Hey, I’m new to the site and as some of you seem to have some really good knowledge I’m hoping you might be able to help me. I had a little girl 3 years ago and since then, my health has been really poor- always having infections or needing medication for something. I found out I had underactive thyroid shortly after I had my daughter and have been on 25mcg for 3 years which has just been increased to 50mcg following a recent blood test but I’ve also got the following blood results which make me believe something else might be going on. I’m wondering if anyone else has had similar results and has had a diagnosis? My Gp keeps just giving me tablets for deficiencies but I feel this isn’t really solving the problem and I don’t want to be on lots of tablets for the rest of my life.
B12- 357
Folate- 2.31
T4- 11.8
Vitamin D- 27
TSH- 4.95
Serum transferrin 3.22
Haematocrit 0.483
I’m currently taking 20,000 vitamin d x 1 per week, 50mcg levothyroxine, 210mg ferrous fumerate, 5mg folic acid.
Sorry for the long post but I’m in desperate need of a light at the end of the tunnel.
Thank you 😊
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GemH2014
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Can you please add the reference ranges for these results so that we can interpret them accurately, ranges vary from lab to lab.
I’m currently taking 23,000 vitamin d x 1 per week
How come 23,000iu? That's a very strange amount. Prescription D3 for your level would normally be 20,000iu once or twice a week, nobody makes a 23,000iu dose.
Serum transferrin 3.22
That result is from an iron panel, do you have the rest of the iron panel as well?
Haematocrit 0.483
Do you also have haemoglobin and anything else from a full blood count?
have been on 25mcg for 3 years which has just been increased to 50mcg following a recent blood test
Were you retested 6 weeks after intially being started on Levo?
Have you been tested regularly since (at least annually)?
After initiation of Levo, protocol is that retesting takes place 6 weeks later, increase in Levo dose of 25mcg, retest 6-8 weeks later, increase in dose of Levo, etc, until your levels are where they need to be for you to feel well.
If yourGP did not follow the initiation and titration protocol then he has been negligent and has left you on a start dose for far too long. Normal starter dose is 50mcg unless a child, elderly or have a heart condition.
The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges.
Your current results show that you are very undermedicated to have an over range TSH and an FT4 level which has barely scraped into range. Your GP was correct to increase your dose by 25mcg now but you must ensure you are retested in 6-8 weeks time to see if you need another increase, I think you may need several so you must be proactive in ensuring you get these tests and increases.
**
B12- 357 (range 211-911)
This is too low.
Is the unit of measurement pg/ml or ng/L (which are both the same) or pmol/L.
If pg/ml or ng/L then the following applies:
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."
Your GP wont agree, he'll say your result is in range. However, doctors arent' taught much about nutrition so they wont know anything about optimal levels.
**
Folate- 2.31 (range 3.38- 23.9)
This is folate deficiency and I see you are on 5mg folic acid. How long have you been on this? Are you being monitored?
**
Vitamin D- 27 (range 50-374)
This is just 2 points above Vit D deficiency for most areas where the limit is 25nmol/L, some areas deficiency is diagnosed when level is below 30.
You are on 20,000iu D3 once a week which really isn't enough but your GP may not increase this. You could try to get an increase to twice a week by discussing the NICE treatment summary for Vit D deficiency: cks.nice.org.uk/vitamin-d-d...
(click on Management > Scenario:Management)
"Treat for vitamin D deficiency if serum 25-hydroxyvitamin D (25[OH]D) levels are less than 25 nmol/L.
For the treatment of vitamin D deficiency, the recommended treatment is based on fixed loading doses of vitamin D (up to a total of about 300,000 international units [IU]) given either as weekly or daily split doses, followed by lifelong maintenance treatment of about 800 IU a day. Higher doses of up to 2000 IU a day, occasionally up to 4000 IU a day, may be used for certain groups of people, for example those with malabsorption disorders.
* Several treatment regimens are available, including 50,000 IU once a week for 6 weeks (300,000 IU in total), 20,000 IU twice a week for 7 weeks (280,000 IU in total), or 4000 IU daily for 10 weeks (280,000 IU in total)."
