FERRITIN - 32ug/L (range 10/200) Normal - however iron saturation level very high so was told to stop taking ferrous sulphate every day and to take every other day.
1.5.20
- continue levo 75mcg. PPI meds - potential silent reflux as throat still hurts.
SERUM TSH - 0.66mu/L (0.35-5.00mu/L) "Normal"
SERUM FREE T3 - 3.80pmol/L (2.60-5.70pmol/L) “Normal”
SERUM FREE T4 - 13.3 pmol/L (range 9-22.00pmol/l)
FERRITIN - 23ug/L (range 10/200) Normal. Dropped from March
9.7.20 – continue levo 75mcg however T4 level now dropped
Se thyroid peroxidase Ab conc – 39.6ku/L (range 0.00-5.60ku/L)
SERUM TSH 0.41mu/L (0.35-5.00mu/L) "Normal"
SERUM FREE T3 - 4.6pmol/L (2.60-5.70pmol/L) “Normal”
SERUM FREE T4 - 11.7pmol/L (range 9-22.00pmol/l) Normal
It would really help us if you could put all the tests done on the same date together, rather than separating them into test groups. Thyroid blood test results need to be interpreted in conjunction with each other to see what is going on and why. I did start reading your results but it was just too hard to continue - especially as the list is so long. We need something like this:
What is happening here? You replied to my comment with all your results in the right order, and now they've disappeared! I wrote you a long response:
That's much better!
Don't want to quibble, but there's really no need to write 'normal' after each test, because anyone who knows anything about all this can see at a glance that virtually nothing is 'normal' here. I suppose that's your doctor's oppinion, is it? Well, when a doctor says 'normal', all he means is 'in-range'. He doesn't know enough about it all to understand the nuances of blood tests.
Now, here I'm tempted to say a very rude word beginning with B! Your FT4 is now only 16.15% - lower than it was last August! How can that show that you're on 'adequate thyroxine replacement'? You're going to have problems with this doctor, because he doesn't know what he's doing. You needed an increase of 25 mcg at that point.
1 MAY 2020
- continue levo 75mcg. PPI meds - potential silent reflux as throat still hurts.
Now, here we have a huge mistake on the part of your doctor. PPIs reduce stomach acid. Which is why doctors prescribe them for acid reflux, assuming that acid reflux is always caused by high levels of stomach acid. But, it isn't. Hypos are far more likely to have low stomach acid, but the symptoms are the same. So, now you have the PPI reducing your stomach acid even further, affecting the absorption of everything you put in your stomach - like levo and iron supplements (which he's just reduced!). When what you need is something to raise your stomach acid - even if it's only vit C!
SERUM TSH - 0.66mu/L (0.35-5.00mu/L) "Normal"
SERUM FREE T3 - 3.80pmol/L (2.60-5.70pmol/L) “Normal”
OK, so there, your TSH is much better. And, the FT4 is rising - but still too low. And there we have an FT3 - the most important number - which is also too low - needs to be about 65/70%. But, that's progress!
Se thyroid peroxidase Ab conc – 39.6ku/L (range 0.00-5.60ku/L)
Not much point in retesting antibodies once you know you have Hashi's. Antibodies fluctuate but Hashi's doesn't go away. The actual levels of the antibodies are irrelevant.
SERUM TSH 0.41mu/L (0.35-5.00mu/L) "Normal"
SERUM FREE T3 - 4.6pmol/L (2.60-5.70pmol/L) “Normal”
SERUM FREE T4 - 11.7pmol/L (range 9-22.00pmol/l) Normal
So, there we have further progress. TSH down a bit, FT3 up a bit. FT4 has dropped a bit but I shouldn't worry too much about that, as long as it doesn't drop any further. Could just be down to the Hashi's, or because you're now converting more of it.
That is now so very low, your doctor should be investigating further. Low iron will make you very tired. Perhaps he should refer you to a heamatologist to find out what's going on.
VITAMIN B12 - 869 ng/L (range 200.00 - 910.00ng/L) Normal Result
VIT D - 119 n/mol/L (range 50.00 - 200.00nmol/L) Normal
These are good. But your folate is still a bit low.
Well, I've copied and pasted, but now you haven't got the highlights! lol
Wow. Thanks so much for the above. A lot to take on!
Ref “normal” and “adequate thyroxine replacement” its what my hospital write on the results sheet. I will leave them off next time Oh and yes I supplement B12.
