Help please to understand results before doctors appointment.

Hello all,

Apologies in advance for the long list of results and questions I’d like to ask!

I posted my Medichecks results a few weeks ago but wanted to note them again now I have my NHS results.

Please could I ask a few questions of you knowledgeable people, I know I may have asked some of them before but I’m finding it all a bit of a challenge getting my head around things.

1.Do I need to start taking any vitamins or am I in the optimal range (I’ve read these need to be optimal but I don’t know how to work this out).

2.If I do need vitamins please could you advise which ones, the dosage and where I can buy these from.

3.The Medichecks results suggest I have Hashi’s (which a forum member also indicated in my last post), please could you point me in the right direction on the best material to read so I can read up on this.

4.I’m currently taking 75 mcg of Levothyroxine and am still feeling fatigued/tired and just not myself (can’t say as I know what normal is though) hence the doctor doing further tests (results below) but some of these have come back abnormal. I don’t know what these results indicate so would appreciate any feedback or experience you may have.

5.Am I converting FT4 into FT3 adequately.

Thank you so much for taking the time to read my post it is very much appreciated, thank you for all the advice you have given me so far it has been invaluable in helping me to try and understand this disease which is so complicated.

Results are for the past 12 to 18 months for an overall picture of where I'm at, not sure if some of them are relevant, apologies if they are not.

Thank you and keep safe xx

MEDICHECKS TEST RESULTS - SEP 20

Ferritin - 403 ug/L (13 - 150 ug/L)

Folate Serum - 7.96 ug/L (3.89 - 19.45 ug/L)

Vitamin B12 Active - 133 pmol/L (37.5 – 187.5 pmol)

Vitamin D - 83.5 nmol/L (50 – 175 nmol/L)

TSH – 0.1 mlU/L (0.27 – 4.2 mlU/L)

FREE Thyroxine – 22.5 pmol/L (12 – 22 pmol)

FREE T3 – 5.41 pmol/L (3.1 – 6.8 pmol/L)

Thyroglobulin – 632 kIU/L (0 – 115 kIU/L)

Thyroid Peroxidase Antibodies – 218 kIU/L (0 – 34 kIU/L)

C – Reactive Protein (CRP HS) - 0.87 mg/L (<5 mg/L)

NHS TEST RESULTS

The following tests were performed because of my Serum Ferritin and Serum Folate results below, waiting to discuss the results with the doctor later this week.

*****************************************************************

Serum Iron Level

Oct 20 - 18.4 umol/L (11.0 – 29.0 umol/L)

Serum Transferrin

Oct 20 - 2.43 g/L (2.52 – 4.29 g/L) Abnormal

Transferrin Saturation Index

Oct 20 - 30% (20 – 50%)

Serum Sodium

Oct 20 - 140 mmol/L (133 146 mmol/L)

Jun 19 - 143 mmol/L (133 146 mmol/L)

Serum Potassium

Oct 20 - 4.4 mmol/L (3.5 – 5.3 mmol/L)

Jun 19 - 5.0 mmol/L (3.5 – 5.3 mmol/L)

Serum Creatinine

Oct 20 - 68 umol/L (44 – 97 umol/L)

Jun 19 - 74 umol/L (44 – 97 umol/L)

********************************************************************

These tests were undertaken and because these results came back abnormal the tests above were undertaken, in a previous post a member did indicate possible haemochromatosis which the doctor muted about but said my level would have to be around 1000 before they would investigate further.

Serum Ferritin

Oct 20 - 369 ug/L (10 – 291 ug/L) Abnormal

Sep 20 - 321 ug/L (10 – 291 ug/L) Abnormal

Jun 19 - 228 ug/L (10 – 291 ug/L)

Serum Folate

Oct 20 - 9.5 ug/l (>4.1 ug/l)

Jun 19 - 4.6 ug/l (>5.4 ug/l) Abnormal

*******************************************************************

Serum Vitamin B12

Sep 20 - 523 ng/l (160- 820 ng/l)

Jun 19 - 303 ng/l (160- 820 ng/l)

Serum Total 25-OH vit D Level

No result for vit D, doctor did request it to be tested, doctor did state the lab more than likely wouldn’t carry out the test as they believe everyone should take vit D during winter months!

