I would really appreciate some advice on my sisters private blood test results (Thriva) that I’ve pasted below with the relevant ranges. In particular I would value your opinion on the Thyroid results and whether you believe my sister has an under active thyroid and should be on Levothyroxine. Like me, she displays all or most of the classic symptoms of having an under active thyroid such as being tired, feeling cold, weight gain etc. Unfortunately she wasn’t tested for FT3 on this occasion.
Thyroid Stim. Hormone (High). 5.98 Range 0.270 - 4.2
Free Thyroxine (FT4). 14.0 Range 12 - 22
Ferritin. 41. Range 13 - 150
Active B12. 115.0 Range 37.5 - 188
Folate (serum). 10.6 Range 8.83 - 60.8
25 OH Vitamin D. (Low). 47 Range 75 - 175
Thank you
Steve
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Stevews
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I'm not familiar with Thriva's test bundles, but it's strange that FT3 isn't included with this one. Was it supposed to be and there wasn't enougn blood or some other problem?
Thyroid Stim. Hormone (High). 5.98 Range 0.270 - 4.2
This confirms hypothyroidism, it's over range and some countries diagnose when TSH goes over 3; however, here in the UK we have to wait until it reaches 10 unless there are also raised antibodies tested at the same time.
Were antibodies not included in this test? If not it would be a good idea to get the full thyroid panel:
TSH
FT4
FT3
TPO and Tg antibodies
Free Thyroxine (FT4). 14.0 Range 12 - 22
Low in range, if it was below range she would possibly have been diagnosed.
Ferritin. 41. Range 13 - 150
Too low. Ferritin is recommended to be half way through range although some experts say that for optimal thyroid function it should be 90-110.
She shouldn't consider taking an iron supplement unless she has an iron panel to see if she is iron deficient and a full blood count to see if she is anaemic. 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.
She can help raise her 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
This is low. Folate is recommended to be at least half way through range which would be 35+ with that range. She could consider supplementing with a good, bioavailable B complex such as Thorne Basic B.
25 OH Vitamin D. (Low). 47 Range 75 - 175
As shown, this is low.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.
To reach the recommended level from her current level, she could supplement with 5,000iu D3 daily.
Retest after 3 months.
Once she's reached the recommended level then she'll need a maintenance dose to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. She can do this with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, when taking thyroid meds D3 should be taken four hours away if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Magnesium helps D3 to work. We need Magnesium so that the body utilises D3, it's required to convert Vit D into it's active form. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit best and as it's calming it's best taken in the evening (if taking thyroid meds then four hours away if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium).
In the UK this would be considered subclinical hypothyroidism and treatment can be considered if she’s symptomatic. This is according to NICE guidance, however my TSH/FT4 levels were similar and it took a bit of persistence to get GP to agree. They only did it after first getting everything else (B12, ferritin) into range. I’m now on 50mcg and starting to see a difference so, if she’s symptomatic, it’s worth persevering
A TSH of 5.98 is too high and her Free Thyroxine is on the lower end of normal. I would say she has hypothyroidism. Her Vit D is low as well. She should try taking a VitD3 supplement (available from shops like Holland and Barrett). She should probably take 25mcg daily to see if that makes any difference. I think we're all recommended to take a VitD3 supplement in the UK, especially in the winter.
I’m not a doctor, so wouldn’t and shouldn’t like to try to interpret your sister’s blood results. What I do know is that even a common cold can affect the TSH level. My daughter’s levels have been sky high one week and back to normal 2 weeks later. I started having my TSH checked in 2014 and was finally put on Levothyroxin in 2019. During this time my results were all over the place - TSH being as high as 27.63 and T4 8.6 when I was finally diagnosed with hypothyroidism. During those years my TSH had been between to 5.88 and 27.63, my FT4 between 8.6 and 31.2 and my FT3 between 3.5 and 5.2.
I can't advise about the blood test results but the TSH looks high as others have said below. I think also you need antibody tests as it is important to see what is going on there. I had raised antibodies last year when first diagnosed with Hashimoto's and all the symptoms - brain fog, depression, weight gain, tiredness, cold etc etc. I tried T3 for a while and it didn't help then I was put on Levothyroxine. At first, I didn't think it was helping but I think that is just because it took a few weeks for my body to adjust. Then it started to make a difference - my fatigue improved and my latest blood tests are much better - my thyroid hormones are normal again. HOWEVER, to add, I don't think it is the Levothyroxine alone that has helped, I've changed my diet a lot to try to boost my thyroid health and I think that has made a big difference too. It's worth a try on the Levothyroxine - my GP has me on a low dose only but it seems to have done the trick. Good luck with it, Sarah
I just want to thank everyone who gave up their time to reply to my posting.
Having spoken to my Sister, she used the Thriva’s automated guidance system, various questions about her health, how she felt etc, at the end it made a recommendation for various blood tests. As she’s never used a private lab before she didn’t question the type of tests they recommended. Unfortunately a full Thyroid panel test was not one of them, hence why it was limited to FT4 & TSH.
SeasideSusie,
She did have an iron test and the results was:-
Iron 15.3 Range 10-30 umol/L
As her iron results are within range, I don’t believe she needs any iron supplements.
Just to make it easier, as copy and paste doesn’t preserve the spacing and tabulating, I have attached her Pathology Report. I have redacted her private details for confidentiality purposes.
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