Help with blood tests: Hi all, Here are my... - Thyroid UK

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Help with blood tests

Lordy40 profile image

Hi all,

Here are my latest blood test results after an increase of thyroxine by 25mcg from 150mcg to 175mcg six weeks ago.

TSH- 0.05 ml u/l (0.27-4.2) below reference range

Serum Free T4 - 22.7 pmol/l (12.0-22.0) above reference range

Recorded as abnormal by lab but no further action. I have lowered my thyroxine back to 150mcg a day again as reading was too high, and if anything it’s made me even more tired and out more weight on, and a strange sensation in my neck/throat)

Serum Ferritin 56 ng/ml (13-150ng/ml) satisfactory according to lab results

Serum folate - 17.5 ug/l (don’t know reference range)

Serum vitamin B12- 504 pg/ml (197.0-771.0)

Full blood count- normal lab result

Haemoglobin concentration 121 G/l (115.0-160.0)

Serum c reactive protein level - 3mg/l ( 0.0-5.0) borderline.

Serum creatinine level- 88 umol/l (45.0-84.0)

Thanks for any replies.

43 Replies

Suggest you do a private test of THS, free T4 and free T3. It'snot an expensive test

You were very slightly over-range on the previous dose, but now sound under-medicated. Remember you are only over-medicated if free T3 is over-range. From the sound of it, I would guess that free T3 is a bit rubbish (ie, like me, you are a "poor converter" and would be much happier with a bit of lio adding to the mix - but to know, you need to test free T4 and free T3 together... If it IS low, the next stage is to find a nice lio-friendly endo, but suggest you do a new post hen you have the T3 result

Additionally, I for one, can only lose weight when free T3 is nice and high so if your isn't good, you're always going to be on an uphill struggle with trying to lose :(

As regard nutrients, ferritin looks a bit low to me - can you bear to eat liver from time to time? Any vit D result? x

Lordy40 profile image
Lordy40 in reply to fuchsia-pink

Thank you for your reply.

I’ve made a doctors appointment for Monday week to discuss results, I will look into a medichecks private test to see what the results come out with T3 included. Do you mean my symptoms of tiredness, weight gain and strange sensation are signs of being under medicated as they got worse since the increase to 175mcg. I only dropped the dose today so could carry on with 175mcg for now until I do the private testing.

My ferritin is on the low side as I suffer with heavy periods that last for weeks, I don’t like liver but have been eating more red meat.

That’s the trouble I don’t know if the breathlessness going upstairs or when talking is due to ferritin levels or thyroid, and although the weather has been hot, I’ve been sweating more easily than normal and not sure if that’s due to over medication, just because it’s hot or hormone related as I’m 46. My mind is very muddled on all these things going on.

They didn’t test vitamin D xx

greygoose profile image
greygoose in reply to Lordy40

Do you mean my symptoms of tiredness, weight gain and strange sensation are signs of being under medicated as they got worse since the increase to 175mcg.

Strange as it may sound, increasing your dose of levo could have actually lowered your FT3, the active hormone which causes symptoms. When the FT4 gets too high, the T4 starts to convert to more rT3 than T3, so the FT3 level could drop. If you felt better on 150 mcg, then it might be better to stay on that. Or, try just a 12.5 mcg increase by alternating 150 and 175. :)

Lordy40 profile image
Lordy40 in reply to greygoose

Thank you for your reply. That is very interesting I didn’t realise that. I did feel better on 150mcg. I tried the increase to see if it helped with heavy bleeding, it still took 3 weeks after increase for bleeding to stop so not sure if it helped or was coincidence as had been in period for 55 days. 🤔

greygoose profile image
greygoose in reply to Lordy40

Your ferritin will probably be very low, then. And, I have heard somewhere - though I couldn't for the life of me tell you where! - that having low iron/ferritin, makes bleeding worse. Don't ask me how! lol But, it would be worth getting your iron and ferritin tested.

Lordy40 profile image
Lordy40 in reply to greygoose

That’s interesting, I did wonder if low room levels could make it worse. They have just tested them and said they are in range. I take two ferrous fumarate tablets a day. Have done for about 10 years as long as I’ve had this issue.

greygoose profile image
greygoose in reply to Lordy40

They are so clever, aren't they! They tell us our results are in-range as if we're to b-stupid to be able to see that for ourselves! You don't need to go to med school for 7 years just to be able to see if a blood test result is in-range or not! Oh, they do make me cross!!! lol What they have no idea about is whether or not the result is high enough in range to make you well - have you see the extent of that ferritin range?!? It's vast. You could not possibly feel the same if it's at the bottom as you would at the top. There's just no logic to it.

So, if you don't know already, you need to get hold of the actual numbers: results and ranges. Then post them on here and let's have a look. :)

Lordy40 profile image
Lordy40 in reply to greygoose

Exactly! I never believe it when they say they are in range, and like you say from reading the results I can see they may be in range but they are in the low end! It makes me cross too, we are at their mercy lol.