Serum TSH Level

Sep 20 - 0.13 mU/L (0.10 – 4.00 mU/L)

May 20 - 2.9 mU/L (0.10 – 4.00 mU/L)

Jan 20 - 2.0 mU/L (0.10 – 4.00 mU/L)

Nov 19 - 5.7 mU/L (0.10 – 4.00 mU/L) Abnormal

Aug 19 - 4.6 mU/L (0.10 – 4.00 mU/L) Abnormal

Jun 19 - 4.5 mU/L (0.10 – 4.00 mU/L) Abnormal

Serum Free T4 Level

May 20 - 18.2 pmol/L (9.0 – 22.0 pmol/L)

Jan 20 - 20.3 pmol/L (9.0 – 22.0 pmol/L)

Aug 19 - 17.3 pmol/L (9.5 – 22.0 pmol/L)

Jun 19 - 15.7 pmol/L (9.5 – 22.0 pmol/L)

GFR Calculated Abbreviated MDRD

Oct 20 - 82 mL/min (> 60 mL/min)

Jun 19 - 75 mL/min (> 60 mL/min)

Serum Gamma GT Level

Oct 20 - 16 u/L (9 – 36 u/L)

Jun 19 - 17 u/L (9 – 36 u/L)

Serum Total Bilirubin Level

Oct 20 - 10 umol/L (1 – 21 umol/L)

Jun 19 - 7 umol/L (1 – 21 umol/L)

ALT/SGPT Serum Level

Oct 20 - 13 U/L (0 – 33 U/L)

Jun 19 - 21 U/L (0 – 33 U/L)

Serum Alkaline Phosphatase

Oct 20 - 70 U/L (20 – 130 U/L)

Jun 19 - 81 U/L (20 – 130 U/L)

Serum Total Protein

Oct 20 - 65 g/L (53 – 78 g/L)

Jun 19 - 64 g/L (60 – 80 g/L)

Serum Albumin

Oct 20 - 46 g/L (38 – 51 g/L)

Jun 19 - 46 g/L (35 – 50 g/L)

Serum Globulin

Oct 20 - 19 g/L (14 – 30 g/L)

Jun 19 - 46 g/L (18 – 35 g/L)

Serum C Reactive Protein Level

Oct 20 - 4 mg/L (0.0 – 10 mg/L)

Jun 19 - 4 mg/L (0.0 – 10 mg/L)

Total White Cell Count

Sep 20 - 5.5 x10^9/l (3.7 – 11.0 x10^9/l)

Aug 19 - 5.2 x10^9/l (3.7 – 11.0 x10^9/l)

Red Blood Cell (RBC) Count

Sep 20 - 4.42 10*12/L (3.80 – 5.80 10*12/L)

Aug 19 - 4.29 10*12/L (3.80 – 5.80 10*12/L)

Haemoglobin Estimation

Sep 20 - 131 g/L (115 – 165 g/L)

Aug 19 - 129 g/L (115 – 165 g/L)

Haematocrit

Sep 20 - 0.40 (0.37 – 0.47)

Aug 19 - 0.40 (0.37 – 0.47)

Mean Corpuscular Volume (MCV)

Sep 20 - 91.2 fl (76.0 – 100.0 fl)

Aug 19 - 92.1 fl (76.0 – 100.0 fl)

Mean Corpusc.Haemoglobin(MCH)

Sep 20 - 27.7 pg (27.0 – 32.0 pg)

Aug 19 - 30.1 pg (27.0 – 32.0 pg)

Mean Corpusc. Hb. Conc. (MCHC)