If your prescription remains at 20,000iu once a week then it will take longer to raise your level.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L so this should be your aim regardless of what your GP says is a good level.
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. 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.
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.
Serum iron: 55 to 70% of the range, higher end for men - yours is 67.2% through range
Saturation: optimal is 35 to 45%, higher end for men - yours is 25%
Total Iron Binding Capacity (TIBC) or Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is slightly over range
Ferritin: Low level virtually always indicates need for iron supplementation - yours is 4.63% through range
So your serum iron is very good, if anything a little high for a female, your saturation is a little low, your Transferrin suggests the need for supplemental iron and your ferritin is dire.
You have a mixed bag of results for your iron panel, your serum iron shouldn't really go any higher but your ferritin needs massive improvement. I can't help there, I don't know if your GP can.
Welcome to our forum and am sorry you have hypothyroidism. It is not uncommon for females to develop hypo after childbirth. I think whoever is/was treating you is useless.
Do you follow this procedure when testing your thyroid hormones:-
i.e. blood draw is at the earliest possible, fasting (you can drink water) and allow a gap of 24 hours between last dose of levothyroxine and test and take it afterwards?
25mcg of levo for three years is totally inadequate as we usually start on a low dose 50mcg of levo with a small increment of T4 (levo) around every six weeks until symptom-free and feel well!
Also Vitamin B12, Vit D, iron, ferritin and folate should be optimal. If they've not been tested ask when next blood test is due.
If you want to edit anything in your post, click the down arrow next to 'More' and theb select edit.
Always get a print-out of your results every time for your own records and post them.
It is amazing how little doctors seem to know about hypothyroidism.
Hi, I’ve been in a similar situation as my thyroid gave up after having my son who’s 3 next week. I can’t imagine how you must feel being stuck on 25mcg for three years!
It’s totally unacceptable and your results show you are very under medicated.
In terms of feeling better, you absolutely can. I’m now symptom free but it’s took a long time to get my medication and vitamin and minerals optimum.
In terms of taking lots of pills for the rest of your life I’m afraid that’s the reality now if you want to feel well.
You’re on the right track now but make sure you chase your GP for a repeat blood test 6 weeks after stating your 50mcg dose as it’s likely you’ll need more increases of your medication until you start to feel well.
Once your feeling better I would be tempted to lodge a complaint with your GP practice about the totally unacceptable treatment you’ve received over the past 3 years.
oh dear ... the usual recommended dose to start with is 50mcg, unless the patient has heart problems , or is elderly /frail. This is only meant to be a temporary dose , used as a gradual gentle introduction of replacement hormone to the body , to prevent the full replacement dose given all at once coming as a bit of a shock to it. After that they should review bloods after 6 weeks and increase dose based on interpreting bloods and symptoms, to achieve the correct full replacement dose for the individual, which usually ends up in the region of 75-125 for most folk , (but not every one)
make sure they retest after been on 50mcg for at least 6 weeks, and get the blood test results [including ranges] from that test , Post them here and folk will help you interpret them.
If you also get hold of your previous thyroid blood results from the last three years, you may well find that they explain quite a lot if you have not been feeling well on just 25mcg..... and i'd be very surprised if you have.
Once you start to replace thyroid hormones with Levothyroxine, the body senses the extra , and compensates by reducing your own output further than it was before you started, so the end result is basically if you replace a bit of it , you actually have to replace all of it. (This is a bit of an oversimplification of how it works , but it will do for now)
Some Doctors don't seem to to understand this properly and treat it like , "i've added 25mcg so you've got 25mcg extra" , but the body's HPT (Hypothalamus/Pituitary /Thyroid) Axis is much cleverer and complex than that .
Well done for finding your way here, hopefully things will start to get better for you now , but i can't promise you won't go through a period of being unimpressed with your Doctors
Also low folate, can cause depression and even psychosis so very important. You cannot used the b12 that you have without enough folate, they work together. Did you have any b12 supplements or energy drinks within 4 months of the test?
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