Just got my blood results in.: Hi all, just got... - Thyroid UK

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Just got my blood results in.

MrStruggling profile image
15 Replies

Hi all, just got my blood results back from my MediCheck Thyroid function test.Test was done first thing in the morning prior to taking Levo (over 24 hours since last dose) As I previously stated before I don't really understand what they mean as my doctors have never explained them to me since my complete thyroidectomy in 2012.

Pic Attached

Here's what the doctor reviewing the results reported (which has confused me even more)

"You have opted to have this blood test done to monitor thyroid hormone levels whilst taking levothyroxine following a complete thyroidectomy.

Your CRP level is normal, suggesting no significant inflammation within the body.

You have high iron stores. This is likely to be due to a high dietary intake of iron or taking iron supplements. If you are taking supplements I recommend decreasing your intake. To exclude iron overload I recommend an iron deficiency check which will look at your other iron markers and help us to work out whether there may be iron overload.

You have low serum folate. I recommend increasing your intake of folate-rich foods such as broccoli, brussels sprouts, asparagus, peas, chickpeas and brown rice. You may also want to consider an over the counter folate supplement.

Your vitamin B12 is just below the low end of the normal range. To work out whether there is significant underlying B12 deficiency I recommend arranging a serum methylmalonic acid (MMA) blood test.

If you are symptomatic - altered sensation, numbness, pins and needles, visual changes, sore mouth or inflamed tongue, please contact your GP.

If you are asymptomatic, consider an MMA test.

Dietary sources of vitamin B12 include lean meat (chicken, lean pork), milk, eggs, cheese, fortified cereals and dried yeast flakes.

Your thyroid stimulating hormone is high as is your free thyroxine which is a little unusual.

The thyroid stimulating hormone findings are contradictory to the thyroid hormone levels. A common cause of peculiar thyroid results is the vitamin Biotin. If you are taking this then we recommend omitting it for at least 24 hours before your thyroid blood test. Another

reason why confusing results could arise is when someone has antibodies to one of several common animal species (mice and livestock such as sheep and cattle) as these can confuse the laboratory equipment.

Your thyroid antibodies are negative.

In summary, optimise your folate and vitamin B12 level. If taking iron, reduce of stop the supplements and recheck levels in 3months. If you are not taking iron supplements, consider the 'confusingly labelled' Iron deficiency blood test.

Your thyroid results are slightly contradictory. To get a better understanding, please discuss these with your GP, who is likely to have previous results for you, hopefully, from after the thyroidectomy, for them to compare these to. (In rare cases, thyroid issues can originate from the pituitary gland but it's so very rare for it to originate from the thyroid and the pituitary gland.)"

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MrStruggling
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15 Replies
Lora7again profile image
Lora7again

I would ignore what the clinician has put because they are not experts. Your TSH should not be that high and should be 1 or even lower. A lot of people without a thyroid do well on NDT or by adding T3. Hopefully someone with more knowledge about this will be along to advise you. Just to add some of the comments they have put on my results were completely wrong and I wish I had ticked the box to stop them making them.

SeasideSusie profile image
SeasideSusieRemembering

Mr Struggling

Oh wow, oh wow!

Folate: 1.63 (>3.90)

Medichecks actual range is 3.89-19.45 so I have no idea why they have changed it.

You have folate deficiency, ignore the doctor's comments about eating more folate rich foods (yes it would be a good idea), this is something your GP should prescribe for. See cks.nice.org.uk/anaemia-b12...

Folate level

◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.

Please discuss with your GP and you should be prescribed 5mg folic acid and be monitored.

Active B12: 37.4 (37.5-188)

This is below range and indicative of B12 deficiency.

Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:

viapath.co.uk/our-tests/act...

Reference range:>70. *Between 25-70 referred for MMA

There is a link at the bottom of the page to print off the pdf to show your GP.

Do you have signs of B12 deficiency - check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

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.

I imagine you may need B12 injections. Once injections/supplementation have started, you can then start the folic acid.

Vit D: 60.8nmol/L

The Vit D Council recommends a level of 125nmol/L and the Vit D Society recommends a level of 100-150nmol/L. I recommend that you aim for this level especially as it's been said that a good Vit D level may be helpful during this difficult time with Covid.

