Hi, I have been suffering with fatigue for years now and had my bloods tested recently and I’d like to share my results to see what the people in this forum would recommend.
The HbA1c-(IFCC) results are 34 I got the report separately.
Help with results: Hi, I have been suffering with... - Thyroid UK
Help with results
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Pixelchic
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SeasideSusieRemembering
Pixelchic
Presumably you don't have a diagnosis of hypothyroidism and not on any medication? It's important that we know that because interpretation of results is different from when diagnosed and on thyroid meds.
Did you do the test as we always advise:
* Test no later than 9am
* Nothing to eat or drink except water before the test
This ensures the highest possible TSH which is needed for diagnosis of hypothyroidism.
You haven't included the reference ranges with your results, these are important because ranges vary from lab to lab. This looks like a Blue Horizon test and I do know the ranges.
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HbA1C is fine.
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CRP is an inflammation marker but is non specific. It tells us there is inflammation or infection somewhere.
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Ferritin: 28.9 (13-150)
You should to speak to your doctor about this.
From: cks.nice.org.uk/topics/anae...
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Your GP will say it is within range and it's fine, you should respond by saying why does NICE say it's iron deficiency then?
Your GP should really do an iron panel, that will include serum iron as well as ferritin and that will give further clues about iron deficiency, and he should also do a full blood count to see if you have anaemia. You can have iron deficiency with or without anaemia.
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Magnesium is an unreliable test. A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test. Do you take a magnesium supplement?
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Cortisol: 234
This can only be interpreted if we know the time you did the test because as your result will show there are different ranges for different times of day.
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TSH: 3.72 (0.27-4.2)
FT4: 17.6 (12-22)
FT3: 4.71 (3.1-6.8)
All within range so will be classed as euthyroid (normal).
A normal healthy person would have a TSH of no more than 2, often around 1, with FT4 around mid-range-ish. See this graph of TSH levels in healthy people:
healthunlocked.com/thyroidu...
Your FT4 and FT3 show no problem but your TSH is on the high side. Nobody is tested for baseline thyroid levels in health so none of us know what is normal for ourselves. Your normal TSH could very well be high in it's range, there are a small number that are, as shown on that graph.
However, certain things can affect TSH and give a false reading. Did you drink coffee before the test (or other caffeine containing drink)? This can affect TSH. Do you take a Biotin supplement or B Complex or other supplement containing Biotin? This can affect thyroid results so needs leaving off for 7 days before test.
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Reverse T3 isn't worth doing, it's a waste of time and money. There are many, many reasons for high rT3 and only one is to do with the thyroid, and that is when there is an excess of unconverted T4 and testing FT4 and FT3 tells you that, FT4 would be high and FT3 would be low. You don't have an excess of T4 as your FT4 is 56% through it's range, and your FT3 is 43% through range.
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Thyroid antibodies are well within range so those results don't suggest autoimmune thyroid disease (Hashimoto's). Antibodies fluctuate so this result doesn't rule out Hashi's. It would be worth retesting at some point.
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Vit D is OK at 81 nmol/L although the Vit D Society and Grassroots Health recommend a level of 100-150nmol/L. If you want to improve it you could supplement with maybe 2,000-3,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed 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. This can be done 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, D3 four hours away from thyroid meds 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 you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
naturalnews.com/046401_magn...
drjockers.com/best-magnesiu...
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B12: 150 (<145 = deficient, 145-300 = insufficient)
If this is a Total B12 test rather than an Active B12 test (where the range would be around 25.1-165) then this is a big problem. Very likely B12 deficiency.
So first of all it's essential to know that this is NOT Active B12.
If it is Total B12 with <145 = deficient then you must see your GP as a matter of urgency. You need testing for B12 deficiency and Pernicious Anaemia. You may need B12 injections.
