Recent results are confusing

[Twig2020]

Hi all, I’ve recently had bloods done (NHS and Thriva) and the two are quite different. My Thriva says my TSH is 7.34 and my FT4 is 14.2. It wasn’t a full thyroid test so I don’t have T3 or TPO. My ferritin from the NHS test was low, 12.5 but Thriva test was higher (?). My folate and Vit D is v low. I’ve been feeling fatigued and very sore muscles & shortness of breath. I had mild Covid symptoms back in March and was hoping they’d pass.. they haven’t (hence the blood tests). With your experience, would you push for a thyroid drug? I’m now taking Vit D, folate, Ferrus Sulphate, selenium (you name it!) 😬 and I’m eating super healthily. I was v active prior to Covid, teaching 7+ spin classes a week and now I struggle to walk around the block plus I’ve put on 18lbs in just 3 momths. Any advice would be v welcome 🙏

[SeasideSusie Remembering]

Twig2020

Your GP will probably not take any notice of your Thriva test, so why not post all results that you have got, with reference ranges, so that members can give a more informed reply. Include the vitamin results and tell us what doses of supplements you are taking.

[Twig2020 in reply to SeasideSusie]

Thank you I will 👍🏻

[Twig2020 in reply to SeasideSusie]

NHS Thriva

Serum Free T4 12.5 pmol/L 14.2 pmol/L

Serum TSH Level 4.78 mu/L7.34 MIU/L

CRP 1 mg/L 1.22 mg/L

Folate 5.8 ug/L 15.2 nmol/L

Active B12 561 ng/L 116 pmol/L

Vitamin D 42.9 nmol/L

Iron Profile

Serum Iron level 23 umol/L 34.79 umol/L

Transferrin 2.63 g/L

Transferrin Saturation35%60.31%

Ferritin 25 ug/L50.3 ug/L

Total iron binding capacity 57.69 umol/L

Unsaturated TIBC 22.9 umol/L

HbA1c 35 mmol/mol 37.82

Triglyceride/HDL ratio 0.43 : 1

[Twig2020 in reply to Twig2020]

Hope you can read this ok.. the second line is a bit squashed, it should read..

Serum TSH Level 4.78 mu/L. 7.34 MIU/L

[SeasideSusie Remembering in reply to Twig2020]

Twig2020

We need all the reference ranges as well please, the Thriva ranges will very likely be different from your NHS ranges so we need to work out where in each one's range the result falls.

Your NHS wont be Active B12. NHS does Total B12 which measures something different from Thriva's Active B12.

[Twig2020 in reply to Twig2020]

I’ve just started taking supplements in the last couple of weeks.. I’ve upped my vitamin D to 125 ug per day. Liquid methylfolate 4 drops (400 ug) plus lots of leafy greens. Magnesium 500 mg, selenium 100 ug, and Ferrous sulphate 200 mg plus Vit C.. then lots of fresh ginger/lemon, & turmeric (in moderation).

[SlowDragon Administrator in reply to Twig2020]

Low ferritin

If taking iron supplements you must test iron and ferritin regularly

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...

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

[SlowDragon Administrator in reply to Twig2020]

NHS B12 text is serum test

Thriva is active B12

Both are fine

Vitamin D is low. Aiming to improve to at least around 80nmol

Folate on low side

Ferritin very poor.

Retest FULL Thyroid including thyroid antibodies in another 6-8 weeks

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested. Also important to regularly test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you have autoimmune thyroid disease (Hashimoto's) diagnosed by raised Thyroid antibodies

Ask GP to test vitamin levels

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 .

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?

Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins

List of private testing options

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

Medichecks Thyroid plus ultra vitamin

medichecks.com/products/thy...

Medichecks often have special offers, if order on Thursdays

Thriva Thyroid plus vitamins

thriva.co/tests/thyroid-test

Blue Horizon Thyroid Premium Gold includes vitamins

bluehorizonbloodtests.co.uk...

[Twig2020 in reply to SlowDragon]

Thank you SlowDrsgon that’s really helpful. Yes the NHS and Thriva rests were both early morning and fasted. Thriva Have sent me a replacement iron and thyroid test because I was surprised NHS test was so different. Unfortunately it’s not the full Thyroid test which I will have to order separately.

[cjrsquared]

If you are still breathless on exertion after covid 19 you should see your gp who should refer you for a chest X-ray. Covid 19 causes infiltrates in the lungs, an inappropriate immune response in some people hence reduced oxygen uptake and breathlessness. Depending on the severity of the infiltrates it can take sometime to resolve. Of course you may not have this but current advice is chest X-ray at 6 weeks and then if anything untoward referral to a chest physician.

I also agree with SeasideSusie, post your blood results with ranges so people can give more informed suggestions.

Hope you soon start to improve.

[Twig2020 in reply to cjrsquared]

Thank you for this, yes I had a chest X-ray some weeks ago and it came back clear thankfully. Not sure where to go with the prolonged SOB symptoms, they’re so strange and they come and go.

[Angel_of_the_North in reply to Twig2020]

Can be low ferritin. You can buy a blood oxygen tester for under 30 - don't know how accurate they are, but you'd be able to see if breathlessness happens when oxygen is low. I had breathlessness not helped by asthma inhaler when my B12 and iron were too low for me although my serum B12 looked OK

[cjrsquared in reply to Angel_of_the_North]

If you are breathless due to anaemia sats probe won’t show low oxygen. Sats probe record percentage of oxygen carried by the available haemoglobin, this assumes normal levels of haemoglobin, carrying capacity.

Imagine oxygen molecules as people at a crowded station awaiting trains. If enough trains turn up everyone gets where they want to go. If to few trains turn up, the trains will be crowded (haemoglobin well saturated) but not enough trains to get everyone here they are needed. This is why you need caution interpreting oxygen saturation’s.

This is also why in chronic lung disease, long term low oxygen levels stimulate excess red cell production mimicking what happens when athletes exercise at altitude.

[Twig2020 in reply to cjrsquared]

Is there anything I can do to test this?