Hi all could someone give me some guidance on the results of bloods my son had done with Medic checks
TSH 2.34 (0.27-4.2)
Free T3 5.4(3.1-6.8)
Free thyroxine 12.1(12-22)
Vit d 40 (50-200)
B12 75(25.1-165)
Folate 4.3(>2.9)
Bloods were taken 7am and he fasted from the night before he's not on any medication for thyroid and doesn't take any supplements presently with biotin in them or vitamins they commented he has high cholesterol and that everything else including his Iron stores were within normal range.
On looking at these results he needs to increase his Vit D intake so supplement required but to me his Free Thyroxine looks a bit on the low side?
He is always tired and has gained quite a bit of weight of late
Thanks in advance for any guidance and replies
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Katrina999666
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A normal healthy person would have a TSH of no more than 2, often around 1, with FT4 around 50% through range.
His FT4 is dire, just scraped into range at the very bottom.
I am not medically trained, and I am not diagnosing, but what could possibly be indicated here is Central Hypothyroidism. This is where the problem lies with the hypothalamus or the pituitary rather than a problem with the thyroid gland. With Central Hypothyroidism the TSH can be low, normal or slightly raised, and the FT4 will be low/below range. Your son's results seem to fit with this criteria so it's worth looking into this.
TSH is a pituitary hormone, the pituitary checks to see if there is enough thyroid hormone, if not it sends a message to the thyroid to produce some. That message is TSH (Thyroid Stimulating Hormone). In Primary Hypothyroidism the TSH will be high. If there is enough hormone then there's no need for the pituitary to send the message to the thyroid so TSH remains low.
However, with Central Hypothyroidism the signal isn't getting through for whatever reason. It could be due to a problem with the pituitary (Secondary Hypothyroidism) or the hypothalamus (Tertiary Hypothyroidism).
As Central Hypothyroidism isn't as common as Primary Hypothyroidism it's likely that your GP hasn't come across it before.
Your GP can look at BMJ Best Practice for information - here is something you can read without needing to be subscribed:
You could do some more research, print out anything that may help and show your GP.
You may need to be referred to an endocrinologist. If so then please make absolutely sure that it is a thyroid specialist that you see. Most endos are diabetes specialists and know little about the thyroid gland (they like to think they do and very often end up making us much more unwell that we were before seeing them). You can email Dionne at
tukadmin@thyroiduk.org
for the list of thyroid friendly endos. Then ask on the forum for feedback on any that you can get to. Then if your GP refers you, make sure it is to one recommended here. It's no guarantee that they will understand Central Hypothyroidism but it's better than seeing a diabetes specialist. You could also ask on the forum if anyone has been successful in getting a diagnosis of Central Hypothyroidism, possibly in your area which you'll have to mention of course.
What were his thyroid antibody results?
Vit d 40 (50-200)
This is in the "insufficient" category. His GP may or may not do anything about it.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
To reach the recommended level from your current level, you could supplement with 5,000iu D3 daily, which is more than his GP will prescribe (maximum GP will prescribe is probably 1,600iu, or maybe tell him to buy his own).
Retest after 3 months.
Once the recommended level has been reached 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. You will have to buy these yourself.
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, and large doses of D3 can induce depletion of magnesium. 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.
This is low. Below 70 for Active B12 suggests testing for B12 deficiency. As he's just over that range he could supplement to bring this up to at least 100.
Folate 4.3(>2.9)
This is low. The range is 2.9-14.5 and folate is recommended to be half way through range, so you're looking at 9+ with range.
Both B12 and folate can be improved by taking a good quality, bioavailable B Complex containing methylcobalamin and methylfolate. My suggestion would be Thorne Basic B. If looking at other brands then avoid any which also include Vit C as this needs to be taken 2 hours away from the B12 the B Complex contains.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
everything else including his Iron stores were within normal range.
Medichecks range for ferritin is 13-150, maybe even wider for a male. What is his actual range? Fine just means it's within range and that could be 13 and it could be 150 and he would feel very different with one of those levels compared to the other.
thank you so much for replying. His ferritin was 228 range (30-400)He's not had his antibodies checked nor had coeliac but I am always saying to him that his stomach issues which are frequent could be as a result of intolerance of some kind.
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