Thyroid and MCMC

[Yoll]

I had a blood test as I want to lower my Levothyroixine. I haven't been well for a year now but cannot pin point the reason, I have had gallbladder issue and I look pale sometimes grey. I also have a persistent low grade temperature 37.4 -38.1.

I didn't take the levy before the test, and T4 still came out at 15pmol, TSH 1.11miu. But the more worrying result was the MCMC which was above normal range 37.3g/dL.

What coud the reason fort this be?

I was told No further action needed when I rang the surgery.

I have now been sent for a chest xray and kidney scan?

Any thoughts would be welcome.

[SlowDragon Administrator]

Can you add the ranges on Ft4 please

Obviously just testing TSH and Ft4 is completely inadequate

How much Levothyroxine are you currently taking?

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)

[Yoll in reply to SlowDragon]

Ft4 range ( 11-22) last dose more than 24 before, but I had eaten as I was not told not to.

I take 100mg a day

I want to have a full private test done, but need to wait until things open up again

[SlowDragon Administrator in reply to Yoll]

So Ft4 is only 37% through range

Helpful calculator for working out percentage through range

chorobytarczycy.eu/kalkulator

The aim of Levothyroxine is to increase the dose slowly in 25mcg steps upwards until TSH is under 2 (many patients 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 note 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

[SlowDragon Administrator in reply to Yoll]

guidelines by weight might help push for dose increase in levothyroxine

Even if we don’t start on full replacement dose, most people need to increase dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until on full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

gp-update.co.uk/Latest-Upda...

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

[Yoll in reply to SlowDragon]

I have been on Levo for more than 10 years but never felt it helped that much with the symptoms of tiredness, brain fog, etc.. I quit my job because of it.

It looks like I need to go and do a little more studying to make sense of all this.

I don't have any FT3 results in this test. Just TSH and Ft4

I was thinking of decreasing rather than increasing.

From the 1.6 /kg calculation I am on a correct dose, but feel rubbish!

[SlowDragon Administrator in reply to Yoll]

Well we need optimal vitamin levels for good conversion

So it’s essential to regularly retest vitamin D, folate, B12 and ferritin

What vitamin supplements are you currently taking?

If you have Hashimoto’s often gluten and/or dairy free diet helps

But many people just can’t manage on just levothyroxine

Likely to find Ft3 is low

Reducing levothyroxine likely to make that worse obviously

First step is to get full thyroid and vitamin testing

DIY finger prick test only option at moment

[Yoll in reply to SlowDragon]

At the moment I take Selenium with ACE+D , I eat Marmite for B12 and loads of veg meat and eggs. Magnesium and thiamine.

I find it difficult to get any of the tests required. I was told that they wouldn't bother to test for Hashimoto's as the treatment is the same !!

I have been running again a brick wall for years. Last time I insisted on seing a specialist the letter that was sent was so rude about me been obstreperous and a difficult woman that the specialist just fob me off. I have changed doctors and

now I am retired I'm trying again to sort my health.

Obviously it's not the best time to have a go.

I'll see what I can do about a blood test first, I have the kit just need the person to draw the blood.

Thank you for your help it is most appreciated

[SlowDragon Administrator in reply to Yoll]

About 90% of all primary hypothyroidism in Uk is due to Hashimoto’s.

Low vitamin levels are particularly common with Hashimoto’s.

Gluten intolerance is often a hidden issue too

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Medics ignore the autoimmune aspect....but it’s essential for you the patient to know as there’s much we can do to help ourselves

Extremely important to regularly retest vitamin levels

[Yoll in reply to SlowDragon]

I have never had vitamin levels tested!

I wanted to find out if it was Hashimoto's as I was looking at the studies of LDN and wonder and if that would help, but I am organising myself to go gluten free, and later add dairy free.

I will try and get my vitamins check! Wonder what answer I'll get?

I do think all my problems are link to the thyroid.

Thank you

[SlowDragon Administrator in reply to Yoll]

Easy vitamin D test ..

vitamindtest.org.uk

[SlowDragon Administrator]

Do you mean high MCHC?

Again please add ranges on results

[Yoll in reply to SlowDragon]

Mean cell Haemoglobin concentration was above range range being 30-35 and mine was 37.3

[SlowDragon Administrator in reply to Yoll]

MCHC

medicalnewstoday.com/articl...

Has GP done full iron panel test for anaemia?

Including ferritin

[Yoll in reply to SlowDragon]

No iron test / no liver function test.

The Doc was looking for reason for temperature

[SlowDragon Administrator in reply to Yoll]

So request full iron panel test for anaemia, including ferritin

Ask for vitamin D, folate and B12 test too

[Yoll in reply to SlowDragon]

Thank you I'll have a go!

fingers crossed!

[Teanna]

Hi, I’ve been on Levo for at least 6/7 years. Since being on it I’ve suffered with fatigue, weight gain, lack of sleep etc. I’m up to 150mg daily but it’s not been checked for over a. year. I also suffer with depression, I think that it’s due to lockdown, also my GP is no longer helpful, I know she has had a breavement, but even before that she has the attitude of yr just a number. Amongst the all the other health issues I feel alone. I asked for a telephone appointment, I had everything written down, but she was not interested & cut me short. But one thing I’ve noticed that they have stopped the Ranitidine, I asked my pharmacy that it was missing, he said that the GP’s was stopping this medication.

Now being left with my black legs etc, my GP is not interested.

I hope they will find a vaccine for this virus, but my surgery has ask me to have the flu injection ASAP, why so early??

That’s enough of me. And I’m soooo sorry that I go on & on, bt I’ll be talking to the 4 walls if I’ve got no-one to talk to.

Take care, be safe

Teanna

[SlowDragon Administrator in reply to Teanna]

Teanna suggest you put up a post of your own then more members would see your post and may be able to help