First time iam posting on this great community! Please help me interpret my latest thyroid blood tests done on 15 Nov 2019 (pic attached)that i got done from Thriva privately. Also ,some of my other tests that the GP did and said were normal ,even though CRP and Sedimentation rate were above range:
Results of test on 20th September 2019:
Serum ferritin :93 ug/ (Range: 15-300)
Erythrocyte sedimentation rate :12mm/h
(Range: 3- 9 mm/h )
Serum C reactive protein 7 mg (Range : 0-4 mg/L)
Vitamin D: 63 nmol/L
I have really bad joint pain and very bad hair fall that the NHS Endocrinologist thinks might be link to my thyroid. Also, he suggested recently that i get T3 tablets from abroad. My blood tests are negative for rheumatoid arthritis.
Im currently on 50 mg Levothyroxine. Also taking iron, magnesium and selenium and zinc.
Please recommend what i should do as im not feeling good, have a one year old baby and doctor just keeps on delaying and making excuses for my symptoms. Also , any tests that i should request my GP to do?
Thanks in advance:),
Naadi
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Naadi
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Your high antibodies confirm you have autoimmune thyroid disease also called Hashimoto's
Your TSH is too high, FT4 and FT3 far too low
Your endocrinologist should have increased your dose of Levothyroxine to 75mcg
Likely your endocrinologist was Diabetes specialist.....because these results clearly show you are under medicated
See GP for 25mcg 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
NHS guidelines on Levothyroxine including that most patients eventually need somewhere between 100mcg and 200mcg Levothyroxine.
Also what foods to avoid (eg recommended to avoid calcium rich foods at least four hours from taking Levo)
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.
Hashimoto's frequently affects the gut and leads to low stomach acid and then often low vitamin levels
Low vitamin levels affect Thyroid hormone
Ask GP to test vitamin D, folate, B12 and ferritin
Always get actual results and ranges and come back with new post once you get results
Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common.
According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)
Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies
While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first
Assuming test is negative you can immediately go on strictly gluten free diet
(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially)
Trying strictly gluten free diet for 3-6 months.
You will see thousands of posts about gluten intolerance on here
If no noticeable improvement then reintroduce gluten and see if symptoms get worse
All medication at least two hours away from Levo. Some like HRT, PPI's, magnesium, iron or vitamin D, at least four hours away
Bloods should be retested 6-8 weeks after each dose increase
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
You are awesome. Thanks for the information I had already thought of asking GP for these tests. Hope she agrees. Will talk to her about increase in levothyroxine.
My ferritin test and Vit D test were done on 20th September. Vit D level was 63 nmol/L and ferritin was 93. Should i still ask for test as they were done 2 months ago?
Also, i just checked my tests from September 20th which the Endocrinologist saw, my TSH was 0.82 then.. but i hadn't fasted then although i hadn't taken levothyroxine. Thriva online testing company suggested i fasted for test accuracy. Maybe that is why Endo didn't increase dose cause it ws 0.82 then. These tests results are from yesterday from Thriva.
So the September result perhaps explains why endo didn't increase dose. Was there a FT3 and FT4 result in September?
Ask GP to test B12 and folate
GP only allowed to test vitamin D once a year
Vitamin D is likely not high enough. Many of us with Hashimoto's find we need vitamin D optimal, at least around 80nmol and around 100nmol may be better
Once you Improve level, you will probably need on going maintenance dose to keep it there.
Yes maybe. No GP didn't do FT3 . My surgery doesn't do T3 tests. Serum T4 level in September was 18.3.
Im currently taking a spray of Vit D and K recommended privately by my tricologist. Wierdly the tricologist knows more about my thyroid issues and vitamins then the GP or Endocrinologist. She was the one who recommended all the Multivitamins.
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
You won't know if you need addition of T3 until Levothyroxine is increased high enough to bring FT4 up into top third of range and all four vitamins optimal
Vitamin D deficiency is frequent in Hashimoto's thyroiditis and treatment of patients with this condition with Vitamin D may slow down the course of development of hypothyroidism and also decrease cardiovascular risks in these patients. Vitamin D measurement and replacement may be critical in these patients.
