Help with interpretation of blood test results - Thyroid UK

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Help with interpretation of blood test results

Parody103mg profile image
10 Replies

Can anyone help with recent interpretation of my private test results please. I was diagnosed with an underactive thyroid 16 years ago and have only ever been given Levothyroxine via my GP - many adjustments with doseage - up/down over the years re TSH results (mainly) only but makes no difference to how I feel - always tired and lethargic and no opportunity for endocrine referral. Doing my own research now (extra exhausting!) Would I benefit from either introducing T3 or change to NDT? I doubt my GP will consider this - same old Levothyroxine adjustment route! Also note my high Ferritin result! Advice would be much appreciated. Thanks.

CRP HS:

1.11mg/L Normal range: 0 - 5

FERRITIN:

313ug/L Normal range: 13 - 150 R

FOLATE - SERUM:

10.21ug/L Normal range: 3.89 - 19.45R

VITAMIN B12 - ACTIVE:

92pmol/L Normal range: 37.5 - 187.5

VITAMIN D:

80.7nmol/L Normal range: 50 - 175

TSH:

4.8mIU/L Normal range: 0.27 - 4.2

FREE T3:

3.94pmol/L Normal range: 3.1 - 6.8

FREE THYROXINE:

17.5pmol/L Normal range: 12 - 22

THYROGLOBULIN ANTIBODIES:

267kIU/L Normal range: 0 - 115

THYROID PEROXIDASE ANTIBODIES:

314kIU/L Normal Range: 0 - 34

10 Replies
SlowDragon profile image
SlowDragonAdministrator

How much levothyroxine are you currently taking?

Do you always get same brand of levothyroxine at each prescription.

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)

Is this how you did this test?

What vitamin supplements are you currently taking?

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 is in top third of range and FT3 at least half way through 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)

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

Your high TSH and very low Ft3 show you need 25mcg dose increase in levothyroxine

Bloods should be retested 6-8 weeks later

Presumably you knew that cause of your hypothyroidism is due to autoimmune thyroid disease also called Hashimoto’s, diagnosed by high thyroid antibodies

As you have Hashimoto’s are you on strictly gluten free diet?

Hashimoto's frequently affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten intolerance. Second most common is lactose intolerance

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find strictly gluten free diet reduces symptoms, sometimes significantly. Either due to 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

If no noticeable improvement, reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

High ferritin

Quite common with hashimoto’s

Can be due to inflammation of Hashimoto’s

Or haemochromatosis

Or MtHFR

stopthethyroidmadness.com/h...

Parody103mg profile image
Parody103mg in reply to SlowDragon

Thank you for your informative reply.

I take Levothyroxine 100mcg daily + 25mcg on alternate days. My last TSH test in September 2019 reading was 0.5 and GP suggested I reduced my (then 125mcg) daily dose to 100mcg but I knew that would be too low for me - hence the dosage I currently take with the result now reading 4.8 !!

I am given the same brands each month Accord Levo 100mcg and TEVA Levo 25mcg.

Tests were done early morning before beverage and medication.

Vitamin supplement is supermarket brand with multi vitamins (no iodine) but contains Vit C 90mcg, Vit D 10mcg, Folic Acid 200mcg, Iron 14mg, MtHFRVit B12 20mcg, Selenium 100mcg - amongst others. I took this supplement as I was looking for something to help my brittle hair and nails. I also take an additional Vitabiotics Vit D 1000 IU daily. My last GP test (September 2019) when I indicated I was feeling really tired, came back that I was severely Vit D deficient so I was prescribed 47,000 units of Vit D once weekly for 7 weeks and to then take over the counter vit D and Vit supplement which is what I have done since last November.

No, I do not follow a gluten free diet but I have certainly heard about this in relation to Hashimoto's. I didn't even realise I have Hashimoto's until I decided to get my bloods tested privately (through medichecks online) this week. The last antibody test I had through my GP was over 10 years ago! They have subsequently refused to retest as they said I have already had it done and it wouldn't have changed!! I will get a coeliac test done - probably privately again as I'm guessing my GP will poo-poo the idea. I can then proceed with coeliac diet according to results after that as you suggest.

