I have had a private blood test prior to an appointment that I have booked at a fertility clinic to look at starting my journey, because I want to be in the best health.
Amongst other abnormalities shown, my TSH is currently 3.6 which I'm aware for conception/fertility it is high despite being in "normal range". I've been lucky in that my GP has already kindly referred me to endocrinology and I have my first appointment with them in January too. I'm seeking any advice/guidance on what to discuss during this consultation?
Also, could the thyroid be affecting my other bloods or are my other bloods affecting my thyroid?
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LittleMiss234
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I have been treated for hypothyroidism for over 45 years and can say I have never had liver results as high as yours (I have regular liver function tests due to taking a medication that can affect the liver). You need to discuss these results with your doctor.
Your TSH is saying that your thyroid is struggling. A normal healthy person would generally have a TSH level no more than 2, often around 1. Did you have FT4, FT3 and thyroid antibodies tested too? If not then I would urge you to get them done. In some countries hypothyroidism is diagnosed when TSH reaches 3.
Your cholesterol is very likely raised because you are basically hypothyroid.
Your nutrient levels are poor. The results in your picture are small so I hope I have read the levels correctly.
Vit D: 45.8nmol/L.
You can see that this is below the "sufficient" range. The Vit D Council recommends a level of 125nmol/L and the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.
To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,000-5,000iu D3 daily.
Retest after 3 months.
Once you have 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. You can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but 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.
This is low. Ferritin is recommended to be half way through range, so around 82 with that range. Low ferritin can suggest iron deficiency or iron deficiency anaemia. You need an iron panel to see if you have iron deficiency and a full blood count to see if you have anaemia. Ask your GP to do these tests.
Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
If you don't have iron deficiency or anaemia you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
This is below range. You should ask your GP to test for B12 deficiency and Pernicious Anaemia.
Folate: 6.05 (8.83-60.8)
This is low but it's not obviously folate deficiency. You can help raise your folate level by taking a good, bioavailable B Complex such as Thorne Basic B or Igennus Super B. This can also help raise your B12 level. However, due to your very low B12 level and the need for further testing there, don't start a B Complex before further testing of B12 has been carried out and B12 injections or supplements started, this is because the folate in a B Complex will mask signs of B12 deficiency and skew results.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
If you haven't had thyroid antibodies tested (TPO and Tg) I would urge you to do so. This would indicate whether or not you have autoimmune thyroid disease (know to patients as Hashimoto's) which is where the immune system attacks and gradually destroys the thyroid eventually leading to overt hypothyroidism. When Hashi's is present it's very common to have low nutrient levels or deficiencies, so your nutrient levels could very well be so poor due to this.
For information on individual tests or groups of tests, click on the + signs for more info.
Your liver function tests (first page) are not terribly good. It is possible that low levels of thyroid hormones might be contributing to the poor results. But there are lots of things that can affect the liver :
Diet
What do you eat?
Do you choose to restrict your calorie intake to keep your weight down?
Do you eat fats and oils? If yes, what type?
What kind of protein do you eat?
Do you eat a lot of sugar and/or carbs?
Do your drink a lot of alcohol?
Do you eat gluten?
Do you take any prescribed medicines or supplements regularly? If you do you should find out if they can affect liver function.
Lipids (cholesterol and triglycerides)
You won't find many people on here who are fans of reducing cholesterol and taking statins. Note that statins can cause birth defects so do NOT take them.
Levels of cholesterol and triglycerides are affected by diet.
The only thing that worries me about my cholesterol level is my triglycerides. I don't care about the other levels. See this picture :
"If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid."
Bone Profile
Alkaline Phosphatase can be considered as part of liver health checking or bone health checking. I think there is a possibility that your raised liver function results and bone results could be caused by an unhealthy gallbladder and/or inflamed bile ducts. Have you spent years eating a low fat diet? Because if you have it can really screw up your gallbladder and bile ducts.
