Thyroid Results help needed please : My results... - Thyroid UK

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Thyroid Results help needed please

Lollipops45 profile image
9 Replies

My results all say normal is this correct, I feel rubbish.

FT4 15.7 range (12 - 22)

TgAB No result

TPOAb 11.2 (0-34)

TSH 1.79 (0.27-4.2)

T4 99 (66-181)

FT3 3.5 (3.1-6.8)

B12 70 (37.5-188)

Ferritin 66 (13 - 150)

Folate No result

Vit D 68 (50-175)

I'm taking 100mg of levothyroxine per day, (for 2 years) vitamin D was previously low, was prescribed high dose in March, advised they don't check it again, was taking maintenance dose but stopped at the start of summer.

Do these figures look ok?

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Lollipops45
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9 Replies
fuchsia-pink profile image
fuchsia-pink

Well they're "in range" - but they're not great ...

TSH is higher than I would want. Free T4 is only 37% through range. Free T3 is really low - only 10.8% through range, I'd try and get an increase of 25 mcg of levo and see where that takes you, but you really need better conversion as well as both frees being higher.

Good luck x

Lollipops45 profile image
Lollipops45 in reply to fuchsia-pink

Thanks for the advice, I'll book an appointment.

fuchsia-pink profile image
fuchsia-pink in reply to Lollipops45

Hopefully you'll get your folate and Vit B12 tested as well - these need to be nice and high - and on a rubbish day like today, take your vit D as well :)

SlowDragon profile image
SlowDragonAdministrator

Presumably Medichecks are sending new test kit for folate and TG antibodies

Do you know if GP ever tested thyroid antibodies in past

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

Important to see exactly what has been tested and equally important what hasn’t been tested yet

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 do your tests?

As fuchsia-pink says ..results suggest you need 25mcg dose increase in levothyroxine

When you see GP ....guidelines on dose by by weight might help push for dose increase

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...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

A small Dutch double-blind cross-over study (ArchIntMed 2010;170:1996) demonstrated that night time rather than morning dosing improved TSH suppression and free T4 measurements, but made no difference to subjective wellbeing. It is reasonable to take levothyroxine at night rather than in the morning, especially for individuals who do not eat late at night.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

bestpractice.bmj.com/topics...

Vitamin D needs improving to at least around 80nmol and around 100nmol maybe better

Ferritin borderline

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.

Lollipops45 profile image
Lollipops45 in reply to SlowDragon

Thanks for replying, the test was through Thriva and they have offered a part refund.

I'll phone the doctors tomorrow and get previous blood tests, they have never mentioned anything about antibodies tests results.

I have a low white blood cell count which needs checking again anyway, so hopefully should be able to all blood tests done.

I'll start vit d again and try improve the iron in my diet, many thanks.

SlowDragon profile image
SlowDragonAdministrator in reply to Lollipops45

Ask Thriva to repeat the folate and TG antibodies tests

NHS won’t test TG antibodies as your TPO are negative

Lollipops45 profile image
Lollipops45 in reply to SlowDragon

Ok , will do, thank you

Karenk13 profile image
Karenk13

You're vitamin D is in range but only just. You should continue to take your maintenance dose if you stop it will just drop again. Low vitamin D can cause alot of problems like fatigue, depression, general feeling of unwellness etc. I would start taking it again if I were you

Lollipops45 profile image
Lollipops45 in reply to Karenk13

I've started again now, going to take the spray with 3000 a day and see hows it goes, thank you

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