Sep 20 - 326 g/L (320 – 365 g/L)

Aug 19 - 327 g/L (320 – 365 g/L)

Red Blood Cell Distribut Width

Sep 20 - 12.6 (11.5 – 14.5)

Aug 19 - 12.6 (11.5 – 14.5)

Platelet Count

Sep 20 - 304 x10^9/l (150 – 450 x10^9/l)

Aug 19 - 290 x10^9/l (150 – 450 x10^9/l)

Neutrophil Count

Sep 20 - 2.8 10*9/L (1.7 – 7.5 10*9/L)

Aug 19 - 2.5 10*9/L (1.7 – 7.5 10*9/L)

Lymphocyte Count

Sep 20 - 1.9 x10^9/l (1.0 – 4.5 x10^9/l)

Aug 19 - 2.2 x10^9/l (1.0 – 4.5 x10^9/l)

Monocyte Count

Sep 20 - 0.4 10*9/L (0.2 – 1.1 10*9/L)

Aug 19 - 0.3 10*9/L (0.2 – 1.1 10*9/L)

Eosinophil Count

Sep 20 - 0.2 10*9/L (0.0 – 0.6 10*9/L)

Aug 19 - 0.2 10*9/L (0.0 – 0.6 10*9/L)

Basophil Count

Sep 20 - 0.0 10*9/L (0.0 – 0.1 10*9/L)

Aug 19 - 0.0 10*9/L (0.0 – 0.1 10*9/L)

HbA1c Level – IFCC Standardised

Jun 19 - 36 mmol/mol (< 41 mmol/mol)

Serum Cholesterol

Jun 19 - 6.2 mmol/L (< 4.0 mmol/L) Abnormal

Serum HDL Cholesterol Level

Jun 19 - 1.8 mmol/L (> 1.2 mmol/L) Abnormal

Serum Triglycerides

Jun 19 - 0.8 mmol/L (0.3 – 1.8 mmol/L)

Serum LDL Cholesterol Level

Jun 19 - 4.0 mmol/L (< 2.0 mmol/L)

Serum Cholesterol/HDL Ratio

Jun 19 - 3.44 mmol/L (< 6.00)

Se non HDL Cholesterol Level

Jun 19 - 4.4 mmol/L

Serum Calcium

Jun 19 - 2.32 mmol/L

Serum Adjusted Calcium conc

Jun 19 - 2.44 mmol/L (2.20 – 2.60 mmol/L)

[SlowDragon Administrator]

Yes high thyroid antibodies confirms hashimoto's

High ferritin but low transferrin

Serum Iron Level

Oct 20 - 18.4 umol/L (11.0 – 29.0 umol/L)

Serum Transferrin

Oct 20 - 2.43 g/L (2.52 – 4.29 g/L) Abnormal

Transferrin Saturation Index

Oct 20 - 30% (20 – 50%)

humanbean or SeasideSusie may pop along and comment on this

Hashimoto's is most common reason for primary hypothyroidism

Have you had coeliac blood test done yet?

High percentage of hashimoto's patients find strictly gluten free diet helps or is absolutely essential .....but important to test for coeliac first .... before changing diet

Do you always get same brand of levothyroxine at each prescription?

Which brand of levothyroxine are you currently taking?

Teva brand upsets many people

Best websites

Isabella wentz

Chris kresser

Dr k news

Amy Myers

All based in USA

[Hidden in reply to SlowDragon]

Hi SlowDragon,

Thank you for replying and reading material recommendations much appreciated.

I first took 25mg (Teva) and when I was increased to 75 mg I was persrcibed 50mg (Accord), these are the only brands I have taken and each refill has been the same.

I've not been tested for coeliac but have been reducing gluten although not totally gluten free at the moment, however i have felt less bloated since not eating as much as i used too.