Evidence of a link between increased level of antithyroid antibodies in hypothyroid patients with HT and 25OHD3 deficiency may suggest that this group is particularly prone to the vitamin D deficiency and can benefit from its alignment.
My Vit D levels were low a few months ago but in Sept it was 63. The results just said Serum vitamin level so will confirm from GP. I take vit D supplement daily. What range should my Vit D level be?
Try taking the vitamin D spray you will absorb it much more easily. I would change your Doctor if I was you because he is incompetent to keep you on a starting dose of 50mcg when he should of increased it after 6 weeks ... does he actually know about thyroid disease or is he a diabetes specialist like most of the Endocrinologists in the NHS.
Iam spraying 3000iu Vitamin D spray with K2, 3 sprays daily. Do you have any recommendations for good well priced Vit D spray with maybe higher dosage? Thankyou SlowDragon. You aren't slow at all but a genius dragon!😇
Thankyouuuu everyone for your indepth replies! I also felt it wierd Mary-intussuception that he wants me to purchase it from abroad. He wrote letter to GP that i be given funding for a trial but won't be possible in long term due to funding. He was like it costs more than £2000 per person for t3 medication when my husband said that is the amount of tax he pays monthly. I checked online, it costs £258 monthly. However, i can get t3 from Pakistan. Do you think it is worth the hassle asking GP about trial of it?
You could ask, but 1) Your LT4 dose has not yet been increased, monitored & stabilised. 2) As far as I'm aware, in the UK, it is only Endocrinologists that can decide on and prescribe T3.
I note that your Endocrinologist is not aware of the 15 November results ? You should contact him. Take a photo copy to his secretary or email her.
Also you haven't given FT3 & FT4 or T4 results from earlier tests done by NHS and what dose, if any, Levothyroxine then.
Looks like you don't have Vitamin D deficiency. Your Ferritin is good too.
Are you taking anything apart from 50mcg Levothyroxine?
Any multivitamins or minerals ? Any supplements at all? Do you eat fortified cereals?
ALSO :
CRP not too bad - but do you know why they tested CRP and ESR (Inflammation markers) ?
Have you had an Ultrasound scan of your Thyroid? Worth asking GP to send you for one?
- Before bed: 3000iu Vitamin D spray with K2, 100mg magnesium glycinate, and 1 x Florisene Iron Tablet.
I take these Multivitamins above daily and eat oatmeal daily.
They tested inflammation markers cause my joints really hurts and with time more joints getting effected.
No i haven't done ultrasound of thyroid. What is that needed for?
I have appointment with Gp on Friday. Don't know if she will entertain requests for blood tests and ultrasound but if i have health issues and have a little baby to look after, it should hopefully be sorted out.
My first Ultrasound scan showed my Thyroiditis . GP requested it after I asked him to. Then refered my to the Endocrinologist who tested the TPO along with others.
However, more recently had scan of Thyroid & Parathyroids which revealed small cyst on Thyroid and small cyst on a Parathyroid. Believed to be benign, but monitored annually.
Will you be asking about the ESR and CRP results on Friday? Hasn't the GP requested xrays of any joints?
Any Arthritis in the family ? Any Psoriasis in the family?
Oh ok. I will discuss scan with her in next appointment as she says that she can't pay attention to all issues in 10 mins. I did ask about inflammation markers, she said they are normal. Only one joint was xrayed and it came normal. My aunt has bones issues as they break over a slight fall.
I think my cousin has some psoriasis but not sure she is very young. Im going to request GP for referral to Rheumatologist as she had told me she will refer me if pain doesn't go and it has been one year.
Good Idea, I was thinking about referal to Rheumatologist. Mine wasn't brilliant, but some are good, I hear. Hopefully you'll get full bloods done ( lots of Antibodies ). Then you can request copies of your hospital records, free of charge, and see everything for yourself.
You could ask the Rheumatologist about the ESR & CRP results.