Your vitamin D is much too low at approx 46 nmol/L. You should be aiming for a level of 100 - 150 nmol/L. (If you research vitamin D, note that US pages use different units of measurement and optimal levels are 40 - 60 ng/mL.)
To work out your own dose of vitamin D3 supplement that you need, see this link :
If I assume you weigh 140 lbs (10 stone) then these are the results I get from it :
----------------------------------------------
All suggested intake amounts are based on a weight of 140 lbs
Maintenance Dose
To achieve the desired serum level within approximately 3 months, a supplementation amount of
3,000 IU* (75 mcg) per day (this includes your current intake amount)
will be sufficient for 50% of people to achieve the desired serum level of 100 nmol/L
or
5,000 IU* (125 mcg) per day (this includes your current intake amount)
will be sufficient for 90% of people to achieve the desired serum level of 100 nmol/L.
Loading Dose
To quickly achieve the desired serum level within days†, a dose of
25,000 IU (625 mcg) per day can be taken for 5 days, followed by the above maintenance dose.
*Values rounded to the nearest 1,000 IU and are capped at a maximum of 10,000 IU/day.
†This calculation is based on published data by van Groningen et al., Eur J Endocrinol., 2010
Hundreds of peer-reviewed scientific studies have documented the well-established safety of single 'loading' doses of vitamin D to get levels up quickly (1-26). Loading doses ranging from 100,000 IU to 600,000 IU have been shown to rapidly increase vitamin D levels, but fail to sustain levels longer than 2-3 months. Larger doses induce more rapid breakdown of vitamin D (1-2). Therefore, the customized loading dose has been divided into doses of 25,000 IU over a number of days to achieve the initial increase in vitamin D levels. The maintenance dose is your custom daily dose recommended to achieve and sustain the desired levels of vitamin D.
------------------------------------------------
The best kind of vitamin D3 supplements to buy are capsules/softgels containing only oil and vitamin D3. Doctor's Best make these but there are other brands available.
Taking vitamin D3 increases absorption of calcium from the diet. You want that calcium to go into your bones and teeth, not lining your arteries. To achieve that you need to take magnesium and vitamin K2 with your vitamin D3. Read SeasideSusie 's replies to others on the subject. You can find all her replies here :
Your results for these are much too low and I think you ought to be tested for Pernicious Anaemia.
Optimal for folate is mid-range up to top of range i.e. approx 35 - 61 with your range.
Optimal for Serum Vitamin B12 varies depending on what you read. It could be
1) Minimum of 500pmol/L
2) Upper half of the range
3) Top of range
4) Approx 1000 pmol/L
Personally, I always go for number 4. Vitamin B12 is NOT poisonous, and the reference ranges for it in the UK are far lower than it is for some other countries. Allegedly, Japan uses a top of range of 1300, but I have no proof of that.
There is another type of vitamin B12 test, that is actually better than the one you had, called Active B12. It is not measuring the same thing as the Serum B12 test and the reference ranges are completely different, so be careful not to get them confused.
Your ferritin is much too low for good health. Optimal is around mid-range or a little bit over i.e. 82 - 120 or 82 - 130.
Ferritin (iron stores) and anything to do with iron is more complicated than other nutrients.
I'm rather knackered now, so I'm going to stop there.
Congratulations on considering how to improve your health before getting pregnant. Not many women do that, and it is so important for your own health and the health of any future offspring.
By far the most common cause of being hypothyroid is autoimmune thyroid disease also called Hashimoto’s diagnosed by high thyroid antibodies
You need FULL thyroid testing
TSH, Ft4 and Ft3, plus both TPO and TG thyroid antibodies
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 .
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
What time of day was this test done
Private tests are available as NHS currently rarely tests Ft3 or thyroid antibodies or all relevant vitamins
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Hypothyroidism causes low stomach acid and low stomach acid leads to low vitamin levels
Improving low vitamin levels will significantly improve symptoms.
Come back with new post once you get full thyroid results
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Gp sticking to blood test ranges
Blood Test
Doctors app blood test 
TSH results for fertility treatment
