More Bloods test results any advise

[SAUK]

Thanks all for your advice on my previous post about my bloods.

I had a few more done and keen for an advise

TSH 0.003 (0.35-4.75) been like this for 2 years since being on liothyronine and levo combi

T4 9 (10-12)

T3 6.6 (3.5-6.5)

Ferritin 70 was 54 2 weeks ago (15- 250) previously 33

Vit D 56 (72-250) I take 3000mg vit D spray daily

Serum Iron 8 (9-30)

Transferring 2.4 ( 2.5- 3.8)

Transferring Sat % 12 (15-50 %)

B12 470 done in yr 2020 (200- 900)

HbAiC 33 (20-41)

I'm on 75mcg T4 and 40mcg T3. I also take 200mcg of ferrous sulfate ( 5 hours away from thyroid meds), 3000mc spray of Vit D and B vit complex (in am hour after thyroid meds)

Mira coil fitting went fine. Haven't felt any major symptoms.

Endo happy to not change anything with thyroid. Suggesting merformine 500mcg in the evening as a profolacative only.

Any ideas about the iron and vit D will be do helpful

[SeasideSusie Remembering]

SAUK

TSH 0.003 (0.35-4.75) been like this for 2 years since being on liothyronine and levo combi

T4 9 (10-12)

T3 6.6 (3.5-6.5)

These are the exact same results as you posted here 2 weeks ago which SlowDragon commented on.

healthunlocked.com/thyroidu...

That can't possibly be the correct range for FT4, it only has a width of 2 and normally it is around 10 or 12, eg 12-22, 7-17, 9-19, 11-23.

Perhaps you can clarify. Whatever it is, your FT4 is low in range.

Any ideas about the iron and vit D will be do helpful

I also take 200mcg of ferrous sulfate, 3000mc spray of Vit D

Ferritin 70 was 54 2 weeks ago (15- 250) previously 33

Serum Iron 8 (9-30)

Transferring 2.4 ( 2.5- 3.8)

Transferring Sat % 12 (15-50 %)

Presumably the ferrous fumarate is prescribed.

Did you leave your iron tablets off for 7 days before the test and do the test after fasting for 12 hours (water allowed)?

Your ferritin is improving but your serum iron is below range as are Transferrin and Saturation%. You need to discuss these with your GP as this suggests iron deficiency and you may need your iron tablet dose changing.

Vit D 56 (72-250) I take 3000mg vit D spray daily

The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L.

To reach the recommended level from your current level, you would be better increasing your D3 dose to 4,000-5,000iu D3 daily.

Retest after 3 months.

Are you taking D3's important cofactors - magnesium and Vit K2-MK7?

B12 470 done in yr 2020 (200- 900) - is this pmol/L or pgml or ng/L (the latter two are the same)

Not really relevant now so you might want to retest.

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."

HbAiC 33 (20-41)

Good result.

B vit complex (in am hour after thyroid meds)

You should move the time of this supplement. We should leave 2 hours between thyroid meds and any supplements or medication (although some need 4 hours, this one needs 2 hours).

Did you leave your B Complex off for 7 days before the test?

[SAUK in reply to SeasideSusie]

Thanks SeasideSusie

Yes some of the results were the ones from last post.

T4 reference range 10-20 .... sorry typo

Thank you re: Vit D. Will increase this. I use magnesium cream and Vit K spray but can increase this.

I only stopped the iron the day before not for a week, hence the Ferritin jumped that quickly. I will leave it for 7 days in future, but feel so weak without iron don't think I can stop it for that long.

Thanks about the B12. I work in specialist Neurology so have good understanding of this reference range for brain function. I was looking for pernicious aneamia with the B12 but does not seem the case.

Will move by B vits to later, thanks for the tip.

[SeasideSusie Remembering in reply to SAUK]

SAUK

For K2-mk7, 90-100mcg is enough for up to 10,000iu D3.

For B12, if you think there may be pernicious anaemia then it might be worth doing an Active B12 test as this measures the amount of B12 that is available to the cells. The range is quite narrow compared to the normal serum Total B12 test, around 37.5-188 and anything below 70 suggests testing for B12 deficiency. Unlikely to be done on the NHS but Medichecks do it as a fingerprick test:

medichecks.com/products/vit...

Discount code here:

thyroiduk.org/help-and-supp...

[SAUK in reply to SeasideSusie]

Amazing. Thank you so much! Really appreciate the advice