I have added the latest results in the top of this post with the other tests they did.

They are serum ferritin 56 NFAS/l (13-150 ng/ml

And serum folate -17.5 ug/l that didn’t have a reference range next to it. 🤔😊

greygoose profile image
greygoose in reply to Lordy40

The folate should be ok. But, the ferritin is much too low. However, before supplementing, your doctor should test your serum iron, because it's possible to have high iron with low ferritin. Please don't ask me for details! Iron is so complicated, I fail to get my head round it. :)

Lordy40 profile image
Lordy40 in reply to greygoose

I did think the ferritin was still too low. They did full blood count there was lots of results like white blood cells etc that I didn’t post as there was lots of results. I’ll ask the doctor when I go next Monday. Iron is so complicated! 🙂

greygoose profile image
greygoose in reply to Lordy40

It is indeed! Far too complicated for me.

Lordy40 profile image
Lordy40 in reply to greygoose

Me too!

rjb112 profile image
rjb112 in reply to greygoose

"What they have no idea about is whether or not the result is high enough in range to make you well - have you see the extent of that ferritin range?!? It's vast. You could not possibly feel the same if it's at the bottom as you would at the top. There's just no logic to it."

Excellent

dunestar profile image
dunestar in reply to greygoose

And sometimes the range is so wide that it becomes rather meaningless.

greygoose profile image
greygoose in reply to dunestar

Exactly!

SlowDragon profile image
SlowDragonAdministrator in reply to greygoose

humanbean mentioned that low iron tends to make periods heavier

greygoose profile image
greygoose in reply to SlowDragon

Yes, I know. But, it was something I heard long before that.

jgelliss profile image
jgelliss in reply to SlowDragon

For sure . I experienced it myself. Dr's where aware of my low Iron levels yet never made a suggestion to raise my Iron levels. What else is new???

waveylines profile image
waveylines in reply to Lordy40

It sounds like that you need a dose between 150 and 175mcg. You could try alternate days. This should bring your ft4 back into range. A lovely endo (now retired) once told me that you can do no harm so long as you keep your thyroid hormones in range. So you've done the right thing to reduce but dropping back to 150mcg maybe too low.

Lordy40 profile image
Lordy40 in reply to waveylines

Thank you for your reply. I will look into trying that, that may work better. Good idea.

RoboTh profile image
RoboTh in reply to Lordy40

Has GP considered tranexamic acid to take first 2 days of period to preserve your iron.

Lordy40 profile image
Lordy40 in reply to RoboTh

I take tranexamic acid when on periods, take it for 4 days but it hasn’t been helping. I’m due to have a hysterectomy soon.

gabkad profile image
gabkad in reply to Lordy40

Your haemoglobin is only 121. That's why you get breathless going up the stairs.

Some women take birthcontrol pills continuously for a year in order to stop their periods and get their iron status up.

You were bleeding for 55 days? Have you had an ultrasound done? Anytime there is abnormal bleeding, this needs to be checked out. It's quite simple to bleed to death.

Lordy40 profile image
Lordy40 in reply to gabkad

Thank you for your reply. That would make sense with the stairs. I can cross trainer for an hour and not be breathless.

I’ve tried birth control pills, it made the bleeding worse. I have fibroids. I had an ultra sound last October. I have had this issue with bleeding for weeks on and off over the last 10 years.

That is very scary to think of isn’t it.

vocalEK profile image
vocalEK in reply to Lordy40

Have you tried progesterone only? That is micronized progesterone, not the crap they used in the Women's Health Initiative. One brand name is Prometrium. I was surprised to learn that this can alleviate many menopausal symptoms and symptoms of PCOS.

"Tablets that contain the hormone progesterone can be taken for the treatment of heavy periods. Progesterone inhibits the growth of the lining of the womb before menstruation, which lessens the bleeding during menstruation." When I had heavy bleeding, HRT straightened it out, but now that I am in my 70s they won't give me estrogen. I no longer have periods, but have begun taking Prometrium to deal with hair loss and night sweats.

Lordy40 profile image
Lordy40 in reply to vocalEK

Thank you for your reply. I will ask the doctor about that. Every time I have asked the GP or hospital consultant about any other treatments such as HRT they’ve said there is nothing. I will look further into it.

gabkad profile image
gabkad in reply to vocalEK

I take 200 mg progesterone daily. Those little balls. But without estrogen I get themost wicked sick making hot flashes. I tried to go without and it was horrible. So I am

using Estrogel. Post menopause 11 years but last year I got some bleeding after I was

sick. As far as I'm concerned it was Covid based on the rather unique symptoms but

back then in March/April they were only testing people who had travelled or been in contact with someone who tested positive and had travelled. After the fever went

away, a week later I started spotting and a week after that I got a full out period for 6 days. I had been in contact with someone who just returned from Sidney, Australia after being on a cruise. She is the prime suspect but has not informed me if she had

been ill. She did email me a month afterwards asking if I was okay...... kind of suspicious.

