IRON BLOOD TEST HIGH TIBC

[ninja1]

IRON 22 5.8 - 34.5

TIBC 75.7 45 - 72

UIBC 53.7 24.2 - 70.1

TRANS SATS 29.06 20 - 50

FERRITIN 85.5 13-150

I had these bloods done as i am very breathless.

My Active B12 is 49 range 37.5 to 187.5

What does elevated TIBC mean, doc say all is well

[SlowDragon Administrator]

When were thyroid levels last tested?

Results from year ago show you were very under treated

healthunlocked.com/thyroidu...

How much levothyroxine are you currently taking?

For full Thyroid evaluation you need TSH, FT4 and FT3 tested. Also EXTREMELY important to test vitamin D, folate, ferritin and B12

Low vitamin levels are extremely common, especially if you are under medicated

Ask GP to test vitamin D levels and folate

Or have you had these tested privately?

Active B12 is far too low

Anything under 70 is too low

What vitamin supplements are you currently taking

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?

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...

If you can get GP to test vitamins and cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off if go on thyroid uk for code

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

monitormyhealth.org.uk/thyr...

Medichecks - JUST vitamin testing including folate - DIY finger prick test

medichecks.com/products/nut...

Medichecks often have special offers, if order on Thursdays

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...

[ninja1 in reply to SlowDragon]

thyroid just been tested

TSH 5.11 (0.27 - 4.20)

Free t4 19.1 ( 12-0 - 22 - 0)

Free t3 3.93 ( 3.1 - 6.8) (

Folate 19.70 - 8.83 - 60.8)

magnesium 93 ( 0.66 - 0.99)

vit d 49 ( 50 - 175)

I take Levothyroxine 100 one day and 75 the next. If my T4 goes over 20 i get very breathless on exertion., more breathless than normal

My Cortisol Random is 505 (113-456) 9am

I have inappropriate sinus tachycardia as well

I dont know why my TIBC would be out of range, am i doing something wrong

[ninja1 in reply to ninja1]

I had my thyroid removed for multinodular goitre 25 years ago so rely totally on Levo. Blood test were done fasting