To reach the recommended level from your current level, based on the Vit D Council's suggestions you could supplement with 4,000iu 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:

vitamindtest.org.uk/

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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

afibbers.org/magnesium.html

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.

Recommendations for supplements:

D3 - oil based softgels are well absorbed, I have done very well with Doctor's Best D3 softgels. Tablets are poorly absorbed.

K2-MK7 - I like Vitabay or Vegavero. 90-100mcg is sufficient for up to 10,000iu D3.

Your TSH is very high for a treated Hypo patient. Most people feel best when it's around 1 or lower with FT4 and FT3 in the upper part of their ranges. The doctor's comments are spot on about yuor TSH and FT4 being contradictory, one would expect your FT4 to be low in range with that TSH. Is there anything that could have caused this, eg do you take a B Complex or Biotin supplement and didn't leave it off for 7 days before the test, or did you take your Levo before your test?

Do you take iron supplements? Your ferritin is over range, but this can be caused by inflammation and although your CRP (an inflammation marker) is in range it is close to the top.

MrStruggling profile image
MrStruggling in reply to SeasideSusie

Thank you for your reply.

I do not take any vitamins or supplements at all, so I’m unsure as to what the heck is happening with my TSH and Ferritin.

So confused and just want to feel normal again.

Lora7again profile image
Lora7again in reply to MrStruggling

I have high Ferritin and I think mine is caused by inflammation. My CRP used to be 9 at one point as well. It is a pity you couldn't get NDT because I think that would help a lot because it contains both T4 and T3.

Lotika profile image
Lotika

I find your results quite confusing too, but others who know better will be along! It strikes me as odd that fT4 is so high whilst TSH is high too. But you also look like someone who isn’t converting fT4 into fT3 well at all, again assuming all the tests were done first thing in the morning before your levo etc.

Hang tight - I am sure the cavalry will be along soon! Definitely some issues with vitamins as well, aren’t there? It’s very clear to me that you will have been feeling absolutely terrible if those results are correct.

MrStruggling profile image
MrStruggling in reply to Lotika

Hi, thanks for replying.

I did my test first thing in the morning more than 24 hours after the last dose of Levo.

I feel absolutely atrocious and have for a long time, really hoping I can move forward from these results and get back to some normality.

Lotika profile image
Lotika in reply to MrStruggling

I hope so too. But if it helps at all, I can only imagine how unwell you feel with those vitamin and thyroid numbers as they are :( If it is obvious to me, who knows very little, then it will be very obvious to an endo. And you are going in the right direction - you have some concrete results to take to the endo and discuss at your Feb appointment.

pennyannie profile image
pennyannie

Hey there again :

OK - if we just look at your conversion of T4 into T3 we need to divide your T3 into your T4 result ;

So if we do that we get 6.40 and the acceptable conversion ratio when on Levothyroxine only is said to be 1 / 3.50 - 4.50 : T3/T4 : so you are not converting T4:

Your T4 is coming in at just over 100% through the range but your T3 is coming in at just 13% through the ranges and these two vital, essential thyroid hormones need to be balanced :

Ideally you need to drop some T4 and add some T3 - Liothyronine :

T3 is the active hormone that the body runs and is said to be about 4 times more powerful than T4 - which is a storage which your body needs to be able to convert into T3.

Having had a thyroidectomy you have lost your own production of thyroid hormones which would have included trace elements of T1 and T2 and calcitonin, plus a measurable amount of T3 and T4 said to be around 10 mcg T3 + 100 mcg T4 daily.

With the exception of ferritin, all your other vitamins and minerals need supplementation as no thyroid hormone works well unless all four of these core strength vitamins and minerals are optimal:

Just for reference I need my ferritin at around 100 : my folate at around 20 ; my active B12 at around 70+ ( serum B12 500+ ) and my vitamin D at around 100:

I would think your ferritin may need investigation :

I would make an appointment with your doctor and show him these results and would like to think he would immediately suggest a referral to an endocrinologist.

Thyroid UK hold a list of " friendly, supportive, sympathetic endos and specialists " and I would suggest you ask to be referred to someone on this list.

I am truly sorry to see your results but at least we can see what's going on and start turning things around and helping to advise you of your next steps back to better health.

I too haven't a thyroid and my conversion came in at 5.50 and I was feeling very unwell.