Ultrasound showed overgrowth of the endometrium and a biopsy (painful as hell) was

negative for cancer. So the gynecologist prescribed these progesterone pills No bleeding since. I have to go for a followup ultrasound. Soon.

Meantime I've been on HRT for 15 years and never had an ultrasound so who knows

what sort of shape the endometrium has been all these years.

shaws profile image
shawsAdministrator

Did you get your blood drawn at the earliest possible time? Did you allow a gap of 24 hours between your last dose and the test and take levo afterwards?

Lordy40 profile image
Lordy40 in reply to shaws

Thank you for your reply. I did leave 24 hours between last dose and test was done at 7.50am. Then I took levo after.

SlowDragon profile image
SlowDragonAdministrator

You need vitamin D

Plus TSH, Ft4 and Ft3 tested together

Can do all these via Monitor My Health

Lordy40 profile image
Lordy40 in reply to SlowDragon

Ok thank you, will look in to getting that done.

SlowDragon profile image
SlowDragonAdministrator

As you have Hashimoto’s are you on absolutely strictly gluten free diet

Or tried it?

If not, get coeliac blood test done BEFORE considering trial on strictly gluten free

Lordy40 profile image
Lordy40 in reply to SlowDragon

No I’m not on a gluten free diet and have never tried it. It something I have thought about but not sure if I can stick to it.

I will look at getting a coeliac blood test done before thank you.

SlowDragon profile image
SlowDragonAdministrator in reply to Lordy40

It’s much easier than you might expect

approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal

Before considering trial on gluten free diet get coeliac blood test done FIRST just to rule it out

lloydspharmacy.com/products...

If you test positive for coeliac, will need to remain on gluten rich diet until endoscopy (officially 6 weeks wait)

If result is negative can consider trialing strictly gluten free diet for 3-6 months. Likely to see benefits. Can take many months for brain fog to lift.

If no obvious improvement, reintroduce gluten see if symptoms get worse.

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

restartmed.com/hashimotos-g...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

ncbi.nlm.nih.gov/pubmed/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

ncbi.nlm.nih.gov/pubmed/300...

The obtained results suggest that the gluten-free diet may bring clinical benefits to women with autoimmune thyroid disease

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

hypothyroidmom.com/how-to-l...

Eliminate Gluten. Even if you don’t have Hashimoto’s. Even if you have “no adverse reactions”. Eliminate gluten. There are no universal rules except this one.

Lordy40 profile image
Lordy40 in reply to SlowDragon

Thank you, I will have a good read of everything and arrange a test to rule that out before trying gluten free.

Hi Lordy40 . I'm on the same dose as yourself 150 mcg T4. I had TT several years ago . I was on much higher doses for suppression purposes. I also noticed that nutrients are co factors to our thyroid meds. It really helps our thyroid meds work better for us. Vitamin "D"/K2 , B-Complex, B-12/folate, Iron if you test low. You will never hear Dr's tell you this. Dr's will just tell you take this pill once a day and you'll be just fine.

Wonderful members on this Great Forum will give you great suggestions .

Best Wishes.

Lordy40 profile image
Lordy40 in reply to jgelliss

Thank you for your reply. I totally agree with you. I take vitamin D, B complex and B12 and ferritin and I think do help support thyroid meds. I always worry every now and then that I’m taking too many vitamins but I think generally they help.

There are fab members of this forum, it’s a lovely place to feel supported and listened too.

Best wishes to you too on your health journey.

SlowDragon profile image
SlowDragonAdministrator in reply to Lordy40

Important to stop taking vitamin B a week before all blood tests as contains biotin and biotin can falsely affect test results

When testing iron and ferritin levels, stop iron supplements a week before testing

Never supplement iron without full iron panel test.

Medichecks do full iron panel test

If taking vitamin D, retest twice year

Lordy40 profile image
Lordy40 in reply to SlowDragon

Thank you, I hadn’t taken any vitamin B supplements for two weeks before test done, and not on any iron supplements just the ferrous tablets. Medichecks have an offer today will take a look. Thank you for your advice.

SlowDragon profile image
SlowDragonAdministrator in reply to Lordy40

Ferrous is iron

When were iron and ferritin levels last tested

Lordy40 profile image
Lordy40 in reply to SlowDragon

Last week they were tested.

SlowDragon profile image
SlowDragonAdministrator in reply to Lordy40

Did you stop iron supplements for week before test, or were you not on ferrous supplements then

If you get full iron panel test via Medichecks, stop ferrous supplements week before test

Lordy40 profile image
Lordy40 in reply to SlowDragon

I was taking the ferrous supplements. Ok, thank you. I will do that.

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