Blood test results help: Hi ladies & gentlemen... - Thyroid UK

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Blood test results help

PJP1 profile image
PJP1
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Hi ladies & gentlemen, Please help me to check my blood test results back from the doctor and wondered if anyone would be able to confirm its "normal" as the doctor has advised - the blood test was taken on Monday 8/6/20 with the last thyroxine tablet taken on 6/6/20 - I had my thyroid removed over 20 years ago due to multinodular goitres and take 100 thyroxine every day with 2 days a week having an extra 25 per day - I also use Vitamin D3000 spray daily - unless the temperature is warm my hands and feet remain cold from the afternoon up to around 11pm at night with dry skin, fingernails splitting down the nail and obviously weight gain. I also have painful shoulders and possibly muscular problems with my knee with legs being very weak after a short walk of 300-400 yards, so much so that I need to stop and wait a little while before walking again.

TSH - 2.8 - range 0.34 - 5.60

Free T4 - 13 - range 7.7 - 15.10

Free T3 - 5.3 - range 4.30 - 6.80

Folate - 7.7 - range 3.80 - 25.00

Ferritin - 149 - range 11.00 - 307.00

Vitamin D - 159

Vitamin B12 - 214

Sorry for the long description - Many thanks

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SeasideSusie profile image
SeasideSusieRemembering

PJP1

the blood test was taken on Monday 8/6/20 with the last thyroxine tablet taken on 6/6/20

Why did you leave your Levo off for 2 days?

Last dose should be 24 hours before blood draw, so your results are showing a false low FT4.

Your TSH at 2.8 is telling us that you are undermedicated - but did you fast overnight from evening meal the night before and did you drink water only before the blood draw (no coffe, tea, etc), and was your blood test done no later than 9am? All these things can affect TSH result.

Your FT4, allowing for the fact that it would be higher if you'd only left 24 hours from last dose of Levo, is telling us that you are adequately medicated. It's showing as 71.62% though range, it would be possibly 10-20% higher with correct timing of last dose.

Your FT3 is 40% through range so not in balance with your FT4.

Low T3 causes symptoms.

Ferritin and Vit D are OK.

Folate a bit low, it's recommended to be at least half way through range (14.5+ with that range).

B12 is poor. This could be part of your problem. Can you say if it's ng/L or pg/ml or pmol/L.

If it's ng/L or pg/ml then according to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Many people with a B12 level in the 300s have been found to need B12 injections.

You should check for signs of B12 deficiency:

b12d.org/submit/document?id=46

b12deficiency.info/signs-an...

If you have any then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

PJP1 profile image
PJP1 in reply to SeasideSusie

Thank you for your reply - as I said I take my thyroxine at night now which is why there was a gap and only had water before blood test - went straight from surgery to take out coffee 👍🏻 - on the sheet it states B12 is ng/l with the figure of 160ng/l - will definitely check with doctor re the B12 levels - thank you very much

SeasideSusie profile image
SeasideSusieRemembering in reply to PJP1

PJP1

as I said I take my thyroxine at night now which is why there was a gap

In that case you should alter the timing of your dose for a day or two before the test so that you can leave the required 24 hours.

on the sheet it states B12 is ng/l with the figure of 160ng/l - will definitely check with doctor re the B12 levels - thank you very much

ng/L is the same as pg/ml

160ng/L will be the low limit of the range, the top limit may be something like 800 or so.

Your doctor will say you are in range so everything is OK. Please be aware that it's symptoms that are important where B12 deficiency is concerned, not numbers, which is why I said to check those links and see if you are experiencing any signs and symptoms. If you are you will need to list them and show your GP. If you have signs and symptoms do not be fobbed off with "your level is within range" by your GP, you will need testing. As mentioned, many people with a level in the 300s have been found to need B12 injections. Your level is low whatever your doctor says.

PJP1 profile image
PJP1 in reply to SeasideSusie

Thank you - I’ll speak to doctor if/when this is over

greygoose profile image
greygoose

When a doctor says 'normal', all he means is 'in-range'. And, yes, as any idiot can see, your results are 'in-range'. But, that doesn't mean they are right for you.

Why did you leave such a long gap between your last dose of levo and the blood draw? You're only supposed to leave 24 hours. So, you have a false 'low' FT4, there. Had you left 24 hours, you probably would have had an over-range FT4. Your FT3, on the other hand, is only 40% through the range, which is too low. Whether or not that is affected by the long gap between last dose and blood draw is impossible to say. But, your TSH is too high - should be down to 1 or under - so that FT3 result is probably correct. You are a poor converter. Which could account for your continuing symptoms.

Your vit B12 and folate are too low.

PJP1 profile image
PJP1 in reply to greygoose

Thank you for the reply - I should of said that since working from home I take my thyroxine at bedtime so I can have a coffee as soon as I come downstairs so although it was 6/6 it would’ve been around midnight although that would mean around 34 hours after when the blood test was taken, would that also be too long?

greygoose profile image
greygoose in reply to PJP1

That would be much too long, yes. So, you do have a false 'low' FT4 reading.

PJP1 profile image
PJP1 in reply to greygoose

Thank you - your comments have been very helpful

greygoose profile image
greygoose in reply to PJP1

You're welcome. :)

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