The brain needs an awful lot of T3 and that was where I suffered the most with my cognitive function severely compromised, but my doctor suggested anti depressants, please don't go there, as they are of no help at all.

I was refused both NDT and T3 on the NHS and now self source and feel much improved - hopefully you'll be better placed and it's best to try and start treatment within the NHS framework where there is meant to be knowledge, help and support.

MrStruggling profile image
MrStruggling in reply to pennyannie

Thanks for the response,I’ll be making an appointment in the morning with my GP to look at what is going on with my ferritin level.

I’ll contact Thyroid UK for the list of helpful Endo’s, how do you go about getting referred to these people though ?

pennyannie profile image
pennyannie in reply to MrStruggling

Hey there :

Initially through your doctor I would imagine :

You might like to discuss the blood test results with your doctor, as I'm sure you have talked with him before about your ailing health, and he might offer some advice and expertise on how to resolve the issues we have touched on.

There is a facility on the Thyroid uk website on how to obtain the list of recommended endos - though don't know how current the details are, as it is up to forum members to give the feedback after appointment.

You could also start a new message on here, asking the same question of the forum members, but that replies are via the Private Message facility that this forum offers, as we are not allowed to openly discuss doctors / endocrinologists/ specialist on the main rolling screen.

SlowDragon profile image
SlowDragonAdministrator

Conversion of Ft4 to Ft3 is absolutely terrible at the moment

Getting dire vitamins improved to GOOD levels should help improve this ......but only time will tell

After thyroidectomy you are likely to need the addition of small doses of T3

Which brand of levothyroxine are you currently taking?

How much levothyroxine are you currently taking?

MrStruggling profile image
MrStruggling in reply to SlowDragon

Thanks for the response.I take 125 micrograms daily.The brand is NorthStar.

helvella profile image
helvellaAdministratorThyroid UK in reply to MrStruggling

I assume you get dispensed a 100 and a 25 microgram tablet?

Look closely at the packets and/or the Patient Information Leaflets. The 25 microgram Northstar tablet is made by Teva (same as those branded Teva). The 100 microgram Northstar tablet is made by Accord (same as those branded Accord).

Some people find they do not tolerate the Teva formulation. Others find it the best of the those available in the UK.

MrStruggling profile image
MrStruggling in reply to helvella

Your absolutely right my 100’s are Actavis and the 25 are Tiva.I thought I was getting the same brand.

helvella profile image
helvellaAdministratorThyroid UK in reply to MrStruggling

Some details - hopefully to help! :-)

UK Levothyroxine Tablets

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

Last updated 13/09/2020.

This is a list of currently marketed levothyroxine tablets in the UK.

Please note that re-branding (whether by a manufacturer or as an ‘own label supplier’) – which has happened with several products – does not mean any change to formulation.

—————————————————————

🔹 Accord (marketing authorisation holder) – formerly Actavis

🏭 Accord-UK (manufacturer)

🥛 contains lactose – 39.95mg in 50 microgram tablet, 54.90mg in 100 microgram tablet

  50 microgram  PL 0142/0104

  100 microgram  PL 0142/0105

🟢 50 microgram and 100 microgram PIL: mhraproducts4853.blob.core....

🟣 50 microgram SPC: mhraproducts4853.blob.core....

🟣 100 microgram SPC: mhraproducts4853.blob.core....

—————————————————————

🔹 Advanz (marketing authorisation holder) – branded both “Mercury Pharma Levothyroxine” and “Mercury Pharma Eltroxin” which are identical

🏭 Custom Pharmaceuticals Ltd. (manufacturer)

🥛 contains lactose – 30.49mg in 25 microgram tablet, 48.86mg in 50 and 100 microgram tablets

  25 microgram  PL 12762/0016 5.5mm diameter

  50 microgram  PL 10972/0031

  100 microgram  PL 10972/0032

🟢 Eltroxin 25 microgram PIL: mhraproducts4853.blob.core....

🟢 Eltroxin 50 & 100 microgram PIL: mhraproducts4853.blob.core....

🟢 Levothyroxine 25 microgram PIL: mhraproducts4853.blob.core....

🟢 Levothyroxine 50 & 100 microgram PIL: mhraproducts4853.blob.core....

🟣 Eltroxin and Levothyroxine 25 microgram SPC: mhraproducts4853.blob.core....

