Followed the great advice from my 1st post and got my results back from Thriva ( excellent service by the way thank you for recommending ) although they said there was a problem testing for folate so unfortunately that's missing. Not sure at all if the other results depend heavily on it. It's not clear what all the ranges are with Thriva but dark green is optimal and light green normal so I've guessed it's inclusive of both when they are together and just optimal when no light green showing. Hope that makes sense.
Active B12 - 62.3 pmol/L ( 37.5 - 188 )
Ferritin - 159 ug/L ( 30 - 400 )
FT3 - 5.81 pmol/L ( 3.1 - 6.8 )
TSH - 5.44 mlU/L ( 0.27 - 4.2 )
TgAB - 10.4 kU/L ( 0 - 115 )
TPOAb - < 9 klU/L ( 0 - 34 )
T4 - 96.7 nmol/L ( 66 - 181 )
FT4 - 15 pmol/L ( 12 - 22 )
Vitamin D - 60.4 nmol/L ( 50 - 175 )
Any feedback would be greatly appreciated
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Charlyboy
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Thriva have a very confusing way of giving results/ranges. The range is the whole of the green bar, both light and dark green areas. Forget optimal, they have that very wrong, optimal is very individual, it's where we feel best.
The best thing to do is forget the graphic with the coloured bar and just look at the results with ranges that are in the list like this
I assume you're still on 25mcg Levo as mentioned in your previous post.
TSH - 5.44 mlU/L ( 0.27 - 4.2 )
T4 - 96.7 nmol/L ( 66 - 181 )
FT4 - 15 pmol/L ( 12 - 22 )
FT3 - 5.81 pmol/L ( 3.1 - 6.8 )
TSH is over range, FT4 is 30%through range and your body is doing it's best to push out as much T3 as possible (the active hormone that is required by every cell in our bodies) and that is currently 73.24% through range so that's pretty good.
Your TSH and FT4 are telling us that you are undermedicated and need an increase in dose of Levo. I gave you details of Dr Toft's article in reply to your last post which should support your request for an increase.
I haven't commented on Total T4 as it's not a particularly useful test, it's FT4 that tells us what we need to know.
TgAB - 10.4 kU/L ( 0 - 115 )
TPOAb - < 9 klU/L ( 0 - 34 )
These are nice and low and do not suggest autoimmune thyroid disease (Hashimoto's).
Active B12 - 62.3 pmol/L ( 37.5 - 188 )
Active B12 below 70 suggests testing for B12 deficiency according to to Viapath at St Thomas' Hospital:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
If you don't then you could supplement with a good quality, bioavailable B Complex such as Thorne Basic B or Igennus Super B. It's important to note that when taking a B Complex it must be left off for 7 days before any blood tests (including thyroid) because it contains biotin and can give false results when biotin is used in the testing procedure (most labs do use biotin).
they said there was a problem testing for folate so unfortunately that's missing.
B12 and folate work together so really it's needed, but there is a shortage of the reagent for the folate test at the moment it they're not being done.
Ferritin - 159 ug/L ( 30 - 400 )
Are you male? That range is usually for males. (I'm asking because it doesn't say whether you're male or female in your profile, and some people use their pet's name as their user name, so you could be female and Charlyboy could be your cat )
Ferritin is recommended to be half way through range but I have seen it said that 150 is a good level for males (100-130 for females).
Vitamin D - 60.4 nmol/L ( 50 - 175 )
The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L.
If you want to improve your level then to reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 3,500-4,000iu D3 daily.
Retest after 3 months. If all you're testing is Vit D then the cheapest and easiest way is with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Once you've reached the recommended level then you'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range.
There are important cofactors needed when taking D3 as recommended by the Vit D Council.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
Yes I am male, 53 yrs. Had a telephone consultation today with my doctor armed with all the info you and others kindly offered and my test results and it appears I've actually chalked up a win. Agreed to increase my dose to 50mcg and carry out further blood tests in 8 weeks. First positive step forward and I couldn't have done it without the great advice I got from you guys, thank you so much hopefully better days ahead.
B12 is a touch low. Need folate tested (currently a temporary shortage of folate test kits nationwide)
Ask GP to include B12 and folate at next nhs test when thyroid is retested in 8 weeks time
Make sure to do all thyroid tests as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
On levothyroxine the aim is to increase the dose slowly upwards in 25mcg steps (retesting 6-8 weeks after EACH dose increase) until Ft4 is in top third of range, and Ft3 is over 60% through range and TSH is UNDER 2.5
Many people will have a TSH well under one when adequately treated
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.
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.
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