New Blood test

[crmavb]

Hello, I’ve treated myself to a private ‘MOT’ blood test. If any of you have suggestions please let me know. Symptom wise I have a bad back for over a week and am not sleeping well. Thank you and Merry Christmas

[SlowDragon Administrator]

Your ferritin is very very low. You will need full iron panel testing for Anaemia

Are you vegetarian? It's much harder to maintain optimal ferritin levels on plant based diet

Folate could be higher. Do you take a good quality daily vitamin B complex?

[SlowDragon Administrator]

What time did you do blood test?

[crmavb in reply to SlowDragon]

9:15am on an empty stomach and before morning meds

[crmavb]

Hi yes I follow a plant based diet and occasionally eat fish. But even when I ate meat, a year ago , I still had that issue. I occasionally take folate, but perhaps need to be more regular. I take 112mcg -125mcg T4 and 6-12mcg T3 per day Thank you

[SlowDragon Administrator in reply to crmavb]

You can't take different doses of T3 on different days. Absolutely essential to take exactly same dose T3 every day. Many people need 2 or 3 split doses T3 per day

humanbean or SeasideSusie msy pop along to explain importance of getting full iron panel. You can have very low ferritin and normal iron. But if iron is low you will need iron supplements

Presumably you supplement B12 daily ?

But 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...

So your cortisol result is low

You might want to do Regenerus cortisol and DHEA saliva test to see what diurnal variation is like

As you have Hashimoto's are you on strictly gluten free diet or tried it?

[Lucy1000 in reply to SlowDragon]

Reading the conversation about hip and back pain, I looked back at the blood results and saw this part of the discussion. Can you explain why taking different doses of T3 on different days is a problem? That is what I currently do on advice from a doctor. I am struggling though and not feeling well.

[SlowDragon Administrator in reply to Lucy1000]

Levothyroxine is a storage hormone so it’s ok to take different doses on different days

T3 is active hormone and it’s absolutely essential to take exactly same dose every day. Otherwise it strains adrenals trying to cope with different doses on different days

Similarly it’s extremely important to always get same brand levothyroxine at each prescription and same brand T3 at each prescription

Essential to regularly retest vitamin D, folate, ferritin and B12

[Lucy1000 in reply to SlowDragon]

Taking 10 mcg 3X a week, 5 mcg the other 4 days after a blood test that showed high free T3. This dosing results in T3 within range. Taking 10 mcg every day caused my levels to go too high although I didn't feel bad. I think I feel worse now. Mostly having trouble with mental tasks. How would you suggest arranging dosing?

[SlowDragon Administrator in reply to Lucy1000]

2.5mcg 3 x day ….7 days a week 7am, 3pm and 11pm

How much levothyroxine are you currently taking

When were vitamin D, folate, ferritin and B12 last tested

[Lucy1000 in reply to SlowDragon]

100 mcg 5X a week and 50 the other two days - I need to be tested for the other things - it has been two years. I tend to run low in the ranges but supplement all four. I suspect digestive issues to be a factor. Does it matter about having an empty stomach for T3 doses? I felt when I was splitting my 10 mcg dose early on, that the second pm dose wasn't making a difference. And...what if I forget a dose??

[SlowDragon Administrator in reply to Lucy1000]

Put split doses in a daily pill dispenser….then you can see if you have forgotten

45mins nothing apart from water before or after T3

Aiming for optimal vitamin levels by supplementing

Strictly gluten free diet helps thousands. Test for coeliac before cutting gluten out

[crmavb]

Yes I’m strictly gluten free and mostly dairy free.

[SeasideSusie Remembering]

Your thyroid results are what one would expect to see when someone is taking a combination of Levo and T3.

When was your last dose of T3?

You haven't said how you feel thyroid-wise.

CRP is over range, possibly inflammation.

Do you supplement Vit D? Recommended level is 100-150nmol/L.

Do you supplement B12 or a B Complex?

Ferritin is very low. Low ferritin can suggest iron deficiency anaemia. You need a full blood count and an iron panel.

[crmavb]

I tend to have T3 once a day in the morning. I had reduced to 6mcg and had wondered if the reduction had a part in my back pain. I sometimes have throat aches. But thyroid wise I’m not too bad. Feel sleepy at times so perhaps not optimum.

My last dose had been 24 hours prior to the test.

Yes I randomly supplement with vitamin D.

I’ll start taking spirulina again for the ferritin. And ask my drs for the full blood count and iron panel in the new year.

[SlowDragon Administrator in reply to crmavb]

Last dose of T3 should be 12 hours prior to blood test.

[SeasideSusie Remembering in reply to crmavb]

My last dose had been 24 hours prior to the test.

For Levo the last dose is 24 hours before blood test, for T3 last dose is 8-12 hours before test even if it means altering the time and/or splitting the dose. So as your last dose was 24 hours before the test then your results show a false low FT3.

I had reduced to 6mcg and had wondered if the reduction had a part in my back pain.

Personally, I doubt it but that's just my opinion. I have been undermedicated with T3 and my FT3 has been as low as 2.8 (2.8-7.1) and it didn't cause me to have back pain.

Yes I randomly supplement with vitamin D.

How much D3 do you take?

With your current level you should be taking a maintenance dose to keep it there, or even improve it a bit especially during the winter when we can't make Vit D naturally from the sun.

Do you take D3's important cofactors - magnesium and Vit K2-MK7?

I’ll start taking spirulina again for the ferritin

As a supplement? Check to see if it contains iodine, if it does then don't take it.

[Angel_of_the_North in reply to SeasideSusie]

I don't think you'd be able to to eat enough spirulina to get your ferritin up; I know I couldn't. If you had poor iron as a meat eater, you might need a colonoscopy and investigation by gastroentrology to see why you are not absorbing iron . You need to take ferrous fumarate 3 x 210mg a day with vit C if there is no internal bleeding etc.