2019 Thyroid Test Results

[Archway]

I've had my annual thyroid blood test. I have the results on Patient Access:

Serum TSH level 2.6 mu/L (0.5-4.4)

Ft4 not tested this year.

Serum ferritin 17 ug/L (25 - 350)

Vitamin D 43 nmol/L (50 - 200)

Calcium 2.17 mmol/L (2.20 - 2.60)

An admin called me from my GP's practice. I was told that my TSH was fine and that I should buy some Ferrous Sulfate 200 mg tablets and take them with orange juice. I don't know whether I'm supposed to buy just one pack of 28 or more than that. No mention was made of my Vitamin D and calcium results. I've been taking Vit D supplements every day for a year and it is still below normal.

Any comments or suggestions? I'm on Levothyroxine: 75 mcg daily.

[RedApple Administrator]

Archway, if you can also say how you are feeling, members with suggestions can take this into account alongside your test numbers.

[Archway in reply to RedApple]

Thanks for the suggestion. I feel tired most of the time. I often become breathless when I walk anywhere. I also have intermittent joint and muscle pain. The pain is worst in my hands/fingers and feet/toes.

[RedApple Administrator in reply to Archway]

In which case, I suggest a TSH of 2.6 is not right for you. How much levothyroxine are you taking?

[Archway in reply to RedApple]

Levo 75 mcg

[RedApple Administrator in reply to Archway]

I think you need to communicate the symptoms you've described here to your GP, and request an increase to 100mcg levo. When you've been taking the increased dose for around 6 weeks, you may see some improvement in your pain and stamina. Also, at this stage, your thyroid levels should be tested again.

[Marz]

I would suggest a FULL Iron Profile be done as LOW Ferritin does not always reflect low serum iron. Saying that Ferritin needs to be around 70 for your T4 to convert into the Active hormone T3. Your result for T3 last year was quite good so in spite of low Ferritin you seem to be converting well.

How much h VitD are you taking ? Your level has dropped and would be better around 100. Co-factors were suggested last year too. Have a read through last years replies for more info.

Another increase of Levo would/should improve matters ...

Eating liver and black pudding once a week can help raise Ferritin ...

[Archway in reply to Marz]

Thanks for comparing with last years results.

I've been taking 1000 IU of Vitamin D daily.

[Marz in reply to Archway]

I think you need to up the dose to something like 4500 iu's. Did you look at your last post to read about the co-factors needed when taking VitD ?

grassrootshealth.net

The above website explains the dose required according to your results for VitD. You can sign up for their Newsletters to keep up to date ... also ...

vitamindcouncil.org

[SlowDragon Administrator]

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

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)

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Your vitamin levels are extremely low, probably because your results suggest you are under treated and on too small dose of Levothyroxine

See GP and request a 25mcg dose increase in Levothyroxine

Also ask for full iron panel test. Your Ferritin is well below bottom of range. So low you may be better having an iron infusion. If not an infusion then likely ferrous fumerate 2 or 3 per day. Iron and ferritin should be retested after 6-8 weeks

Vitamin D is far too low. GP will 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.

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 when hypothyroid we need higher dose than average

Suggest you get vitamin D mouth spray and try at least 2000iu per day

Retesting twice yearly via vitamindtest.org.uk

Local CCG guidelines

clinox.info/clinical-suppor...

Essential to test B12 and folate too. Plus BOTH TPO and TG thyroid antibodies need testing if not ever been tested.

High thyroid antibodies would confirm cause of hypothyroidism is due to autoimmune thyroid disease also called Hashimoto's

All four vitamins need to be regularly tested and frequently need supplementing to maintain optimal levels

Many people find different brands of Levothyroxine are not interchangeable. Do you always get same brand of Levothyroxine?

[Archway in reply to SlowDragon]

I've noticed that I now get another brand of Levo called Teva. I used to be given another brand until recently. I can't remember what it was.

[SlowDragon Administrator in reply to Archway]

Teva brand upsets many, many people. But a few love it.

Did you feel better on Teva?

healthunlocked.com/search/p...

[Archway in reply to SlowDragon]

I haven't noticed any difference so far - but then I've only been taking Teva tablets for a few weeks.

[SlowDragon Administrator in reply to Archway]

So you need FULL Thyroid testing after 6-8 weeks on Teva

Getting vitamins optimal is essential.

Calcium should naturally increase as vitamin D rises

Ask GP to test vitamin B12 and folate or test with thyroid in 6-8 weeks