Advice on results please

[Fencerope]

Hi Everyone, would appreciate your input into my Medichecls results please.

I am on 50mc of thyroxin, and self medicate with t3.

When I recently had to go my surgery for a six month medicine review, they insisted on giving me a thyroid check.I knew what was going to happen- and it did. Y tSH was 0.01(0.3-5.0) t4 was 13(7.9-16.0). Of course the doc said I must reduce. Y medication, and she was not happy about me scourcing t3 from abroad.

I replied that I was not happy either, but I didn’t have a choice!

Up till recently, if a tSH was that low, the lab would automatically test t3, alas, not any more. I had the usual argument with her and said that unless t3 was done, how could she possibly know if I’m over medicated, earring in mind my t4 was well within range.she said it was obvious I knew what I was talking about, but she is trained to go by tSH only! It’s not her personal fault, just the training.

Anyway, I decided to have a Medichecks plus ultravit done

My tSH 0.019(0.27-4.2)

Free t3 5.13(3.1-6.8)

Free t4 18.6(12-22)

According to those figures, I’m not over medicated.

I also wanted a private test as I have been very slowly losing weight since about. Arch this year. Not rapidly,just about half a pound a week or a fortnight.It seems to be more in my face and upper body, and I am looking a real old hag! I am one, but don’t want to look like one!, I had to satisfy myself with another test, as she would just say you are over medicated.

What did surprise me though, was some of the other results.

My b12 was good, but my folate was low 3.07(>3.89. Actually, that is ok isn’t it?

On the doc’s report, it said to supplement, and has been given a red marker.

I was also surprised that my vit d was quite low, being as I am in the garden working a lot in the summer in shorts and a vest top. I haven’t been taking the spray lately, as I didn’tthink It necessary, it zi will start again now 54.9(50-175)

My main concern is my ferritin which is 202(13-150). the doc commented on reducing supplements if taking them( which I don’t) and perhaps going to my go to request further investigation.

As I know very little about this, what do zi do if she fobs me off saying it’s not important and dismisses it. I would really value your help

Sorry about the long rant, and the typos, it’s the middle of the night and I. An’t sleep. It was my birthday yeasterday, went out for a meal with friends, had ONE glass of Prosecco, which is enough to keep me awake!!

[SlowDragon Administrator]

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).

If/when also on T3, make sure to take last dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

Is this how you did the test

Presumably you have Hashimoto's ?

Low vitamin levels are extremely common with Hashimoto's

We often need to supplement virtually continuously

Vitamin D is too low. GP can only prescribe to bring vitamin D up to 50nmol. Aiming to improve by self supplementing to at least 80nmol and around 100nmol may be better .

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Retesting twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is good as avoids poor gut function.

It's trial and error what dose each person needs. Frequently with Hashimoto's we need higher dose than average

Low vitamin D and low B vitamins may be linked as explained here

drgominak.com/sleep/vitamin...

Supplementing a good quality daily vitamin B complex, one with folate in not folic acid may be beneficial.

chriskresser.com/folate-vs-...

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Ferritin can be high due to inflammation of Hashimoto's

Ideally GP should do full iron panel to test if iron is high as well or only ferritin

[SeasideSusie Remembering]

my folate was low 3.07(>3.89. Actually, that is ok isn’t it?

No, there's nothing OK about a result below range. That's folate deficiency.

Have a read through the NICE Clinical Knowledge Summary for Folate and B12 deficiency here (start at Summary and work through the menu):

cks.nice.org.uk/anaemia-b12...

You should discuss this with your GP rather than self supplement at this point.