosage off the top of my head. But can confirm when I am home after work.
The advice I received with my Bloods results was:
"your vitamin D levels show that you have a vitamin d insufficiency. This may progress to a vitamin D deficiency if you don't take steps to increase your vitamin D levels. We recommend supplementing with 20-50 mcg of vit D per day for 12 weeks"
I will certainly read up on Central Hypothyroidism before I see my GP thank you for the helpful links.
My Pharmacist advised me to take a multi-vitamin with Iron in tablet form. I'm sure on the dosage off the top of my head. But can confirm when I am home after work.
OK, sorry to say that pharmacists are about as much use as doctors when it comes to advice about nutritional supplements.
First of all, multivitamins are a waste of time and money. They tend to contain too little of anything to help and usually the least absorbable and wrong forms of active ingredients. They also tend to include things which we should be tested for and only supplement if found to be deficient, eg calcium, iodine, iron. And probably worst of all, when it includes iron then that affects the absorption of everything else as iron needs to be taken 2 hours away from other supplements. I hope it was cheap enough to throw away, or alternatively if it's not been opened take it back and say it's not suitable.
What you actually need is to treat each poor nutrient level separately.
I've given you suggestions as to what to do about your folate and B12.
As for your Vit D:
46.1 nmol/L = 18.44ng/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, based on the Vit D Council's suggestions you could supplement with 4,900iu D3 daily (nearest is 5,000iu)
The best absorption from oral supplements that are swallowed comes from D3 softgels, far superior to tablets and capsules.
A good D3 softgel containing just D3 and extra virgin olive is Doctor's Best, a tiny softgel which is easy to swallow, and best price always seems to be from here:
(they do different sizes, better value the bigger the pack).
Some people prefer an oral spray (eg BetterYou) but I don't like the fact that it contains too many unnecessary ingredients, I prefer as few as possible.
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
K2-MK7 comes in oil based softgels like D3, eg Healthy Origins. Or there are sublingual oil based liquids such as Vitabay Organics.
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).
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
Sorry if this sounds a bit silly. But are my T3 and T4 levels going to be seen as low by a GP or Endo. Or is it the case that ranges vary? This confuses me still as I can tell from the Thyroid UK community response that they seem to be low but when checked by any where in the health care world they are normal! I think my biggest fear is going to my GP and being basically turned away.
Ranges vary from lab to lab so you can only use the range from the lab which does the test. So with your Medichecks result of FT4: 13.2 (12-22) you are 12% through the range.
If you tested with, say, your GP's surgery and their range was, for example, 9-19 then 12% through that range would be 10.2
No, it doesn't sound silly, but I know what you mean. The problem is, that doctors - all doctors - are very badly educated in a lot of areas. Two of those areas are hormone - especially thyroid hormones and the thyroid in general - and reading blood test results.
'Normal' just means 'in-range'. And, yes, your results are 'in-range'. But so what! They are too low in-range - and the range is too wide - which is something we have to spell out for them. For a doctor, if something is 'in-range' it has to be perfect, and that just isn't true for several reasons. But, not only that. I'm sure you know that the TSH stimulates the thyroid to make more hormone, and the less hormone the thyroid makes, the higher the TSH goes. So, the TSH level is intimately linked to the FT4/3 levels. So, when the FT4/3 are low in range like yours, the TSH should be higher. Yours isn't. So, that means that there's a problem with the source of the TSH: the pituitary or the hypothalamus, what we call Central Hypo. And, that's where they should be looking to see where the problem lies.
However, due to their poor education, GPs have probably never even heard of CH, so wouldn't pick it up on their own. So, we need to convince them, and educate them, show them studies that talk about CH. That's why Susie gave you those links, to print out and take to your doctor.
Thank you, that has made things clearer in my mind. I have printed all those documents out ready to take to my GP appointment. Must say im a tad nervous incase they take it the wrong way and think im telling them how to do their job x
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