Can some1 help me I have hasimotos I still don't no how to read bloods!!!!

[Cassie101]

Hi i was dignosed with hasimotos 4 years ago now i got my bloods done on the 29 of may!! Can you tel me what I need i did tell them to test vid d but they didn't xx

[SeasideSusie Remembering]

Cassie101

Often Vit D wont be tested because doctors say it's an expensive test. You can do this yourself with an NHS lab which offers this test to the general public:

vitamindtest.org.uk/

Blood test results aren't that hard to understand when the reference range is included, which you have on that print out.

You are either in range or out of range. Out of range obviously suggests there's a problem which needs investingating. As far as in range is concerned, that's all a GP cares about, but it's where within the range you fall that counts, there are recommended and optimal levels which GPs are unaware of.

Starting at the top:

Ferritin: 19 (13-150)

You can see that you are in range but it is very low in range. A GP will think anywhere within that range is fine, but how you feel at 13 and how you feel at 150 would be very different.

It does say "Doctor satisfied with report (? blurred) - no action. But it also says "Consistent with low iron stores". Well ferritin is your iron store and it's been flagged as low, your GP has decided to ignore this.

The recommended level for ferritin is half way through range so really it should be closer to 82 - but your GP wont know or care.

With a ferritin level that low then a full blood count should be done to see if you have anaemia, and an iron panel should be done to see if you have iron deficiency which could be causing your low ferritin.

You have had a full blood count done, your haemoglobin, MCV, MCH and MCHC are in range so don't suggest anaemia.

Your red cell distributin width and neutrophils are flagged as out of range but the comment says your doctor is satisfied with the report, you might want to question these two out of range results.

Your TSH is is 1.61 (0.27-4.20 and your FT4 is 14 (10.50-24.50). The aim of a treated Hypo patient on Levo, generally, is for TSH to be 1 or below with FT4 and FT3 to be in the upper part of their reference ranges if that is where you feel well. Your FT4 is only 25% through range so suggests you could do with an increase in your Levo to raise this level and that should also bring your TSH down. You could ask for an increase in your dose of Levo, 25mcg now, retest in 6-8 weeks.

Liver and Us & Es are all in range, no problems there.

B12 may be better over 550ng/L (which is the same as pg/ml) 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."

Folate at 10.1 is OK.

You could consider a B Complex which would raise your B12 and would also have the effect of raising your folate level. If you wish to supplement with one, choose a good, bioavailable supplement such as Thorne Basic B or Igennus Super B.

[Cassie101 in reply to SeasideSusie]

Thank you so much so does this mean my iron is low and red blood cell? What does red cell mean? Also is my b12 low? Also do you think my antibodies are high? X

[SeasideSusie Remembering in reply to Cassie101]

Cassie101

so does this mean my iron is low and red blood cell

You haven't had an iron panel done so no-one can tell you if your serum iron level is low. Your ferritin is low but that's your iron store, not your serum iron.

Your red cell distribution width is over range not low. It's only slightly over range so you may wish to ask your GP of the significance of this.

Also is my b12 low?

I have already addressed your B12 level in my previous reply and given my suggestion of what to do.

Also do you think my antibodies are high?

Yes they are, you can see they are over range and this confirms Hashimotos's but you already know you have Hashi's. There's no point repeating antibody tests once you have a positive result confirming Hashi's.

[Cassie101 in reply to SeasideSusie]

Thank you so much xx

[Cassie101 in reply to Cassie101]

Hi seaside Susie i took your advice and asked for another blood test i dont understand could you help me please xx

[Cassie101 in reply to Cassie101]

Hi i had to post in a new post because it wouldn't let me upload pic on this post x

[SlowDragon Administrator]

Ferritin is very low

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

dailyiron.net

Links about iron and ferritin

irondisorders.org/Websites/...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

[Cassie101 in reply to SlowDragon]

Hi ya thanks for replying i think I have a bigger problem i have hasimotos disease but my red blood cell distribution width is always low and my white blood cell count is always low to its always flagged up when I have my bloods done I also got everything else tested on previous message with my may good test results if you could help me please xx

[SlowDragon Administrator in reply to Cassie101]

Just replied about those on other post

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

[Cassie101 in reply to SlowDragon]

Yes been gluten free for 8 weeks now ill take a look on my other message x

[Cassie101 in reply to Cassie101]

This is the 1 with all bloods were done but was concerned about how low things was i got them to retest so is my b12 iron.. vit d .. all low and my thyroid?? Xx

[SlowDragon Administrator in reply to Cassie101]

Vitamin levels are bound to be low when hypothyroid

Hypothyroidism causes low stomach acid and low stomach acid results in low vitamin levels

With Hashimoto’s we frequently need to supplement vitamin D, B complex, magnesium virtually continuously

Working hard on improving low ferritin with iron rich diet

If you are prescribed iron supplements, iron levels need retesting regularly.

[SlowDragon Administrator in reply to Cassie101]

It takes many months for gut to heal on gluten free diet

And does need to be absolutely strictly gluten free. Watch out for cross contamination, use separate toaster for GF toast, separate butter, jam, cutting boards etc

[SlowDragon Administrator]

Many people find Levothyroxine brands are not interchangeable.

Once you find a brand that suits you, best to make sure to only get that one at each prescription.

Watch out for brand change when dose is increased or at repeat prescription.

Many patients do NOT get on well with Teva brand of Levothyroxine. Teva contains mannitol as a filler, which seems to be possible cause of problems. Teva is the only brand that makes 75mcg tablet. So if avoiding Teva for 75mcg dose ask for 25mcg to add to 50mcg or just extra 50mcg tablets to cut in half

Teva and Aristo are the only lactose free tablets

healthunlocked.com/thyroidu...

Teva poll

healthunlocked.com/thyroidu...

academic.oup.com/jcem/artic...

Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).

Levothyroxine is an extremely fussy hormone and should always be taken on an empty stomach and then nothing apart from water for at least an hour after

Many people take Levothyroxine soon after waking, but it may be more convenient and perhaps more effective taken at bedtime

verywellhealth.com/best-tim...

No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.

Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away

(Time gap doesn't apply to Vitamin D mouth spray)

[Cassie101 in reply to SlowDragon]

I have changed all brands of levo and still have the same side effects none of them agree with me x

[SlowDragon Administrator in reply to Cassie101]

Which brands of levothyroxine have you tried

Starting on very low dose often causes problems

You may need lactose free levothyroxine, or liquid levothyroxine

[Cassie101 in reply to SlowDragon]

I have tryed all of them cant remember there names it was a year ago but iv been through them all as doctors said change over but none agree with me x

[SlowDragon Administrator in reply to Cassie101]

Well you have to be taking high enough dose and stick on each dose and brand for minimum of 6-8 weeks

[Cassie101 in reply to SlowDragon]

Yeah I worked with my gp last year thats how we got to the 1 i am on now it was hard work i take it at night tym so I feel ok in the morning xx

[SlowDragon Administrator]

You might find this similar post from yesterday helpful

healthunlocked.com/thyroidu...