Latest results - advice please

[Ljdaly74]

New results after 3 months:

Serum vitamin B12 level 436 ng/L [120.0 - 900.0]

Adequate B12 stores.If the patient is on IM B12

therapy, it is not necessary to monitor B12 levels

Serum ferritin level 52 ng/mL [15.0 - 300.0]

Ferritin >15 and <100ng/mL. With low Hb and MCV,

a normal ferritin in the presence of inflammatory

changes does not exclude iron deficiency.

Thyroid function test

Serum TSH level 0.14 mu/L [0.3 - 5.0]

Below low reference limit

Serum free T4 level 11.3 pmol/L [7.9 - 16.0]

Plasma fasting glucose level 5.6 mmol/L [3.5 - 6.0]

[SeasideSusie Remembering]

Ljdaly74

Can you tell us if you are on thyroid meds, if so what dose and did you do the test no later than 9am, before eating or drinking anything but water, and last dose of Levo 24 hours before test?

Do you take any supplements?

[Ljdaly74 in reply to SeasideSusie]

Yes 125mcg levo and yes to rest

[SeasideSusie Remembering in reply to Ljdaly74]

FT4 is 41.98% through range which is rather low to be considered optimal.

Can't really comment on vitamins without you saying what supplements/dose you take.

[Ljdaly74 in reply to SeasideSusie]

So does that mean more levo? Will this suppress TSH even further though? Take iron, b12, 5mg folic acid, vit d, omega oil, coq 10, vit c with zinc. Vit d and folic levels were fine but ferritin and b12 low have previously been advised on here.

[SeasideSusie Remembering in reply to Ljdaly74]

Ljdaly74

So does that mean more levo?

Well, you haven't said how you feel. Do you feel undermedicated? If so then you would need to get your FT4 higher in range and Levo will do that.

Will this suppress TSH even further though?

Suppressed TSH is below 0.1. Low TSH is between 0.1 and bottom of range.

Taking more Levo will most likely lower your TSH and will likely end up supressed. However, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional magazine for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"

*He recently confirmed, during a public meeting, that this applies to Free T3 as well as Total T3.

If you would like a copy of the article you can email Dionne at

[e-mail]

and this information is in answer to Question 6.

[Ljdaly74 in reply to SeasideSusie]

Tbh i dont feel any different from when i was on 50, 75, or 100mcg. I only found out i was hash/hypo after recurrent miscarriage investigations in 2016. I am not ovulating regularly so want to be optimal to improve fertility rather than way i feel. Although any improvements on weight loss and tiredness would be appreciated!

[SlowDragon Administrator in reply to Ljdaly74]

Take iron, b12, 5mg folic acid, vit d, omega oil, coq 10, vit c with zinc.

Vit d and folic levels were fine

Please add actual results and ranges. When were these last tested

Iron you need full iron panel test before supplementing iron

Ask GP or order via Medichecks

Remember to stop taking any iron supplements a week before testing iron levels

As you have Hashimoto’s you may be better supplementing folate or a good quality vitamin B complex rather than folic acid