Thank you x

[humanbean]

Serum Ferritin

Oct 20 - 369 ug/L (10 – 291 ug/L) Abnormal

Sep 20 - 321 ug/L (10 – 291 ug/L) Abnormal

Jun 19 - 228 ug/L (10 – 291 ug/L)

Medichecks - Sep 20 - Ferritin - 403 ug/L (13 - 150 ug/L)

These results do suggest that your ferritin is rising quite rapidly.

Have your periods stopped as a result of menopause in the last 3 - 5 years?

Do any of your supplements or prescribed drugs contain iron in any amount?

Do you eat a lot of meat or liver or meat products?

Do you take a lot of vitamin C?

What kind of diet do you eat?

Are you diabetic or pre-diabetic?

Serum Iron Level - Oct 20 - 18.4 umol/L (11.0 – 29.0 umol/L) 41% of the way thru range - lower than optimal

Serum Transferrin - Oct 20 - 2.43 g/L (2.52 – 4.29 g/L) Abnormal - under range, which is what I would expect in someone with very high ferritin

Transferrin Saturation Index - Oct 20 - 30% (20 – 50%) - lower than I would expect with such high ferritin but fits quite well with your serum iron level - optimal is 35% - 45%

Your results are really quite contradictory.

Ferritin - three recent results which are over range suggesting that you have too much iron

Serum iron - is actually below optimal which is 55% - 70% of the way through the range

Serum transferrin - under range which is what you would expect with very high ferritin

Transferrin saturation - is actually lower than I would expect with such high ferritin

I don't think you have haemochromatosis - your serum iron is too low for that as is your Transferrin Saturation Index.

...

Anaemia of Chronic Disease (ACD) looks more likely to me than haemochromatosis but you would expect high C-Reactive Protein (CRP or CRP-HS) with this condition. CRP is a measure of inflammation and, personally, I would like my CRP to always be below 1.

Your CRP results with the 0 - 10 reference range are higher than I would like. Some testing places appear to have doubled the width of the reference range for CRP in recent months (it used to be 0 - 5 or < 5), which means that the medical profession is quite happy for people to have higher levels of inflammation that they can ignore.

Serum C Reactive Protein Level

Oct 20 - 4 mg/L (0.0 – 10 mg/L)

Jun 19 - 4 mg/L (0.0 – 10 mg/L)

Medichecks - C – Reactive Protein (CRP HS) - 0.87 mg/L (<5 mg/L)

...

See these links :

selfhacked.com/blog/high-fe...

selfhacked.com/blog/conditi...

For info on what kind of test results to expect with different iron-related conditions, see this link :

irondisorders.org/Websites/...

For info on optimal iron results :

rt3-adrenals.org/Iron_test_...

For a good description of what ACD is and what causes it :

irondisorders.org/anemia-of...

See page 8 : irondisorders.org/Websites/...

I don't know whether the above links give you any insight into your iron and ferritin results. I am not a doctor and don't have the knowledge or training to say what might be causing your raised ferritin - they don't seem to fit any particular pattern.

[Hidden in reply to humanbean]

Good morning humanbean,

Thank you so much for all your responses and comprehensive information I can't thank you enough, I really appreciate the time you have put into replying to me, I will start and work my way through the information and links and hopefully I will have a better understanding about Hashi's as my knowledge grows with the help of this wonderful forum.

In response to your questions above:

Q. Have your periods stopped as a result of menopause in the last 3 - 5 years?

A. Yes they stopped around 2012, after suffering for 20 + years of heavy painful periods and debilitating menstrual migraines a locum doctor took pity on me and I had a womb ablation in 2011.

In 2016 I had a laparoscopic bilateral salpingo-oophorectomy and a benign tumor removed which was attached to my right fallopian tube and ovary.

After these two procedures and migraines all but ceased I thought the fatigue and tiredness would have disappeared but I'm still battling it but now because of hypothyroidism so it seems.

