Help with blood test results please

[Lillybet2]

Hi all and thank you for letting me join this fantastic community.

I would truly appreciate any help interpreting my blood test results.

I am 58 years old, menopausal and have been taking HRT (Femoston2/10) for 3 years. Dr, changed my medication early this year to patches, mis-prescribed and then correctly prescribed Evolo Conti patches. They made me poorly so now back on Femiston. My hair is coming out in handfuls and I don't have a lot to begin with following fertility treatment in my 30's, so this is beyond worrying. I have low energy levels and I am anxious - pretty much the symptoms I had for menopause pre-medication. I went back to the surgery for blood tests and the nurse has diagnosed low thyroid and prescribed Levo 50mg. I am not starting these until I am absolutely sure of the diagnosis. I went back to the surgery for T3 blood test. I have also just had the results of a Thyroid Check Ultravit Blood Test (Medicheck) for a second opinion.

I am hoping the recent symptoms I have, especially hair loss, are down to not having any HRT for a couple of months whilst mis-prescribed and then using an ineffective one, or perhaps vitamin deficiencies.

Here are my NHS results - data taken from the sheets given to me:

NHS 01/10/19 9:35am (non fasting sample):

Serum free T4 level 8.1 (7.00-17.00)

Serum TSH level 5.36 (0.20 - 4.50)

Serum prolactin level 170 (40.00 - 425.00)

08/10/19 Se thyroid peroxidase Ab conc - (AA) - No (o.oo - 9.00kiu/L)

Here are the Medicheck results:

12/10/19 11:15 am (fasting sample) but sample only arrived at Lab 14/10/19)

TSH 3.32 (0.27 - 4.2)

Free T3 (5.17 (3.1 - 6.8)

Free Thyroxine 13.900 (12-22)

Thyroglobulin Antibodies 226.00 (<115)

Thyroid Peroxidase Antibodies 11.8 (<34)

Ferritin 119 (13-150)

Folate - Serum 4.32 (>3.89)

Vitamin B12 - Active 87.5000 (37.5 - 188)

Vitamin D 50.1 (50 - 175)

CRP HS 6.96 (<5)

Thank you.

[greygoose]

Looks like you're hypo to me. Your TSH is too high and your FT4 is too low. And, you probably have Hashi's, with those high antibodies. I'd start taking the levo, if I were you.

Your folate and vit D are also too low.

[Lillybet2 in reply to greygoose]

Thank you. Reply much appreciated. Would be good to know what dose Folate / Vit D to use and product suggestions if possible?

[greygoose in reply to Lillybet2]

Sorry, all I can tell you is that you would probably be best off with a B complex containing at least 400 mcg methylfolate. Don't take folic acid, it's not as well absorbed. The one I take is Igennus, which I buy on Amazon. But, I'm not well up on vit D.

[JAmanda]

Agree it looks like hashimotos. Just my opinion that I’d try the 50 of levo for six weeks (an hour before food and away from supplements etc) and see if you feel better. I imagine you will. 50 levo seemed pretty benign to me (but higher doses and t3 less well tolerated). So I wouldn’t be too fearful anc would give it a go. (I am 53, similar tsh, menopausal etc and saw a lot of improvement within s few weeks on 50 - if still not quite better yet!)

[Lillybet2 in reply to JAmanda]

So grateful. Thank you. Have started Levo this morning and will but supplements today.

[JAmanda in reply to Lillybet2]

I have honestly had no luck increasing my b12 folate and D! So I’ve just bought d+k2 spray and will religiously take Bs to try a bit harder before next expensive tests.

[SlowDragon Administrator]

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

Once you Improve level, you may 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

Local CCG guidelines

clinox.info/clinical-suppor...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

If vitamin D is low, B vitamins may be too. As explained by Dr Gominack

healthunlocked.com/thyroidu...

folate on the low side. 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

Igennus Super B complex are nice small tablets. 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 Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

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...

Bloods should be retested 6-8 weeks after each dose change in Levothyroxine

Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water .

Last dose of Levothyroxine 24 hours prior to blood test. (taking delayed dose immediately after blood draw).

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip, best not mentioned to GP or phlebotomist)

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...