🟣 Eltroxin and Levothyroxine 50 microgram SPC: mhraproducts4853.blob.core....

🟣 Eltroxin and Levothyroxine 100 microgram SPC: mhraproducts4853.blob.core....

—————————————————————

🔸 Almus ‘own label supplier’ – (a brand owned by Walgreen Boots Alliance – Boots pharmacies and Alliance distributor)

  50 microgram – This is repackaged Accord – formerly Actavis.

  100 microgram – This is repackaged Accord – formerly Actavis.

—————————————————————

🔹 Aristo (marketing authorisation holder)

🏭 Aristo Pharma GmbH (manufacturer)

No lactose ingredient

  100 microgram  PL 40546-0159

🟢 PIL: mhraproducts4853.blob.core....

🟣 SPC: mhraproducts4853.blob.core....

—————————————————————

🔹 Glenmark (marketing authorisation holder)

Note: This product may not currently be dispensed.

🏭 Glenmark Pharmaceuticals Europe Limited (manufacturer)

No lactose ingredient

  25 microgram  PL 25258/0293

  50 microgram  PL 25258/0294

  100 microgram  PL 25258/0295

🟢 PIL: mhraproducts4853.blob.core....

🟣 25 microgram SPC: mhraproducts4853.blob.core....

🟣 50 microgram SPC: mhraproducts4853.blob.core....

🟣 100 microgram SPC: mhraproducts4853.blob.core....

—————————————————————

🔸 Northstar ‘own label supplier’ – (a brand owned by McKesson – Lloyds pharmacies and AAH distributor)

  25 microgram – This is repackaged Teva. ❗

  50 microgram – This is repackaged Accord – formerly Actavis. ❗

  100 microgram – This is repackaged Accord – formerly Actavis. ❗

—————————————————————

🔹 Teva (marketing authorisation holder)

🏭 PLIVA Croatia Ltd (manufacturer)

No lactose ingredient

  12.5 microgram  PL 00289/1971

  25 microgram  PL 00289/1972

  50 microgram  PL 00289/0038

  75 microgram  PL 00289/1973

  100 microgram  PL 00289/0039

🟢 12.5 and 50 microgram PIL: mhraproducts4853.blob.core....

🟢 25, 75 and 100 microgram PIL: mhraproducts4853.blob.core....

🟣 12.5 microgram SPC: mhraproducts4853.blob.core....

🟣 25 microgram SPC: mhraproducts4853.blob.core....

🟣 50 microgram SPC: mhraproducts4853.blob.core....

🟣 75 microgram SPC: mhraproducts4853.blob.core....

🟣 100 microgram SPC: mhraproducts4853.blob.core....

—————————————————————

🔹 Wockhardt (marketing authorisation holder)

🏭 CP Pharmaceuticals Ltd (manufacturer)

🥛 contains lactose

  25 microgram  PL 29831/0130

🟢 PIL: mhraproducts4853.blob.core....

🟣 SPC: mhraproducts4853.blob.core....

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

🔹 – identifies marketing authorisation holder

🔸 – identifies ‘own label supplier’ products

🏭 – identifies manufacturers (where known)

🥛 – contains lactose

– Take particular note of the actual product which varies by dosage.

🟢 PIL – Patient Information Leaflet

🟣 SPC – Summary of Product Characteristics document

🟢🟣 Single document combining typical PIL and SPC information

—————————————————————

Only products which definitely contain lactose are identified (🥛 contains lactose). Please always check other products. Where products are ‘own label supplier’, check the marketing authorisation holder for the specific product.

There are links to product information on the MHRA (Medicines and Healthcare products Regulatory Agency) website. products.mhra.gov.uk/ These are the latest versions known.

If there is anything inaccurate in this information, please let me know by Private Message, or on the forum:

healthunlocked.com/user/hel...

➖➖➖➖➖➖➖➖➖➖➖➖➖➖

This document is updated whenever I am aware of any changes or enhancements are needed. Please check the Last updated date. The current version is available as a PDF here:

dropbox.com/s/6h3h0qi4eqwi6...

The PDF version of this document has QR code above this sentence. If your device has a camera and can interpret QR codes, this QR code should take you to the same place as the link and make it easier to download on devices, such as phones and tablets.

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