Hi
I’d be grateful of any thoughts on what my next steps should be with these blood results (attached). Also Folate was 8.9 ug/L (range 1.9-25). B12 was tested but it’s not active B12 as it was at the GP, however results were 518 (range 197-771).
Currently on a 3 day cycle of 125mcg thyroxine for day 1 & 2, then 100mcg day 3. Alongside 10mcg of T3.
I feel absolutely exhausted.
Thanks for any advice.
Spangle15
I think the first thing that you should do is reduce your dose of meds to bring your levels into range.
If those were my results I would be reducing Levo first, this will reduce FT4 and depending on how much natural conversion you have it should also reduce your FT3. I'd start with taking 100mcg daily and see how much difference that makes, retest in 6-8 weeks. It could take some time tweaking doses to find the optimal doses that you need.
Folate is on the low side, it is recommended to be at least half way through range which with that range would be at least 13.5+
If B12 is ng/L or pg/ml (they are both the same) then 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."
I would suggest you take a good quality, bioavailable B Complex such as Thorne Basic B or Igennus Super B which will help raise both folate and B12 levels.
Your ferritin is low but your iron panel doesn't suggest iron deficiency so it wouldn't be a good idea to take iron tablets as this will raise your serum iron and saturation % too high. 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
apjcn.nhri.org.tw/server/in...
I'm afraid I can't help with your parathyroid result, hopefully the member who knows about this (sorry can't remember username) will see your post and comment.
Thank you so much SeasideSusie .
Yes B12 was ng/L.
I’ll start reducing thyroxine. I’m really struggling to get the levels right this past year, I’ve had to change my dose up or down every blood test. I was on ERFA and thyroxine combo previously and I’m thinking on going back to that.
Sorry, forgot to say that when taking a B Complex remember to leave it off for 7 days before any blood test (including thyroid) as it contains Biotin and when Biotin is also used in the testing procedure (which most labs do) then it can give false results.
Thank youz
SeasideSusie has suggested what I was going to say - levo reduction to 100mcg per day to begin with.
How much vitamin D are you currently taking When was vitamin D last tested
Are you also taking vitamin K2 and/or magnesium
Obviously your ferritin is very poor ...won’t be helping
Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test....do you always get same brand of levothyroxine at each prescription
How do you take your T3
On day before blood test was last 2.5mcg taken roughly 8-12 hours before test
Are you on strictly gluten free diet
Hi SlowDragon
Vitamin D was done about 6 weeks ago, it was 106. I take Vitamin D and K2.
I’m just about to start magnesium.
Yes to blood test being done first thing before eating.
I take my T3 first thing with my thyroxine an hour before breakfast.
Yes, I’ve been gluten free for years now.
Was your calcium tested ?
Yes it was. it is currently 2.22 adjusted.
It was low back in November at 2.11, with a PTH of 8.35. so I was advised to supplement wth calcium. Then in January it was 2.21, PTH 8.62.
Has you D, calcium and PTH been tested in the same blood draw ?
It looks like you are still short of calcium.
Do you take boron and magnesium to help absorb D?
Yes, it was back in November, when my calcium was picked up as being low. At that point my vitamin D was 113.
I don't supplement with Boron, and I wasn't taking magnesium regularly either.
Usually when PTH is high calcium is low. Your parathyroids regulate calcium and if they are not working as they should, or if say your kidneys are not working as well as they should, you get odd readings.
I would get your GP to check out your parathyroids.
Hi spangle15💗
M
I'm just going to comment on your parathyroid hormone being 7 as it says above the range... Personally I'd be asking for a calcium blood to be taken to, as a elevated parathyroid hormone can be a sign of hyperparathiyroidism, although it does not always need a big elevation in calcium to diagnose this, I myself I'm going through this, my parathyroid hormones were 8.1 and 9.5...with a calcium of 2.67, if you can look up hyperparathiyroidism, I was also diagnosed with hyperthyroidism then after a tussle with my endo eventually got the antibodies checked then an uptake scan to conferm graves, I have no thyroid now, but hyperparathiyroidism can make you feel awful.. ❤️👍👍
Hi Birkie
Thank you for commenting. So your calcium was above range at 2.67?
Mine has never been above range, but I did have two parathyroid tumours removed about 3 years ago because of high PTH. It was actually low this time with the high PTH (see above).
I have no thyroid either.
Hi💖
There are to types of hyperparathyroidism,, primary and secondary, I have primary, this means I have a elevated pth and a elevated calcium, secondary is a conditioning which a disease outside of the parathyroid glands causes all of the parathyroid glands to become enlarged and hyperactive the most common cause of secondary hyperparathyroidism are kidney failure and vitamin D deficiency. In kidney failure, the kidney is no longer able to make enough vitamin D or remove all of the phosphorus that is made by the body which leads to low calcium levels, these low calcium levels stimulate the parathyroid glands to make more pth thus increasing the levels of pth.. Either way you should as some on here have commented check your pth and calcium again 💖💖💖
Hi spangle15💖I also just want to mention you don't need to have a high calcium level to be diagnosed with hyperparathyroidism, in some cases the calcium was only slightly elevated while some remained at 2.60 the top end for calcium, 💖
When the low calcium was found, creatinine, eGFR and phosphate levels were in range. So hopefully that means kidneys are ok. As was vitamin D.
Who knows what’s going on, I never seem to have it straight forward.
My GP says my blood tests (as per top of this post) were fine! So he’s no help at all 
I would ask GP to test PTH, calcium and D. In 3 months. Just to keep an eye on things.
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