Do you have any signs of B12 deficiency – check here:
b12deficiency.info/signs-an...
b12d.org/submit/document?id=46
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
Please let us know (a) if this is Total or Active B12 and (b) if Total B12 what your GP is going to do about it.
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Folate: 6.56 (8.83-60.8???)
See your GP who may prescribe folic acid. Do not start any medication or supplement for your low folate until further testing of your B12 has been carried out and B12 injections (or supplements) started.
Hi, yes it is blue horizon test and the bloods were taken midday but I hadn’t had anything to eat or drink other then water.
I have been given levothyroxine for the past 8 years, the does 125mcg. However nothing has helped and if I am being honest I haven’t taken it for the past year. So I do not understand why I still have sever fatigue and weight gain
Pixelchic
If you have a diagnosis of hypothyroidism then you really need to continue your Levo. If it's not working properly then you need to look at why. Did you see your GP about this? Does your GP know you don't take your Levo?
There may be a reason you're not absorbing it properly and that could be due to taking it incorrectly (it should be taken on an empty stomach, one hour before or two hours after food, with water only, and water only for one hour each side). Thyroid hormone needs optimal nutrient levels to work properly and you do seem to have some dire levels.
If you had done the test no later than 9am you would have had a higher TSH, very likely over range, this shows you need to go back on your Levo.
So I do not understand why I still have sever fatigue and weight gain
Your weight gain could very well be connected to your hypothyroidism so restarting your Levo should bring down your TSH and improve your FT4 and FT3 levels.
The fatigue is easy. What about the B12? Is it Active B12 or the Total B12 test? If the Total B12 test, have you checked the signs and symptoms of B12 deficiency? Fatigue is one of them. But your Ferritin level will also be a cause of fatigue
So you stopped the prescribed Levo a year ago Pixelchic? Did you reduce the dose or just completely stop? Many of us with thyroid issues fine feel well until TSH is one (or below). However, your current issues may be due to low levels of folate/ B12 so as SS suggests, do ask yourGP about investigating this further. Very best wishes to you.
Hi, I did stop completely as I wasn’t feeling any better and the GP kept saying the range was normal so didn’t get anywhere with it.
I did the B12 test from blue horizon it was part of the platinum package but it doesn’t state if it’s the total or active B12.
Ps I also did take the levothyroxine during the day on an empty stomach and didn’t eat or drink until 1 hour after
And after reading the B12 links sent they do seem like I have a lot of the symptoms so perhaps I may need to ask the GP for a Total B12 test again
Sorry for not being any clearer.
I would phone GP early next week and make an appointment to discuss your blue horizon test re B12. Some like to do ‘own blood tests’ before prescribing. Do post to let us know how you get on!
Pixelchic
the GP kept saying the range was normal so didn’t get anywhere with it.
Was he only testing TSH or did he also test FT4 and FT3? TSH is not a thyroid hormone, it's a signal from the pituitary, it's FT4 and FT3 that are the thyroid hormones and tell us what we need to know about whether or not we are optimally medicated or not.
I did the B12 test from blue horizon it was part of the platinum package but it doesn’t state if it’s the total or active B12.
So what is the range? If it says <145 = deficient it's the Total B12 test. If it's something like 25.1-165 then it's the Active B12 test. Usually if it's the Active B12 tet it states this, the Total B12 test just tends to state B12. They always used to do Total B12 but I don't want to assume this although I think this is what you've had done.
And after reading the B12 links sent they do seem like I have a lot of the symptoms so perhaps I may need to ask the GP for a Total B12 test again
No, you need testing for B12 deficiency and Pernicious Anaemia, you already have your B12 result now you need further different testing.
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Hi
The doctors were only testing for TSH and despite me asking for further tests they decided it wasn’t required as they were not out of range.
The ranges from the tests are include in the image below. I will ask the GP for the further tests
Photo
Pixelchic
So that's Total B12 and the range starts at 145. Although you just scrape into that range the chances of B12 deficiency are very high. If GP is resistant to further testing you must emphasise any symptoms of B12 deficiency you have, they are supposed to prioritise symptoms over numbers with B12.