FYI Aug last year I went to the docs as I was very tired and had brain fog. My ferritin level was 8 so I was put on ferrous sulphate. January 2020 I was still no better and had a dreadful sore throat, like I was being strangled. The doctor suspected thyroiditis which was confirmed with the blood tests. I went to see an endo privately (from off healthunlocked list). He put me on 50mcg levo and increased to 75mcg after my second blood test.
The throat pain continued and a thyroid scan in March 2020 showed thyroiditis. My endo prescribed prednisolone for three weeks, but the pain didn’t go. So he referred me to an ENT, however COVID started and the first private appointment I could get was for August! There were no NHS appointments.
With the throat, I also had terrible stomach pain and was burping constantly. I spoke to my GP (and also got a second opinion) and she thought I may have silent reflux which was causing the throat pain (and obviously the burping/stomach pain) so I was put on PPIs. As soon as I started them the burping stopped instantly and the stomach pain improved. But the throat pain still hasn’t gone. This was all via phone conversations due to COVID.
The NHS started to open up appointments. I was referred to an NHS ENT consultant - I went for a barium swallow test and an MRI which showed some reflux, but not a lot. He did not want to do an endoscopy as it’s so invasive/risky.
As the pain has continued, last week I was finally offered an appointment for an endoscopy. However I was told I would have to completely self isolate - and not even see my children!!!This is impossible. Next step is I have a phone call with my endo in a weeks time. I will ask about the PPIs for sure, iron levels and perhaps Vit C. Although he may not be able to advise.
Ref seeing a heamatologist, I may ask for this. My ferritin has been an issue for some time. I just can’t seem to get the ferritin level up. Didn’t help that when it was at its highest of 50, my iron saturation level went too high and my doc consulted with a heamatologist who recommended that I have iron every other day.
My throat hurts, I’m tired and run down and can’t see anyone!! it’s such a terrible time to be ill! But I’m grateful that it (hopefully) isn’t anything serious.
Ref “normal” and “adequate thyroxine replacement” its what my hospital write on the results sheet. I will leave them off next time
As long as you know it's not true. Results are not 'normal' just because they're in-range. And that FT4 result was a long way off showing that you were on adequate thyroid hormone replacement.
Oh and yes I supplement B12.
Ok, good. But, when we take B12, we should also take a B complex, because the Bs all work together, and need to be kept balanced. So, if you get one with at least 400 mcg methylfolate, that will bring your folate level up nicely. Igennus do a good one, and you can get it on Amazon.
Your thyroid is probably swollen, which is causing the throat pain. PPIs won't help with that. Are you still taking them? They should only be taken for short periods of time. They're actually pretty nasty things to take. Especially if you don't need them. The fact that you stopped burping doesn't mean they're doing you any good.
Vit C is a very good thing to take, for all sorts of reasons. For one thing, it helps you absorb just about anything. Have you not been taking it with your iron? One should always take vit C with iron supplements, to help you absorb it, and to protect your stomach. They might help you in a lot of ways. I take between 2000 and 5000 mg daily - especially with the threat of COVID hanging over our heads! But, I wouldn't expect any doctor to know much about it. Just buy some and take it - you don't need the endo's permission.
They do say that the best way to raise ferritin is to eat liver once a week. Not more than once, because it's very high in vit A. And, you do need to still have a source of vit C with it. But, worth a try if you can eat liver. Personally, I love it!
Yes, it is a bad time to be ill. But, all the more reason to take vit C - give it to the kids, too! As soon as the pandemic started, I stocked up on Vit C for myself, my daughter and my granddaughters, and Amazon was running out fast! Should be more in stock by now, though.
Thanks so much for the above. I do have some solgar 1500 with rose hips that I take all winter. It helps greatly with colds so will defo start taking them again with my iron. Will also look at the b complex.
Interesting that you say that the thyroid is probably hurting as it’s swollen. It makes sense... so fingers crossed when I get my meds right it will settle down. As the scans didn’t really find anything significant they almost made me feel it was in my head (mentioned globus sensation!)
Thanks so much for listening and taking the time to respond! So therapeutic!!
The aim is for the FT4 and the FT3 to be in the right place for you, where you feel well. As the Frees rise, the TSH will go down, that's how it works. But, the TSH is not the most important number. Once it goes below one, it doesn't give us much useful information. The most important number is the FT3. And, if the TSH falls below range when your FT3 is in the right place, so be it. I doubt your doctor would agree with me, but that's the way it is in real life.
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