Blood test results

[Ladybex]

I have put up 3 posts of my blood tests as I can’t get the photos on one post

Please help

Ann

[SeasideSusie Remembering]

Ladybex

I have just spent 5 minutes corelating all your posts and directing all replies to your original one which you have now deleted before I could submit the links to the other posts.

You can only put one photo on a post. When you do multiple posts like you have done for each photo, it makes it very confusing for members to flick back between 3 or 4 posts to see the results, and they may only respond to one post and not realise there are other results that need to be taken into account.

It's best to put one photo in a post then type out all the other results in that post to keep everything together and make it easier for people to help you.

[Ladybex in reply to SeasideSusie]

I didn’t know that, apologies I won’t do it again ... weren’t results ok ...

[SeasideSusie Remembering in reply to Ladybex]

Ladybex

Because you deleted the post with one set of results and I don't know what they were, I don't know if there are any missing.

The posts you still have up show:

Full blood count - all in range.

Liver and renal - all in range.

Glucose/TSH/vitamins:

Glucose in range.

TSH - hard to say as I don't know if you are on Levo, if you are it's too high, if you're not then it's not high enough for a diagnosis of hypothyroidism.

Vitamins - all low.

Were there any others?

[SlowDragon Administrator]

How much levothyroxine are you currently taking?

Still only on starter dose of 50mcg?

Results here

healthunlocked.com/thyroidu...

TSH - too high .

On levothyroxine TSH should be under 2

Official NHS guidelines saying TSH should be between 0.2 and 2.0 when on Levothyroxine

(Many of us need TSH nearer 0.2 than 2.0 to feel well)

See box

Thyroxine replacement in primary hypothyroidism

pathology.leedsth.nhs.uk/pa...

Aim is to bring a TSH under 2.5

gp-update.co.uk/SM4/Mutable...

Vitamins levels are all low, because of being under medicated

What vitamin supplements are you currently taking?

Ferritin too 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

List of iron rich foods

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.

B12 very low

Folate low

But as both within range GP may not agree to further testing

Do you have Low B12 symptoms ?

b12deficiency.info/signs-an...

recommended to supplement a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B or jarrow B-right are other options that contain folate, but both are large capsules

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before any blood tests, as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Essential to test vitamin D too

vitamindtest.org.uk

Thyroid disease is as much about optimising vitamins as thyroid hormones

[SlowDragon Administrator]

See/contact GP for 25mcg dose increase levothyroxine up to 75mcg

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).

[SlowDragon Administrator]

guidelines on dose levothyroxine by weight

Even if we don’t start on full replacement dose, most people need to increase levothyroxine 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...

[SlowDragon Administrator]

Post from four months ago

healthunlocked.com/thyroidu...

SeasideSusie gave very detailed replies on all your very low vitamin levels

That it was ESSENTIAL to get tested for PA with such low B12 result and especially as your mother had Pernicious Anaemia.

Have you told GP that your mother had PA?

Did you get tested for PA?

Are you on B12 injections or daily B12 supplements?

[SlowDragon Administrator]

Also still can’t see any vitamin D test results?

Did you buy an NHS postal kit (£29)

Vitamin D needs testing at least annually

If GP won’t do it ....order online here

vitamindtest.org.uk

Come back with new post once you get vitamin D results

Looking to improve vitamin D to at least around 80nmol

[SlowDragon Administrator]

Folate is lower now than 4 months ago

Four months ago - was too low then

folate: 7.0 ug/L (2.7-34.0)

Now

folate: 4.1ug/L (2.7-34.0)

B12

Four months ago

200ng/L (180.0-914.01)

Now

225ng/L (180.0-914.01)

Minuscule improvement....looking for B12 to be at least over 500

Ferritin

Four months ago

32ug/L (20.0-275.0)

Now

50 ug/L (20.0-275.0)

Good to see .......This is improving. Aiming for at least over 70 minimum

Keep working on eating iron rich diet, 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

List of iron rich foods

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.