Iron panel, CRP, ESR?

[Minimouse1]

Hi all, so after having a Medichecks full thyroid test in April my result were:

TSH 1.39 mIU/L (0.27-4.2)F

Freethyroxine 19.4pmol/l (12-22)

Yesterday my GP repeated a TSH only test which came back as follows:

0.62 mIU/L (0.38-5.5). Could I be going slightly hyper now?

I wasnt expecting the GP to repeat my thyroid test as the reason I went to them was that the Medicheck test raised concerns around my high CRP & Ferritin levels, therefore I had asked GP to do a full iron panel. However GP ended up doing bloods for Iron, LFT, FBC, CRP, ESR. Pls see as follows:

Serum Iron - pls see photo attached.

LFT bilirubin 6 umol/ (0.0-20.0),S Serumalanine aminotransferase 15u/L (10.0-49.0)

FBC - platelet count, monocyte & Eosinophil all marked observation

CRP & ESR still above ref range so are high. Is any of this telling a story??

I know CRP & ESR indicate inflammation but am unsure of the iron result. Is anyone able to advise if the result is ok? Also is it ok to take iron supplements when on levothyroxine?

Thank you.

[Bearo]

As no one has replied, perhaps edit the title of your post to iron panel, CRP, ESR etc to attract the experts

[SeasideSusie Remembering]

Minimouse1

Bearo makes a good point. If your post heading reflects what your question is about then it attracts members who may have similar experiences to read your post and possibly respond.

Something else that might be why you've had no responses is because it's very difficult to pick out your test results when just included in sentences in your post. It's a case of "can't see the wood for the trees". We all have our problems, that's why we're here. One of mine is exactly how your results have been presented, it is difficult for me to plough through a big paragraph of text to pick out the important bits, it's just a big blur so I don't respond to those posts. It's always best to present results as one test/result/range per line, eg

TSH: 2.5 (0.2-2.4)

FT4: 15 (12-22)

This makes everything nice and clear and for those of us whose eyes can't cope with big blocks of text it is very helpful.

You ask if you could be going "slightly hyper" now as your TSH is lower. No, you are hypOthyroid, you cannot suddenly become hypERthyroid although you can be overmedicated but you would need to test FT4 and FT3 as well and it's the FT3 that tells you if you are overmedicated. Also, when Hashi's is present then levels fluctuate.

[SeasideSusie Remembering]

Minimouse1

Also is it ok to take iron supplements when on levothyroxine?

We can take iron tablets when on Levo, they have to be taken 4 hours away, but we should only take them if needed and it's best if they're prescribed and the GP should regularly monitor your levels. Too much iron is toxic and is as bad as too little.

Optimal iron panel levels according to rt3-adrenals.org/Iron_test_... are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 43% so a little lower than optimal.

Saturation: optimal is 35 to 45%, higher end for men - yours is 31% so a tad lower than optimal.

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 - your transferrin is slightly below range.

Ferritin: Low level virtually always indicates need for iron supplementation; High level with low serum iron/low saturation indicates inflammation or infection; High level with high serum iron and low TIBC indicates excess iron; Over range with saturation above 45% suggests hemochromatosis - yours is 58% through range

Your iron panel doesn't seem to suggest that you need iron supplementation. Your serum iron and saturation are a little bit lower than optimal but they're not dire. Your ferritin is just over half way through range and we always say here that half way through range is recommended for ferritin, also some experts say the optimal ferritin level for thyroid function is between 90-110 ng/ml. However, as your Transferrin is below range you might want to ask your GP the significance of this.

FBC - platelet count, monocyte & Eosinophil all marked observation

So they must be out of range I expect. But which way - over or under? You can check with labtestsonline for explanation of blood test results (recommended by NHS as a source of information), this is their page for FBC, click on "What does the result mean?" and it opens up a table giving information on all the different tests in a FBC

labtestsonline.org.uk/tests...

CRP & ESR still above ref range so are high. Is any of this telling a story??

Just that they are inflammation markers so they are indicating that somewhere you have some inflammation or infection.

[Minimouse1 in reply to SeasideSusie]

Thank you very much I will defo take the low transferrin issue up with my GP - I thought the iron may be the cause for the dizzy light headed spells I've been having for a few months. Been to ENT nothing found 🤔.