Thank you SeasideSusie i will definitely stress this. As I have not been well for years and always had a feeling it wasn’t totally related to my thyroid.
I will keep you updated
Just thought I might add this, not sure if it helps anyone else. But about early April I came out in this bizarre rash and swelling on both feet which the doctors are unable to explain. After reading the B12 symptoms makes me wonder if it is vasculitis and all related.
Photos
I don't know. I have no personal experience. A friend had vaculitis a couple of years ago, hers affected her heart and she nearly died. Fortunately she saw the only decent doctor at our surgery and says she owes her life to him, if she'd seen one of the others she probably wouldn't be here (yes, they are that bad 
)
Hi, just an update, my GP has said he will repeat the tests done again and has decided to stop my levothyroxine medication for now since I haven’t taken it and the levels are still in the normal range.
What about the B12?
He will do that too and if it comes back low then will do the pernicious anaemia test. Apparently he said I was tested for anemia and it came back normal.
Did he not take into account your symptoms?
You could post on the PA forum here on HealthUnlocked with your list of symptoms, apparently testing can give false negatives and they may be able to help further about this.
No he was adamant that we will only test got PA if the B12 results came back showing concerns.
I do have severe fatigue which intensifies during my cycle. Sometimes walking from kitchen to living room is really difficult. Then I get a weak feeling in my legs like I can’t support myself and weight gain.
I see you have posted on the PA forum. I would add your symptoms to that post and mention that your GP will only test if results show concerns.
Rash looks like coeliac or gluten intolerance
Has it stayed or disappeared
Gluten intolerance is EXTREMELY common when hypothyroid
Request coeliac blood test while still eating high gluten diet
Obviously vitamin levels are dire as direct result of not taking your Levothyroxine
Which brand Levothyroxine do you get
Many people find different brands are not interchangeable
Looks like vasculitis
healthline.com/health/skin-...
This was the rash and swelling at their worst
Swelling
Swelling could be due to stopping Levothyroxine
It might be, I will let you know what the doctor says about getting tested for B12 deficiency and take it from there.
Levothyroxine is for life
It’s a replacement thyroid hormone
The reason we get free prescriptions with hypothyroidism is because it’s essential to take it every day
Important to be on high enough dose, always same brand Levothyroxine and all four vitamin levels OPTIMAL
You need testing for pernicious anemia before starting on daily folic acid supplements for folate deficiency and almost certainly B12 injections every 2 months
Agreed. Will start levothyroxine again I’ve been so down with my symptoms I just decided to stop and I am sure the brands I get change all the time too.
Work out which brand Levothyroxine suits you best and always get same brand at each prescription
You will need to start Levothyroxine SLOWLY at 50mcg every day. Always take on empty stomach.
Blood test should be done 6-8 weeks after each dose change
Dose increased upwards in 25mcg steps
Getting all four vitamin levels OPTIMAL
If you Google vasculitis and hypothyroidism you will see they can be connected
Once on Levothyroxine it’s important to always take Levothyroxine EVERYDAY
Being hypothyroid frequently results in low stomach poor nutrient absorption and low vitamin levels as direct result
Hmm, the rash and swelling have gone down considerably now.
Hmm, the rash and swelling have gone down considerably now.
Just thought I might add this, not sure if it helps anyone else. But about early April I came out in this bizarre rash and swelling on both feet which the doctors are unable to explain. After reading the B12 symptoms makes me wonder if it is vasculitis and all related.
Photos
I will do, thank you for your replies, I have been suffering for years now and wished I had found this forum earlier. Will definitely keep you updated
I can only comment on your cortisol result, if it was done around midday then it is within normal reference range but slightly low. Cortisol is best tested first thing in the morning but I would expect yours to be much higher then & don't think any Endo would be concerned about it.
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