Opinions/help on blood tests and ongoing symptoms

[liaratsoni]

Hi everyone!

I had a host of blood tests done this week and just got the results and they are both very good and also confusing! My previously low for years b12, ferritin and vitamin d were all great (the only thing I am currently supplementing is b12 which I laid off for a couple of weeks before the test)

vit d was 91 (75-200)

b12 was 1086 (200-900)

ferritin was 89! (15-250) (highest its been in YEARS and I haven't even been eating meat for over six months and was on a liquid diet over christmas so I was incredibly shocked!)

Folate was 8.8 (2-17) (i also didnt fast before the test as I didn't know I was having it but is this a little low?)

So overall I seem to be absorbing vits again likely thanks to t3 which I am overjoyed about. However strangely my white cell count and monocytes are still under range and my neutrophils are on the bottom number of the range. They also did my t3 and t4 unexpectedly but I don't know how accurate they are as I had not been on the dose 4 weeks (I started on 10mcg on 23 January for 2 weeks then increased to 15mcg for a couple of days but couldn't tolerate it so decreased to 12.5 then back to 10 on the 15th feb)

t4 was 17.3 (10-20)

t3 was 5.6 (3.5-6.5)

as you can see t4 is still great (I am surprised it is so high though I thought it decreased with addition of t3?) and t3 better than the 4 it used to be. However I still don't feel well. I feel a bit better but I am still exhausted, have digestion issues - constipation and slow digestion/reflux though more improved from before, and have some other new strange symptoms like shaking in hands and dizziness/vertigo especially when standing and with exercise like climbing stairs. I've also suddenly got awful acne - which is probably my digestion. My hematologist I saw last week also said I was on the verge of anemic with a hemoglobin of 118 (115-165) and it was she that got vits tested but all my vitamins appear fine so I am very confused.

Does anyone have any advice. From what I calculated my t3 is 70% through range so not yet in top quarter so could it still be improved? I previously as mentioned tried to go up to 15mcg t3 but had headaches/heart rate increase as with first dose which I took as sign my body couldn't tolerate it yet and moved back down. I am currently eating more than I used to be able to and around 1600 calories a day (the ideal for my height/mbr etc is 2000 and I am still underweight). Do you think the symptoms could still be related to undertreatment? Many thanks!

[SeasideSusie Remembering]

liaratsoni

Good to know that your nutrient levels have improved.

As for your thyroid results, I really don't think you can take anything from them. You need to wait 6-8 weeks after a dose change for levels to stabilise so because you'd been on the T3 for less than 4 weeks and had gone from 10 to 15 to 12.5 to 10 all in a very short space of time, with the last dose change only a week or so before the test then your FT3 result really isn't telling you anything at all. I would stay on your current dose now and retest in 6-8 weeks' time, things could be very different.

[liaratsoni in reply to SeasideSusie]

Thats what I thought would be the case! May I ask if it is unusual for my t4 to remain high while on the t3? Thank you!

[SeasideSusie Remembering in reply to liaratsoni]

Well your FT4 has come down from 18.8 to 17.3, you haven't lowered your dose of Levo, so assuming that your test was done exactly the same as previously - same time of day with last dose of Levo 24 hours before blood draw, then there has been a bit of a reduction and you are on a small dose of T3 and your levels haven't stabilised. I would just wait and see what happens when you next retest at the correct time.

[liaratsoni in reply to SeasideSusie]

I see thank you for all you help!

[SlowDragon Administrator]

When you get thyroid levels tested after 6-8 weeks on constant unchanging dose

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)

If/when also on T3, make sure to take last 1/2 or 1/3rd of daily dose 8-12 hours prior to test, even if this means adjusting time or splitting of dose day before test

[liaratsoni in reply to SlowDragon]

Thank you for the info!