Blood test results

[ninja1]

Finally got results can someone please advise

[helvella Administrator Thyroid UK]

I have removed the image of your results.

First, your name was obviously on the image. Please ensure that you do not include personally identifying information such as name, address, date of birth. This is for your own safety.

Second, I couldn't make out a single word of the results.

If you are using a camera, get closer. Cut off, cover up or use a black marker to obscure information, if needed. If you know how, crop the image. The least that surrounds the important text, the more likely it will be legible.

Re-add the edited image when you can.

[ninja1 in reply to helvella]

Sosorry Thank you for that. The results have come in feint like that so i will try again and if not i will type them out.

[ninja1 in reply to ninja1]

CRP 0.8 mg/l (0-5)

Ferritin 80 ug/L (13-150)

Folate 7.0 ug/L (>2.9)

B12 Active 34 pmol/L (25.1 - 165)

Vit D x40 nmol/L Def <25

Insufficient 25-49

Normal 50-20nmol/L

Thyroid TSH x 10.00 mlU/L (0.27 - 4.2)

Free T3 x 2.9 pmol/L (Range 50-200) nmol/L

Free Thyroxine 15.1pmol/ (Range 12-22)

thyroglobulin 13.4 IU/ml ( Range 0-115)

peroxidase antibodies 10.7 IU/mL ( Range 0-34)

Im feeling pretty rubbish at the moment.

[SeasideSusie Remembering]

ninja1

Looking at previous posts in your profile, it would seem that you are taking Levothyroxine after a total thyroidectomy.

How much Levo are you taking?

When was your last dose before this test? Last dose should be 24 hours before test.

Thyroid TSH x 10.00 mlU/L (0.27 - 4.2)

This is obviously way, way too high for someone on Levo and we need to know why. Could it be that you have stopped Levo for a while? Or do you use a B Complex or biotin supplement and didn't stop this for 3-7 days befor the test? Or did you eat and drink before the test? We should only have water before any thyroid test.

Or you could simply be undermedicated.

Free Thyroxine 15.1pmol/ (Range 12-22)

This is only 31% through range which is very low for someone on Levo only. Again, shows undermedication unless something has interfered with the results.

Free T3 x 2.9 pmol/L (Range 50-200) nmol/L

This is the wrong range. You have put the range for Vit D. The range for Free T3 is 3.1-6.8

Obviously this is below range, again suggesting undermedication or assay interference.

Thyroid antibodies are negative.

**

CRP 0.8 mg/l (0-5)

This is an inflammation marker so the lower the better. Yours is fine.

**

Ferritin 80 ug/L (13-150)

Ferritin is recommended to be half way through it's range which is about 82 with that range so yours is OK. Do you supplement at all?

**

Folate 7.0 ug/L (>2.9)

When there is no proper range, we tend to say aim for a level in double figures.

**

B12 Active 34 pmol/L (25.1 - 165)

I think Medichecks will have advised on this.

Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:

viapath.co.uk/our-tests/act...

Reference range:>70. *Between 25-70 referred for MMA

There is a link at the bottom of the page to print off the pdf to show your GP.

The most important indicators of B12 deficiency are symptoms. Check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do have any 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.

**

Vit D x40 nmol/L

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.

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:

vitamindtest.org.uk/

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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

**

Im feeling pretty rubbish at the moment.

If your thyroid results are a true measure of your normal circulating hormone then this not surprising. However, for any thyroid hormone to work properly we need optimal levels so your B12 and Vit D need addressing, and folate may well benefit from improving too.

[ninja1 in reply to SeasideSusie]

My previous basic results in July wereTSH 3.98

Free T3 3.2

Free thyroxine 16.1

GP says all in normal range no action required but obviously they were not as I dont think a T3 of 3.2 is great. now it is even lower. GP going to call me tomorrow. I was in A andE on Thursday with a racing heart, im wondering if these levels could have caused that

[SeasideSusie Remembering in reply to ninja1]

ninja1

Obviously you were undermedicated in July and needed a dose increase. TSH should be 2 as an absolute maximum, but much lower is acceptable where necessary:

From GP online

gponline.com/endocrinology-...

Under the section

Cardiovascular changes in hypothyroidism

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

You didn't answer any of the questions I asked in my reply above about how much Levo you take, when was last dose before the test and whether or not you take biotin or a B Complex and whether or not you left it off, so without knowing the anwser to these questions it's difficult to say much more.

Did you do both tests under the exact same conditions:

* Blood draw no later than 9am. This is because TSH is highest early morning and lowers throughout the day. If looking for a diagnosis of hypothyroidism, an increase in dose of Levo or to avoid a reduction then we need the highest possible TSH

* Nothing to eat or drink except water before the blood draw. This is because eating can lower TSH and coffee can affect TSH.

* If taking thyroid hormone replacement, last dose of Levo should be 24 hours before blood draw, if taking NDT or T3 then last dose should be 8-12 hours before blood draw. Adjust timing the day before if necessary. This avoids measuring hormone levels at their peak after ingestion of hormone replacement. Take your thyroid meds after the blood draw. Taking your dose too close to the blood draw will give false high results, leaving any longer gap will give false low results.

* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).

These are patient to patient tips which we don't discuss with phlebotomists or doctors.

Palpitations are a symptom of hypothyroidism, but it depends whether your "racing heart" was classed as palpitations or something else. Check list of hypo symptoms here and list whatever you have to discuss with your GP:

thyroiduk.org/if-you-are-un...

[ninja1 in reply to SeasideSusie]

I take 600mcgs per week i.e. 100 x 5 days and 50 x 2 days I dont take any supplements whatsoever due to the fillers up set me. I did bloods 9am with nothing to eat or drink other than water for 12 hours. I followed the guidelines to the letter.

[SeasideSusie Remembering in reply to ninja1]

ninja1

I dont take any supplements whatsoever due to the fillers up set me.

It is possible to find supplements that don't have any excipients, you should try those for where you need levels improving.

When did you take your last dose of Levo before the test?

[ninja1 in reply to SeasideSusie]

the previous morning

[SeasideSusie Remembering in reply to ninja1]

So assuming 24 hours.

In that case there is nothing out of the ordinary with your routine that would cause this high TSH. So we probably can assume one of two things:

1) Assay interference

2) You have gone very hypo for some reason

With (1) you could contact Medichecks, explain the difference and say there is nothing that explains the vast difference in TSH levels and would they be good enough to send you another test (free of charge) to see if the results come back any different.

Or you could do a basic test with another lab. MonitorMyHealth is an NHS lab that does the basic TSH, FT4 and FT3 test for £26.10 with code here:

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

With (2) has your Levo brand changed since previous test? Do you always get same brand of Levo?

[ninja1 in reply to SeasideSusie]

The only think changed earlier this year was I used to get levo in 50s and just sort it myself, I changed GPs and they insisted on packets of 100 and 50s I have been on a medication Doxazosin since June but they were stopped last week as it put me in tachycardia Everytime I took it my heart would race. I have also been diagnosed last year with Inappropriate Sinus Tachycard but I think it comes from my thyroid levels.

[SeasideSusie Remembering in reply to ninja1]

What brand of Levo?

Do you take the Doxazosin well away from your Levo?

[ninja1 in reply to SeasideSusie]

no took it about 1 hour later Levo Boots actavis. They have stopped my Doxazosin now. Im pretty sure its just undermedicated as I was starting to feel it in June but GP says all is normal and I can see myself it wasnt

[SeasideSusie Remembering in reply to ninja1]

Just for reference, any other medication and supplements should be at least 2 hours away from thyroid meds, some need 4 hours, some at opposite ends of the day.

Boots brand is Almus (which is Accord, which was Actavis, and reboxed with Boots branding). There has been no mention of any of the Accord brands (Accord, Almus or Northstar in 100mcg and 50mcg doses) being a problem other than last week we heard of Northstar 50mcg being recalled due to the tablet crumbling.

If you do get an increase in dose, and this is an extra 25mcg tablet, be aware that few brands make a 25mcg dose tablet and Teva upsets many people. Also Northstar 25mcg is Teva reboxed so the same problem there.

If you are given a 25mcg dose increase, it would be best to stick to the brand you know you do well with and say you'd prefer to cut a 50mcg tablet in half to give the 25mcg extra (or take an extra 50mcg alternate days to average 25mcg daily).

So it looks like you have had a major swing to hypo for some reason or there has been assay interference. I would imagine your GP will want to do his own test before increasing your dose.

[ninja1 in reply to SeasideSusie]

Thank you again for your care and comments. Can you recommend any b supplements that have minimum fillers if there is such a thing please

[SeasideSusie Remembering in reply to ninja1]

ninja1

Can you recommend any b supplements that have minimum fillers if there is such a thing please

Off the top of my head HealthLeads brand says no fillers/excipients. If I have time later I can try and find others but you could Google "B Complex with no fillers"

[ninja1 in reply to SeasideSusie]

Thank you will do

[SlowDragon Administrator in reply to ninja1]

As per replies to post in July

On Levothyroxine TSH of 3 is far too high

You should have had 25mcg dose increase immediately after these results in July

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

[SlowDragon Administrator]

Looking at previous posts you have had extremely low B12 at several previous posts over last year or so

Have you been taking any B12 supplements or daily vitamin B complex

Clearly B12 is far too low

Vitamin D also far too low

How much vitamin D have you been taking

Looking at improving vitamin D to at least around 80nmol

What’s your diet like

Are you vegetarian or vegan

[SlowDragon Administrator]

Just read you don’t take any vitamin supplements

Obviously you must improve low vitamin levels

Vitamin D mouth spray by Better You is good as avoids gut issues

Look at taking at least 2000iu daily

Retest vitamin D in 6-8 weeks

You might need higher dose

[ninja1 in reply to SlowDragon]

Thankeveryone for your comments, much appreciated.