High ferritin - have now stopped taking multivitamin supplement (only 2 days ago) which contained iron (only 14mg though).

To be honest, I am losing complete faith in my GP practice regarding this condition and I believe it is quite difficult to find a good, sympathetic Endocrinologist either. However, I have found online - recommended by others on another thyroid site/forum.

Getting and collating all info is very helpful for me to find the best direction forward.

Thank you!

SlowDragon profile image
SlowDragonAdministrator in reply to Parody103mg

Multivitamins are never recommended on here ....often has stuff in we don’t need....in your case iron!

Hopefully you iron will drop.

Suggest you instead take vitamin D mouth spray at 2000iu (Same dose as currently taking)

Better you make one that includes vitamin K2 mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

ouh.nhs.uk/osteoporosis/use...

Government recommends everyone supplement October to April

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

Aiming to keep B12 and folate at good levels 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 when you retest 3-4 months after going on strictly gluten free diet

(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...

Suggest you Request increase in levothyroxine to 125mcg every day in Accord brand levothyroxine

Bloods retested in 6-8 weeks

You may need further increase ...

Accord/Activis don’t make 25mcg ....you would need prescription amended to say 50mcg tablets and then cut them up

Teva brand upsets many, many people

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

Parody103mg profile image
Parody103mg in reply to SlowDragon

Hi SlowDragon

Thank you for your reply.

What is the difference between the Vit D mouth spray and oral intake? Can you let me know the brand you use with K2 and mk7? Probably not on here I guess but maybe a hint (or PM - maybe not possible on this site) ?! Also other vitamins that you suggest - do you get them from a specific site or 'shop around' for individual requirements?

General multivitamin contained Biotin 50mcg - interesting re blood results. Stopped taking that multivitamin now (only 2 days ago) but only started in November. I introduced general vitamin because of hair and nails being brittle and also because of tiredness.

I've heard TEVA doesn't agree with everyone.

All else taken on board and I will read through your links to gain more info.

Thanks so much for your help. It is much appreciated.

Parody103mg

SlowDragon profile image
SlowDragonAdministrator in reply to Parody103mg

Mouth spray vitamin D is often easier to absorb than in the gut, especially with Hashimoto’s.

betteryou.com/vitamin-d-k2

Vitamins Often cheapest on Amazon ....but shop around

Vitamin D swallowed needs to be four hours away from levothyroxine

Parody103mg profile image
Parody103mg in reply to SlowDragon

Thank you SlowDragon - I will check it out. Cheers!

SlowDragon profile image
SlowDragonAdministrator in reply to Parody103mg

T3 is not a magic bullet and by far the easiest is to try 25mcg increase in levothyroxine first

All FOUR vitamins need to be OPTIMAL too

Come back with new post when you get bloods retested 6-8 weeks after levothyroxine is increased and worked on improving all vitamins

Parody103mg profile image
Parody103mg in reply to SlowDragon

I totally understand that and am seeing GP this weeks re hopeful increase of 25mcg. I hope that she will take my private TSH test as read and will not insist on another test before she will increase my dose. I am interested in T3 because it appears I am not converting T4 to T3 adequately. I just want to find a reputable and reliable source as I know my GP won't consider this route - it's a "just in case" thought at the moment. I will not consider taking it until I know the results of further testing in 6-8 weeks time. Which 4 vitamins need to be optimal and how much should I be taking of these to help improve levels? Thanks.

SlowDragon profile image
SlowDragonAdministrator in reply to Parody103mg

Ditching the multi vitamin

Replacing it with vitamin D mouth spray by Better You

Perhaps adding daily vitamin B complex to maintain folate and B12

But remember to stop taking any supplements that contain biotin a week before any blood tests

Get rid of Teva brand and get all Accord Levo

Try strictly gluten free diet

Hopefully high iron levels will drop now stopped multivitamin

Email Dionne at Thyroid UK for list of recommend thyroid specialist endocrinologists who will prescribe T3....it’s not impossible to get prescribed...but difficult

Parody103mg profile image
Parody103mg in reply to SlowDragon

I will address all your advice. Thank you so much.

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