I had severe joint pain and my rheumatoid test was negative but was diagnosed with psoriatic arthritis process of elimination and life long love affair with psoriasis .
My GP couldn't find her way out of a paper bag with a flashlight. It was my eye specialist who diagnoised me it was because I had red inflammed eyes on my visit and my Rheumotologist confirmed after lots of xrays and blood test prior to eye doc and Rheumy I spent lots of time housebound because of severe hip,knees,ankles and feet pain it attacks my tendons being told I'm too active you need to take a break.
Being in pain everyday with no end in site can cause alot of emotional issues especially if your active and now your side lined from pain your GP is wrong and could actually create a bigger problem if you actually do have some form of arthritis and I know this first hand my lack of treatment destroyed my health I'm still unable to walk or stand properly 2 yrs later because of the joint damage.
Oh bless you prayers for your health!! You are right ! She hs been telling me that it is because of post baby pains and aches. All my friends who had baby don't have such severe aches where they can't pick up baby. My baby is 14 months now.
Im going to take my husband to appointment on Friday and wage a war. Thankyou
I just wanted to point out that your ferritin is only 27% of the way through the range. This is too low.
Ferritin is optimal for many of us when it is 50% of the way through the range or a little bit over. For the range you've given - (15 - 300) - mid-range is roughly 160.
Doctors will dismiss ferritin results like yours, and certainly would never agree that they need to be improved, so we are left to our own devices, as so often happens.
You could try adding foods to your diet which contain good levels of iron. Liver is an obvious source, but it is a bit tougher if you are vegan or vegetarian. To find iron-rich foods, try these links :
Yes. In my opinion it's misleading, but it is the figure that is quoted on STTM, as far as I remember, and it has spread everywhere. STTM rarely mentions reference ranges and rarely mentions units of measurement (and sources). Without these I think an optimal level is likely to be meaningless. (You can often get away without mentioning units of measurement, but the reference range is essential for someone to make sense of the numbers they get in testing. )
Is 70 okay when the reference range is 13 - 150, or 15 - 300, or 30 - 400 or some other range?
A level of 70 is 42% of the way through the range of 13 - 150.
A level of 70 is 19% of the way through the range of 15 - 300.
A level of 70 is 11% of the way through the range of 30 - 400.
In my opinion these three different results are not equivalent. If my ferritin was 11% of the way through the range I think I would be on my knees. But I would be probably okay if the result was 42% of the range.
The first time I got my ferritin level close to 70 (to be exact, 67.7) it was only 14% of the way through the range. The reference range was 13 - 400. I felt appalling.
After getting my ferritin to 67.7, the next time I tested it it was 41.5. So you would think it was getting worse. But it was 21% of the way through the reference range and I was starting to feel a tiny bit better.
I agree about more info being needed for routine iron testing. I wouldn't dare take iron pills unless I had a proper iron panel a couple of times a year. But then I'm only taking a relatively small maintenance dose.
If I was taking enough iron to raise my levels I would test a lot more often until such time as I knew how well I absorbed the stuff.
Do you like Broad Beans? They are high in Iron (I can't usually eat them, not in season now anyway ). Lentil soup? Easy to make , if you're ok to stand whilst stirring. But the tinned variety is OK.
Look into pulses and nuts for iron content and how absorbed. Always eat what you like.
If you can, eat liver (I have difficulty with all meat) but do you like an egg for breakfast? A banana? Make sure to drink some Tropicana orange juice (with extra bits) too, or a Vitamin C tablet to help absorption.
Do you have your bloods (including FBC & Ferritin ) monitored by GP ? At least annually?
Oh thanks. That is a good idea. I do like beans and pulses! Im not really into liver but i will make some tasty curry and try it. I do take a banana daily. Egg not really a daily thing i only hv it on weekends.
I do get my blood done annually but only because some issue comes up. I will get them done often now and check iron. Thanks for all info
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I had already thought of asking GP for these tests. Hope she agrees. Will talk to her about increase in levothyroxine. 
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