Q. Do any of your supplements or prescribed drugs contain iron in any amount?

A. The only medication I take is 75 mg levothyroxine daily.

Q. Do you eat a lot of meat or liver or meat products?

A. No liver products but I do have meat protein such as chicken, steak and eggs on a daily basis as I go to the gym 1 to 2 times a week, I used to go 4 times a week but 1 to 2 sessions is as much as I can muster these days.

Q. Do you take a lot of vitamin C?

A. No vitamin C apart from what I ingest from the foods I eat.

Q. What kind of diet do you eat?

A. It was quite varied and probably not the healthiest diet in the world, about six weeks ago I made some changes due to my battle with weight gain, I cut down my gluten and carbohydrate intake and increased vegetables, lean protein and good fats and water intake.

Do you think the high ferritin levels/inflammation marker could have something to do with my Hashi's, my medical record states I have subclinical hypothyroidism, the doctor has only ever tested my TSH and Free T4 so is blissfully unaware at this stage I have had the tests done with Medichecks confirming Hashi's.

My iron test results do seem to be contradictory and a bit all over the place don't they, I will come back with a new post regarding this when I have had my appointment with the doctor.

Thank you x

[humanbean]

Folate Serum - 7.96 ug/L (3.89 - 19.45 ug/L)

Vitamin B12 Active - 133 pmol/L (37.5 – 187.5 pmol)

Vitamin D - 83.5 nmol/L (50 – 175 nmol/L)

Optimal for folate is upper half of the reference range which is about 11.7 - 19.45, so you could try raising your folate a little bit more if you wanted. Please make sure that you take folate rather than folic acid. See this link, which gives you advice on which kind of folate to supplement :

chriskresser.com/folate-vs-...

Optimal for Active B12 is over 100, so yours is fine. If you are supplementing B12 then you might want to reduce your dose to save money.

Vitamin D is optimal at either 125nmol/L or 100 - 150 nmol/L depending on source. SeasideSusie has written extensively on vitamin D and the co-factors required to make the most of it. See this link for her replies to others :

healthunlocked.com/user/sea...

I would suggest that you take a good quality B Complex to maintain your B12 and folate levels. Two that are often mentioned on this forum are :

Thorne Research Basic B - full dose is 1 per day.

Igennus Super B - full dose is 2 per day.

Many people take one of the above products, but once they've gone through one or two bottles they take 1 pill per day of the Igennus product to save money.

[Hidden in reply to humanbean]

Good morning humanbean,

Folate - thank you I will look at the link and the foods to increase my uptake.

B12 - I don't currently supplement B12 .

Vitamin D - thank you I will look at the link and information provided by SeasideSusie to increase my levels to within the optimal ranges.

B Complex - thank you for the recommendations I will purchase some to maintain my levels.

Thank you x

[humanbean]

GFR Calculated Abbreviated MDRD

Oct 20 - 82 mL/min (> 60 mL/min)

Jun 19 - 75 mL/min (> 60 mL/min)

This shows your kidneys are in reasonably good condition. An optimal level would be > 90, although reaching that level may get harder as people age. A healthy diet with nutrient dense food, limited carbs and sugar, decent levels of fat and protein will help kidney function.

en.wikipedia.org/wiki/Asses...

[humanbean in reply to humanbean]

Serum Creatinine

Oct 20 - 68 umol/L (44 – 97 umol/L)

Jun 19 - 74 umol/L (44 – 97 umol/L)

Creatinine is also an indicator of kidney function. Your results are well in range and don't suggest a problem.

healthline.com/health/kidne...

[Hidden in reply to humanbean]

Good morning humanbean,

Thank you for confirming what I thought, I will read the information in the link you have kindly attached.

Thank you x

[Hidden in reply to humanbean]

Good morning humanbean,

Thank you for confirming what I thought, I will read the information in the link you have kindly attached.

