Can anyone help me with blood results?

[Sweeneythyca]

I hope someone can make some sense of my bloods as have just got off phone with Endo and been told they are perfect..... I do not believe they are and the main consideration is I feel dreadful. He says I am in fact overmedicated (Levo))which is certainly not true.

My T4 has been on a downward trajectory for months and TSH is suppressed since Thyca.

T4 is just over 27% through range.

I am confused as I am militant with my dose timing, I take at night (makes sense due to calcium meds in morn) I have not changed a thing yet still my T4 lowers, it was at 22 at one point over a year ago, I just asked him could it be a pituitary problem and he seemed positive there was no problem and that unless I scrape 9 then nothing to worry about.

I have very regular bloods due to calcium issues, have not had folate tested this time nor iron, Endo said we will test again in a month, I asked for folate, iron etc

Last 2 bloods thyroglobulin antibodies were undetectable.

Thank you in advance.

Ok for context I am on 100mcg Tirosint (Levo) I weigh 53kgs

Had total Thyroidectomy for cancer 2 years ago.

I have Hypoparathyroidism so take calcium(calcichews) and alfacalcidol

Due to low ferritin g.p prescribed Ferrous fumerate 210mg

I also take B12 Methylcobalmin (pure encapsulations)

Vitamin D3 1000IU (solar)

Magnesium (together vits)

All bloods done as per instruction on here, early morn, no biotin 1 week prior, missed previous dose etc

(Sorry for the long post, couldn't format it any better)

T4:

12.9 pmol/L Range: 9 - 23 pmol/L

Date:18 Feb 2021 09:46:00

13.2 pmol/L Range: 9 - 23 pmol/L

Date:21 Jan 2021 09:52:00

14.1 pmol/L Range: 9 - 23 pmol/L

Date:06 Nov 2020 10:00:00

16.4 pmol/L Range: 9 - 23 pmol/L

Date:01 Sep 2020 09:30:00

T3

4 pmol/L Range: 2.5 - 5.7 pmol/L

Date:18 Feb 2021 09:46:00

3.6 pmol/L Range: 2.5 - 5.7 pmol/L

Date:06 Nov 2020 10:00:00

TSH

0.07 milliunit/L Range: 0.3 - 4.2 milliunit/L

Date:18 Feb 2021 09:46:00

0.25 milliunit/L Range: 0.3 - 4.2 milliunit/L

Date:21 Jan 2021 09:52:00

0.16 milliunit/L Range: 0.3 - 4.2 milliunit/L

Date:06 Nov 2020 10:00:00

0.15 milliunit/L Range: 0.3 - 4.2 milliunit/L

Date:01 Sep 2020 09:30:00

Vitamin D

112.6 nmol/L Range: 70 - 150 nmol/L

Date:18 Feb 2021 09:46:00

Replete = 70-150

MAGNESIUM

0.83 mmol/L Range: 0.7 - 1 mmol/L

Date:18 Feb 2021 09:46:00

0.86 mmol/L Range: 0.7 - 1 mmol/L

Date:21 Jan 2021 09:52:00

B12

462 ng/L Range: 160 - 800 ng/L

Date:18 Feb 2021 09:46:00

Ferritin. (Awaiting g.p bloods to check latest levels)

23 ug/L Range: 10 - 120 ug/L

Date:06 Nov 2020 10:00:00

[Sweeneythyca]

Thanks so much for your reply... yes sadly I have had more endos than I have boyfriends 🤪.

Fabulous your thyroglobulin is also undetected..... I have been waiting for that result for ages and have to say I was a bit anxious.

I had thought my T3 was reasonable, do you not think it is?

Yes I have always taken my Levo at night, b4 bed, 4 hours after eating, its the only way I can be sure it doesn't interfere with other vits and calcium etc. Also ensures I maintain my weight, no snacking after 6pm lol xx

[Sweeneythyca]

Hahahaha yep already said all that. Hmmmph.I already do source my own amd can increase if i want, only problem is I get it from Greece, and have enough to last till aug, I suspect due to brexit I won't be able to get it anymore. I will see if I can and just increase myself. . X

[Sweeneythyca]

Thank you.... thats what i thought x

[SlowDragon Administrator]

Your ferritin was terrible

Aiming to improve to at least around 70

What’s your diet like

Have you increased iron rich foods in diet

B12 could be higher

No folate result

Rather than just supplementing B12 you may also need a good quality vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Igennus Super B is good quality and cheap vitamin B complex. Contains folate. Full dose is two tablets per day. Many/most people may only need one tablet per day. Certainly only start on one per day (or even half tablet per day for first couple of weeks)

Or Thorne Basic B is another option that contain folate, but is large capsule

If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

With B12 result below 500, recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

healthline.com/nutrition/me...

[Sweeneythyca in reply to SlowDragon]

Thank you...I did think a b complex would be a good idea, thanks for tip.

Ferritin has always been very low, for years. Can't seem to get it any higher.

I'm pretty militant with vit timings, have to take all away from each other (and caffeine etc)and aware of contraindications.

I'm vegetarian so very difficult to increase iron load... take plenty of green veg, and grains and cereals.

I eat very healthily, would be a vegan but for hypoparathyroidism.

Thanks for reply. X

[SlowDragon Administrator in reply to Sweeneythyca]

Suggest you read many of humanbean in depth replies on low iron and ferritin

Likely to need to supplement continuously to maintain good ferritin. But important to retest iron and ferritin every 3-4 months when taking iron supplements

Obviously extremely difficult/impossible to maintain adequate ferritin when vegetarian and on levothyroxine without supplements

List of iron rich foods

dailyiron.net

Links about iron and ferritin

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first

Post discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Why low ferritin needs improving

healthunlocked.com/thyroidu...

[Sweeneythyca in reply to SlowDragon]

Thank you, I have struggled with it for a long time and have read everything on this site regarding ferritin. I suspect it may be connected to MTHFR variant.

[Sweeneythyca in reply to SlowDragon]

I should add I take a high dose vit C supplement and a glass of OJ with iron tab to help absorption.