Help for my mother Part 3 - Private blood test results

[BelfastGirl737]

Good afternoon,

We got back my mum's private blood test results ad I would like to get some help to decipher them. The private GP has said that everything is fine but I would love help to understand them.

Thanks Joanne

[humanbean]

I'm afraid your photos are a bit small for me to read much.

Vitamin D looks low. Is it 29 nmol/L ? An optimal level is around 100 - 150 nmol/L. If I've read it right then your mother would definitely feel better with a much higher level.

You can work out the dose she needs from this link :

grassrootshealth.net/projec...

Vitamin D supplements should always be vitamin D3, not vitamin D2.

Supplementing vitamin D will raise the amount of calcium absorbed from the diet. To persuade this extra calcium to go where it is needed it is essential to supplement magnesium and vitamin K2.

Magnesium can be supplemented without testing (because the test is not accurate anyway) as long as your mother's kidneys are reasonably healthy. What is your mother's eGFR and her creatinine?

I've never known anyone to test vitamin K2, and lots of people supplement it, so I'm guessing it's safe.

Do a search on the forum for magnesium and vitamin K2 and read a few posts on the subject. SeasideSusie writes a lot on these supplements and is the forum guru on them.

I'm guessing that your mother is on a low-salt or no-salt diet? This isn't actually healthy. The body needs salt for lots of essential processes. Salt is sodium chloride, and as far as I can tell both her sodium and her chloride levels are low. Please do your own research on salt.

Before I go any further, what drugs and supplements is your mother currently taking?

[BelfastGirl737 in reply to humanbean]

Thanks for the feedback. She takes Carbimizole 10mg and propananol 10mg for hyperthyroidism. We keep getting told her blood tests are stable but she isn't stable.

Her Vit D levels are 25 which I thought was low.

CREATININE 70 umol/L (44-80)

MILDLY REDUCED eGFR. DOES NOT INDICATE CKD UNLESS

THERE IS OTHER EXISTING LABORATORY/CLINICAL EVIDENCE OF DISEASE.

@ eGFR 69 mL/min/1.73m

Mum isn't on a specific diet. She has a poor appetite and struggles to eat due to her extreme fatigue so this may lead to deficiencies

@SODIUM L 133 mmol/L (136-145)

@ POTASSIUM 4.6 mmol/L (3.5-5.1)

@ CHLORIDE L 95 mmol/L (98-107)

@ BICARBONATE 23 mmol/L (22-29)

@ UREA 4.2 mmol/L (2.8-8.1)

@ CREATININE 70 umol/L (44-80)

[humanbean in reply to BelfastGirl737]

Well, your mother's kidneys appear to be functioning well, so taking magnesium shouldn't cause any problems. There are lots of different types of magnesium supplement, some good, some terrible because the body struggles to absorb them. See SeasideSusie's posts on the subject, as I suggested :

healthunlocked.com/user/sea...

I would say that including some salt in cooking or on her food would probably benefit your mother and should increase her sodium and her chloride levels.

Looking at your mother's haemoglobin she isn't officially anaemic.

Causes and symptoms of high MCH are given here :

healthline.com/health/mch#h...

Don't worry about your mother's cholesterol. In fact, the higher cholesterol is in the elderly the longer they live. See links within this post :

healthunlocked.com/thyroidu...

I wonder if your mother has low Free T3 (or lower than her body is used to having) as a result of the carbimazole and the propranolol. It is Free T3 being too high or too low that causes symptoms of hyperthyroidism or hypothyroidism respectively.

In hyperthyroidism propranolol is prescribed to slow down the heart rate which often goes very fast and is exhausting. But if the propranolol slows down the heart and reduces the blood pressure too much that is exhausting too. If your mum's heart doesn't go fast then perhaps she could start cutting up her pills and reducing her dose. But beta blockers have to be weaned off very slowly. Please buy a blood pressure monitor of the type that doctors use i.e. one with an upper arm cuff of the right size for your mum. Boots in the UK sells them, and of course you can buy them online. Omron are a good brand that you will see in doctor's surgeries.

Please realise that I am NOT a doctor, and anything I say should be checked and double checked and triple checked before you decide whether to ignore what I say or try it out.

Don't forget to buy some vitamin D supplements with the appropriate dose for your mother's very low levels. If you don't want to try loading doses you could start your mum on a lower dose and take longer over raising it. But it is up to you.

[BelfastGirl737 in reply to humanbean]

Thank you so much there is lots of useful information there and I have a lot of research to do. Will look into the Vitamin D this evening.

[SlowDragon Administrator]

There’s no Ft3 or thyroid antibodies

Low GFR often result of hypothyroidism

Vitamin D is dire - she requires LOADING DOSE...300,000iu over 6-8 weeks as per NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Calculator for working out dose you may need

40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Also read up on importance of magnesium and vitamin K2 Mk7 supplements when taking vitamin D

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[BelfastGirl737 in reply to SlowDragon]

Hi SlowDragon,

The tests show the following - Is this antibody tests?

THYROID PEROXIDASE Ab 18.0 IU/ml (0-34)

Method used for Anti-TPO: Roche Modular

Thanks

[SlowDragon Administrator in reply to BelfastGirl737]

She needs TSI or Trab antibodies tested for Graves’ disease

TG antibodies too - can be high with Graves and Hashimoto’s

[SlowDragon Administrator]

Having read the other two posts

Absolutely essential to test TSI or Trab to confirm Graves’ disease

High cholesterol and relatively high TSH ...suggests...like many ....this might actually be Hashimoto’s ...

Or she’s taking too high dose of Carbimazole

List of private testing options

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

Medichecks Thyroid plus vitamins including folate (private blood draw required)

medichecks.com/products/thy...

Graves Disease antibodies test

medichecks.com/products/tsh...

[BelfastGirl737 in reply to SlowDragon]

I requested those and paid for them so I am going to have to go back to the private GP. This is so frustrating. Thank you so much for your feedback.

[SlowDragon Administrator in reply to BelfastGirl737]

We strongly recommend going direct to private blood testing companies

Private GP likely charged a lot high than going direct ....and you get correct tests

Essential to test as early as possible in morning before eating or drinking anything other than water

[pennyannie in reply to BelfastGirl737]

Hey there again BelfastGirl,

Yes, we need a postive for Graves Disease which generally looks like a TSI result ( roughly translated as a stimulating ) number overrange or a TR ab result ( roughly translated as a blocking ) overrange number.

I thought we had this already as why Mum has been put on Carbimazole in the first place - sorry, my mistake.

[humanbean]

One link that might come in handy in the future :

healthunlocked.com/thyroidu...

[magsyh]

Low sodium and high potassium along with lack of appetite can point to low cortisol and aldosterone. Propranolol lowers aldosterone but like me she is only on 10mg so doesn't do much at all. I would suggest she has T3 checked for poor conversion and a 24 HR saliva test for adrenals