New blood tests are back

[Kimkat]

if someone would kindly look at my results, I would be grateful. I’m pleased to see that my TSH is down and the Lab Doctor has commented on everything being ok. I upped my thyroxine by 25mcg in feb/march.

[fuchsia-pink]

How do you feel?

Personally I'd like my TSH to be lower and free T3 to be higher - yours is only 27% through range, though free T4 is nice and high, suggesting you don't convert well.

So if you don't feel great, it might be time to look at adding some lio to the mix. This means getting hold of an endo who is prepared to prescribe it - it's endo-only and not all of them will because (a) it's fiendishly expensive; (b) it has a very short half-life which means it's difficult to measure and (c) a surprising number of them genuinely don't seem to think it works, and the thousands of us who have found it transformative are suffering from some giant shared delusion

You can get a list of T3-friendly endos from Dionne at Thyroid UK - [e-mail] - and/or it's worth a new post asking for recommendations near-ish to you. You don't need to see the nearest person but must obv be reasonably convenient. Good luck x

[Kimkat in reply to fuchsia-pink]

Thanks for that fuchsia, that’s interesting. I don’t feel brilliant but I do feel better than I did, however I’m always tired/lethargic, brain fog, dry skin, nails are just weird looking and my hair is thinning. I don’t have a thyroid now as I had RAI 3 years ago and was left without any levo for 2 years before the nhs decided to start treating me. Would not having a thyroid explain me not converting?

[SeasideSusie Remembering in reply to Kimkat]

Kimkat

Would not having a thyroid explain me not converting?

No, not having a thyroid doesn't explain that, the thyroid makes a small amount of T3 but most conversion takes place outside the thyroid, mainly the liver. This article may help (ignore the fact that they are selling stuff):

rootfunctionalmedicine.com/...

Your low FT3 will be causing symptoms but your thinning hair could be down to your low ferritin.

Ferritin is recommended to be half way through range, yours is 31 and half way through that range is 82. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

You could discuss this with your GP but I expect he'll say it's in range so it's fine. However, don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little. The iron panel will show if you have iron deficiency, you could also ask for a full blood count to see if you have anaemia. Either of these conditions would need prescription iron tablets and regular monitoring.

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...

Folate is low at 5 (2.89-14.5), it's recommended to be at least half way through range. Eating folate rich foods and a good quality B Complex such as Thorne Basic B or Igennus Super B will help raise your folate level.

B12 and Vit D are good. Do you take any supplements?

[Kimkat in reply to SeasideSusie]

I’m a bit confused with the folate reading as it says on my results >2.9 so I thought I was over. I take iron, VitD and vit C at the moment, I was waiting for these results before I started taking anymore supps. How do I get an iron panel, through my GP or can I get a private one done?

[SeasideSusie Remembering in reply to Kimkat]

Kimkat

I’m a bit confused with the folate reading as it says on my results >2.9

Yes, that is the "range", they're using now, they're saying greater than 2.9 is fine. However, this is a test done by The Doctor's Laboratory and their range is actually 2.9-14.5.

County Pathology used to do Medichecks tests until recently and their range is 3.89-19.45 but for some reason they started showing the range as >3.9

It's ridiculous not having a top and bottom end of range because one doesn't know if they're near the low end or high end, if near the low end it means we need to improve it.

The unit of measurement for the folate test is ug/L (mcg/L) and as Folate Deficiency is diagnosed when the level is below 3ug/L then to have a range saying >2.9 seems ridiculous. If the actual result was 3 and the range is >2.9 you can see how poor that result is compared to a result of, say, 20.

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.

[Kimkat in reply to SeasideSusie]

Yes you’re right. I may challenge the online doctor with that, as you are able to question them once logged in to your account. I’ll let you know what the answer is.

[SeasideSusie Remembering in reply to Kimkat]

They're all number focused, if it's in range everything is fine, doesn't matter where in range, 0.1 point from the bottom is fine, it doesn't matter how you feel it's nothing to do with such a low result.

They get on my ... erm ... nerves 😉

I'd be interested to know what they say.

