Blood test results

[Gullysully84]

Can anyone read blood test …

[SeasideSusie Remembering]

Gullysully84

Depends what blood tests, certainly thyroid and key nutrient tests, between us we can interpret many. Post what you have, please include the reference ranges (these vary from lab to lab so we must have the range that comes with the result) and include the unit of measurement for Vit D and B12 if you are posting these results.

[Gullysully84]

Blood results

Blood results

[SeasideSusie Remembering in reply to Gullysully84]

Gullysully84

TSH: 3.16 (0.27-4.20)

FT4: 17 (12-22)

How much Levo are you taking?

When did you take your last dose of Levo before the test (last dose should be 24 hours before blood draw).

Your results suggest that you are undermedicated. The aim of a treated Hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges. Your TSH is far too high and your FT4 is 50% through range. You need an increase in your dose of Levo, 25mcg now and retest in 6-8 weeks. Possibly another increase after that.

TSH should never be over 2 (lower if necessary) according to 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.

Also, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):

"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"

*He confirmed, during a talk he gave to The Thyroid Trust, that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw(Not working as expected?)

You can obtain a copy of this article from ThyroidUK:

[e-mail]

print it and highlight Question 6 to show your GP.

Use the above information to support your request for an increase in your dose.

Ferritin: 13 (13-150)

This is marked as "No action needed". If that note has been put on by your GP then he is being negligent.

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.

So your GP needs to do an iron panel which includes Serum Iron, TIBC, Saturation % plus Ferritin, this will confirm iron deficiency.

Haemoglobin: 116 (120-150)

MCV: 69.5 (83-1-1)

MCH: 22.3 (27-32)

All below range which suggests anaemia, plus your dire ferritin level suggesting iron deficiency, it all suggests iron deficiency anaemia. You need to discuss with your GP and he should prescribe iron tablets and monitor you regularly.

Each iron tablet should be taken with Vit C (eg 1,000mg) to aid absorption and help prevent constipation.

Lymphocytes: 3.1 (1-3)

Very slighly raised and possibly just temporary as they can be raised when the immune system is dealing with an infection or inflammation.

[Gullysully84 in reply to Gullysully84]

Thank you so much for your help , I don’t fully understand it all , but I’ll get on it to the doctor, I thought I was going crazy , I new it wasn’t normal, as I’mAlways sleeping dizzy hands Ache , levo I’m taking 75 , I take it first thing in the morning, I had my blood test at 3pm , they don’t say to leave it 24 hours? I’m going to show my doctor what you have said , why don’t they no this stuff , he always sent me an email just to tell me about my bloods ,

[SeasideSusie Remembering in reply to Gullysully84]

Gullysully84

I take it first thing in the morning, I had my blood test at 3pm , they don’t say to leave it 24 hours?

The majority of doctors don't know this. Here are our recommendations for when doing thyroid tests:

* 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 because most will say it doesn't matter.

There are a very few doctors/endos who do tell their patients this but the majority have no idea how to treat hypothyroidism or how to interpret blood tests, looking just at TSH and adjusting dose by that, and often saying that anywhere within the range is fine, and this is why your Ferritin result is marked as "No action", because it technically lies within range albeit at the very bottom, yet if doctors kept up with guidelines they'd know it confirms iron deficiency.

As your ferritin level is so poor, it's likely that your other key nutrients could be as well. Ask for Vit D, B12 and Folate to be measured. These are the optimal levels we should aim for:

Vit D - 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.

B12 - 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."

So for Total B12 a minimum of 550pg/ml (or ng/L, they are both the same), preferably nearer 1000. Active B12 should be a minimum of 70, preferably over 100.

Folate - at least half way through it's range.

Ferritin - half way through range although some experts say that the optimal level for thyroid function is 90-110ug/L.

[Gullysully84 in reply to SeasideSusie]

I don’t no how I’m earth I’m going to get a blood test before 9am it’s all booked in by the phone now what ever they have available, anyways thank you again I’ll try get my doctor to listen or do something about it all … it’s been ongoing for a few years now ..

[SeasideSusie Remembering in reply to Gullysully84]

My surgery phoned me last week saying they're back to doing routine blood tests and can they book me in. I asked what tests, receptionist told me FBC and liver function. I know that these trigger a thyroid test for me. She offered me an afternoon appointment. I just asked if she had a morning one and was given 9.10am the next day. Just ask, if you're offered an afternoon one just say it's not convenient, early morning is the best time for you and you're happy to wait a little longer for them to fit you in.

[Gullysully84 in reply to SeasideSusie]

Ok will do , thank you again we need more pll like you helping xx

[Gullysully84]

😱

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