Blood test results advice please

[Dunawori146]

I posted this to SlowDragon but lost it??

I have just received the results of my Thyroid Blood test. I have no idea what to make of it.

I would be really grateful for any advice you can offer me, please.

I take 100mcg Almus Levo

Many thanks

[SlowDragon Administrator]

Presumably test was done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

When adequately treated Ft4 should be at least 60-80% through range

Your results show Ft4 is below range

Take these results to GP and request 25mcg dose increase in levothyroxine

Almus (is Accord brand) doesn’t make 25mcg tablets

Ask for prescription for 50mcg tablets and cut in half to get 25mcg

Bloods should be retested 6-8 weeks later

Vitamin D, folate and B12 are all too low. But not low enough for GP to prescribe

You will need to self supplement to maintain optimal vitamin levels

[SlowDragon Administrator]

High CRP needs further investigation by GP

Vitamins are low BECAUSE You are under medicated

What vitamin supplements are you currently taking?

Vitamin D

GP will often only prescribe to bring levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

But improving to around 80nmol or 100nmol by self supplementing may be better

ncbi.nlm.nih.gov/pubmed/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS test options

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need,

Calculator for working out dose you may need to bring level to 40ng/ml = 100nmol

grassrootshealth.net/projec...

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...

Taking too much vitamin D is not a good idea

chriskresser.com/vitamin-d-...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

2 good videos on magnesium

healthunlocked.com/thyroidu...

Vitamin D and Covid

Notice how much vitamin D many of these medics are taking

vitamind4all.org/letter.pdf

[SlowDragon Administrator]

Folate and B12 are extremely low

Are you vegetarian or vegan?

Ideally GP should test for Pernicious Anaemia before you start any B vitamin supplements

But if GP unhelpful you will need to start regardless

supplementing a good quality daily 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

IMPORTANT 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...

Only add one supplement at a time and then wait at least 10 days to assess before adding another

Start with vitamin D, then magnesium

Hopefully by then had testing for Pernicious Anaemia

Then can start vitamin B complex

Last add B12

Retest 6-8 weeks after increase in levothyroxine

May need further increase in levothyroxine after next test

[SlowDragon Administrator]

Head sweating (cranial/facial hyperhidrosis) strongly linked to B12 deficiency

pubmed.ncbi.nlm.nih.gov/252...

[SlowDragon Administrator]

hypergammaglobulinemia also linked to being hypothyroid

pubmed.ncbi.nlm.nih.gov/673...

Hypothyroidism was identified in 4/8 (50%) patients.

[Dunawori146 in reply to SlowDragon]

WOW! Thank you so very much. This is so very helpful to me. I will read all properly to take it in but I think I need to make an appointment with my doctor. I feel very empowered that I will be going with some relevant information (although I know not to rub internet in doctor's face!!)I did follow your advise to the letter and went early morning and didn't take Levo since the morning before

Thank you very much for your support 😀

[SlowDragon Administrator in reply to Dunawori146]

Print out blood test result and give it to GP

Request 25mcg dose increase in levothyroxine (as 50mcg tablets) and further blood test form for 6-8 weeks later

I would also push for testing for Pernicious Anaemia before starting any B vitamins as you have symptoms of low B12

Also point out high CRP to GP

Are you vegetarian or vegan?

[Dunawori146 in reply to SlowDragon]

I will do as you suggest for everything.

I have just recently given up meat for ethical reasons (as much as possible) but do eat 'MSC' fish.

I never was a huge lover of meat, eating mainly chicken, but I'm also not the world's greatest lover of vegetables!!

I am struggling at present to find a happy medium.

[Bearo in reply to SlowDragon]

I had low vitamin D and lowish B12 before hypothyroid diagnosis and I would sweat profusely from my head, face and hairline - which I read was low vitamin D, and sweating in bed at night I put down to vitamin B12. Supplementing both vitamins has resolved these problems.

[Dunawori146 in reply to Bearo]

That's great to know. I hope that these can be resolved by sorting out my Vitamin intake. I carry a bag full of tissues and hand fans everywhere I go. Every chair I sit in, in every room, has a small desk fan next to me. And when I'm in bed I sleep with 2 floor fans - one either side of the room - blowing at me all night long. For the last 15 years, I have slept in a hurricane! 🤣

You must know what this all feels like. I'm just so pleased that you now have got it under control. Thank you for your advice, I appreciate it