[Kimkat in reply to SeasideSusie]

Is an iron panel different to the results in my test above?

[SeasideSusie Remembering in reply to Kimkat]

Kimkat

Is an iron panel different to the results in my test above?

Yes, an iron panel tests Serum Iron, Transferrin Saturation %, Total Iron Binding Capacity and Ferritin.

[pennyannie in reply to Kimkat]

Hey there ;

Optimal conversion when on T4 - Levothyroxine only is 1 - 3.50 - 4.50 - T3/T4 with most people preferring to come in at around 4 or under:

To find your conversion when on T4 only you simply divide your T3 into your T4 result and I'm getting 5.1 : showing poor conversion :

Optimal vitamins and minerals might improve this result :

Ferritin needs to be over 70 and I feel better at around 100 :

I aim for a vitamin D at around 100 :

I aim for folate at around 20: and active B12 70+ or serum B12 500 + :

However since you have has RAI thyroid ablation I think it's inevitable your conversion will be compromised as your feedback loop is now broken and blood tests limited.

A fully functioning working thyroid would be supporting you on a daily basis with trace elements of T1 and T2 and calcitonin plus a measure of T3 at around 10 mcg and a measure of T4 at around 100 mcg,

T4 is a storage hormone and needs to be converted by your body into T3 the active hormone that the body runs on and which is said to be about 4 times more powerful than T4 with the average person needing to utilise around 50 T3 just to function.

Personally I think it makes sense to replace like with like but was refused both Natural Desiccated Thyroid and T3 by the NHS and so i now self medicate with full spectrum thyroid hormone replacement and have my life back.

The TSH is of little value once on any form of thyroid hormone replacement and we need to be dosed and monitored on our T3 and T4 levels though in primary care this seems not to be the case.

Ideally for wellness your T3 and T4 need to be balanced within the ranges and we generally feel better when both T3 and T4 are in the top quadrant of the ranges.

Currently your T4 is at around 90% but your T3 at just 27% and the logical answer is to drop a little T4 and add in a little T3 - Liothyronine.

Currently obtaining anything other than T4 through the NHS is challenging and in my case the challenge exacerbated my Graves symptoms so I decided to self medicate and gave myself a trial of each of the options the NHS denied me.

The thyroid is a major gland responsible for full body synchronisation including your physical, mental, emotional, psychological and spiritual well being, your inner central heating system and your metabolism.

Too low a level T3 for you and you have symptoms of hypothyroid just as too high a T3 level and you may experience symptoms of hyperthyroidism.

[Kimkat in reply to pennyannie]

Thank you for explaining that, it’s so difficult to get your head around all the Ts 😄 but I know at some point the penny will drop. I want to be fully loaded with ammo for my next telephone conversation with my endo, which isn’t until august, so time to study and hopefully he will realise that I’m taking this seriously and not just taking his word for it, when he tells me everything is fine. Going on these results I was going to ring my GP and ask for another increase of 25mcg but after reading your opinion I’m not sure that will help me any, however I’ll speak with him and see what he comes up with. He’s pretty keen to be honest as he’s relatively new, my usual GP has cut his hours drastically as he is preparing for retirement and I got the feeling that he’s just playing the waiting game now and seems to disagree with most things that I say to him.

[pennyannie in reply to Kimkat]

Well there is room for a small increase in T4 and it may well increase your T3 but I think the differential to wide to be closed by this action.

I took my T4 over range and my T3 did improve in the short term but it was short lived and over range T4 just gave me massive headaches.

Your TSH is too high and if this is all the doctor measures you may well get a dose increase.

Your TSH is too high because we can see your T3 and T4 numbers and know you are not converting well the T4 into T3 and I think once you get your ferritin up and over 70 and bring your folate up your conversion will improve and your T3 rise and your T4 will adjust itself down proportionately.

Core strength vitamins and minerals are needed to be maintained at optimal levels irrespective of whatever your choice of thyroid hormone replacement.

[helvella Administrator Thyroid UK]

When it comes to tests, the Lab Tests Online websites can be very useful. For example, their page on Iron Tests:

labtestsonline.org.uk/tests...