Thank you x

[humanbean]

Liver Function Tests :

Serum Gamma GT Level

Oct 20 - 16 u/L (9 – 36 u/L)

Jun 19 - 17 u/L (9 – 36 u/L)

Serum Total Bilirubin Level

Oct 20 - 10 umol/L (1 – 21 umol/L)

Jun 19 - 7 umol/L (1 – 21 umol/L)

ALT/SGPT Serum Level

Oct 20 - 13 U/L (0 – 33 U/L)

Jun 19 - 21 U/L (0 – 33 U/L)

Serum Alkaline Phosphatase

Oct 20 - 70 U/L (20 – 130 U/L)

Jun 19 - 81 U/L (20 – 130 U/L)

Serum Total Protein

Oct 20 - 65 g/L (53 – 78 g/L)

Jun 19 - 64 g/L (60 – 80 g/L)

Serum Albumin

Oct 20 - 46 g/L (38 – 51 g/L)

Jun 19 - 46 g/L (35 – 50 g/L)

Serum Globulin

Oct 20 - 19 g/L (14 – 30 g/L)

Jun 19 - 46 g/L (18 – 35 g/L)

All of the above results are well in range, and suggest that your liver is healthy.

healthline.com/health/liver...

labtestsonline.org.uk/tests...

For the second link, above to get more info click on all the + signs except the first one.

[Hidden in reply to humanbean]

Good morning humanbean,

Thank you for confirming and the link you have kindly provided.

Thank you x

[humanbean]

The rest of your results are, as far as I can see, from a Full Blood Count and a Lipid (Cholesterol) panel. All the results look good.

I asked you earlier if you were diabetic, and have just spotted this result :

HbA1c Level – IFCC Standardised

Jun 19 - 36 mmol/mol (< 41 mmol/mol)

which shows you definitely aren't diabetic nor are you even close to being pre-diabetic which eliminates some of the things I was wondering about.

[Hidden in reply to humanbean]

Good morning humanbean,

Thank you that has definitely put my mind at ease, the last thing I wanted was to be told I was also pre-disposed to becoming/being diabetic.

Thank you x

[humanbean]

Having gone through all your results, my main suspicion would be that you have some kind of gut problem - but I will repeat - I'm not a doctor.

The sorts of things to consider are :

1) Gluten intolerance - to test this people have to be utterly ruthless in giving it up for three months. Cheating ruins the experiment.

2) Lactose intolerance - I would do this after you've tried removing gluten.

3) Some other things to look into - nightshade intolerance, low histamine diet

4) SIBO? - healthline.com/health/sibo

5) Parasites? - I don't know anything about parasites or which ones are likely to crop up in the UK. And I doubt that you would have high ferritin with a parasite problem.

[Hidden]

Good morning humanbean,

Thank you for the links and information, I really do appreciate the time and effort you have put in to responding to me.

There is a lot to think about and changes to make, the gut link/train of thought is interesting . Perhaps with the possible gut link and high ferritin issue this could also have something to do with my poor sleep and the horrible sensations in my upper front thighs, groin area and arms when my sleep is disturbed.

Small steps to make big changes

Thank you and keep safe x

[humanbean in reply to Hidden]

I would recommend supplementing magnesium. Almost everyone on the planet is deficient, and supplementing it will help to reduce various muscle issues such as muscles spasms, twitching, cramp, and benign fasciculations. The only requirement for supplementing magnesium is to have healthy kidneys - any excess magnesium is excreted via the kidneys in urine - and your results show your kidneys are working well.

Testing magnesium is pointless - only about 1% of the body's magnesium is held in the bloodstream, and the body prioritises what it needs in blood by stealing it from other tissues when it gets low in the blood. So the magnesium level in your blood might be perfect while the other tissues in your body are deficient.

SeasideSusie has written a lot about magnesium and what options you have for supplementing it.

[Hidden in reply to humanbean]

Hello humanbean,

I will read up on SeasideSusie's posts regarding magnesium.

Thank you once again, keep safe x