Just got results back and would be so grateful for feedback, all taken after over 24 without my 100 mg levo and over a week without supplements and hrt patches.
That range is too wide for a female, the female range is usually something like 13-150 or 15-300, that is the male range. Regardless your level is way too low. Below 30ug/L (ng/ml is the same) confirms iron deficiency according to NICE. You're not quite that low but even so I'd be asking GP to do an iron panel to check and a full blood count to see if you have anaemia.
If neither then your GP probably wont be worried about this low level but you can help raise your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
Don't consider taking an iron supplement yourself, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.
Serum folate (42U5) 11.2 ng/ml (3.3 -99,999)
I always wonder why they use such a stupid range, nobody is ever in the reign of pigs' pudding going to have a folate level of 99,999 🙄
Normally it's recommended that folate is at least half way through range but that would be ridiculous with that range. When the range is like yours we generally tend to suggest to aim for double figures so yours is OK.
Vitamin b12 XE2pf 319 ng/L (190-910) ng/L is the same as pg/ml
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."
some people with a level in the 300s are found to have B12 deficiency and need B12 injections. Check for any signs/symptoms here:
If you do 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.
If you don't have any, if those were my results I'd be taking some B12 sublingual lozenges - 1000mcg - along with a good quality, bioavailable B Complex to keep all the B vitamins balanced.
Just using one bottle of B12 should raise your level to 500 and then just continue with the B Complex only.
Suggestions for B12 supplements which include two forms of bioactive B12 - methylcobalamin and adenosylcobalamin which you might want to check out:
Note that the Nature Provides supplement contains a much higher dose than the Cytoplan one.
My preference for a B Complex is Thorne Basic B. If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
No Vit D?
Serum TSH 0.37 miu/L (0.35 - 5.5)
Serum free t4 17pmol/L (9-23)
How do you feel with these results?
For a full picture we really need FT3 testing at the same time as this tells us whether we convert T4 to T3 well enough.
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 good and your FT4 is 57.14% through it's range so if you don't feel optimally medicated then there is plenty of room for an increase in your dose of Levo. However, your low Ferritin level wont be helping, it's too low for thyroid hormone to be working well and some experts say that the optimal level for thyroid function is 90-110ug/L so it's important that you address that.
I haven't commented on the other test results because they are all in range.
Hi there, thank you so much for taking so much time to help me.I checked the ferritin and what I wrote was what was on the results, so that’s strange if it’s not something you recognise.
My vitamin D was done in July so they wouldn’t do it again. It was ( Xaboo0) 91mnol/L (50-99,999).
At the same time in July my F3 was 4.2pmol/L (3.5-6.5). I asked repeatedly for ft3 this time ( especially as my gp is aware I have some T3 tablets and want to gradually introduce it into my dosage) , but it wasn’t for some reason done.
Feel slightly better since I increased to 100 mg of levo a day, but because I’ve waited for ages to repeat the tests I stopped the supplements and my hrt and that’s made me feel really tired and sluggish.
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I checked the ferritin and what I wrote was what was on the results, so that’s strange if it’s not something you recognise.
It's not that I don't recognise it, I do, it's the male range but for some reason some labs only use one range rather than use the separate ranges for male and female and then pre-menopause and post-menopause for females.
So if they're going to use that range then it makes your level look even worse because your result is just 2.16% through the range. So my suggestion still stands, as it is such a dire result I would ask your GP to do an iron panel to see if you have iron deficiency and a a full blood count to see if you have anaemia, particularly if any of the following apply:
Symptoms of low ferritin include:
◾Weakness
◾Fatigue
◾Difficulty concentrating
◾Poor work productivity
◾Cold hands and feet
◾Poor short-term memory
◾Difficulty remembering names
◾Dizziness
◾Pounding in the ears
◾Shortness of breath
◾Brittle nails
◾Headaches
◾Restless legs
Symptoms of iron deficiency include:
◾Persistent fatigue
◾Pale skin
◾Shortness of breath
◾Headaches
◾Dizziness
◾Heart palpitations
◾Dry skin
◾Brittle hair and hair loss
◾Swelling or soreness of the tongue or mouth
◾Restless legs
◾Brittle or ridged nails
Vit D is recommended to be 100-150nmol/L by the Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health recommending at least 125nmol/L. Your level wasn't too bad in July but as we can't make Vit D naturally during the winter months it may not be so good now. You can test this yourself with a fingerprick blood spot test with an NHS lab which offers this test to the general public if you wish to see whether you would benefit from supplementing:
If you can't get FT3 tested with your GP (it's unlikely the lab will do it, even if your GP requests it, unless TSH is out of range) and you want to know this, which of course is essential before considering adding T3, then you might want to consider doing what hundreds of us here do and that is a private test. Cheapest for just TSH, FT4 and FT3 is MonitorMyHealth which is an NHS lab which offers this to the general public with a fingerprick test:
Hi again, sorry I misunderstood what you meant re the fact it’s the male range. On my last results I asked my gp for iron tests and I mentioned pernicious anaemia , but he said I was within range, but that was prior to the ferritin results. I also asked for b12 injections and he said I was in range with that too. I’m a veggie so it’s hard regarding liver etc, I do ear a lot of spinach and kale and other sources although I have reactions now to these things sometimes.
Generally I feel dreadful, I have a constant migraine also and have just had my 2 yearly scan at a different hospital to check the nodules surrounding my goitre. I have an appointment with the gp on 20th regarding this as it come back saying US Thyroid report borderline ???? Tbh when I had the scan I felt like a piece of meat, I tried to engage conversation, but they just said refer back to your gp. They didn’t even say bye, hi, or anything to me. One was a student, so I’m not really surprised by the useless result , but it will be interesting to see the actual scan results as I can’t access it at the moment.
You only need to stop vitamin B complex a week before test, (as contains biotin that can falsely affect test results) and can be good idea to take a separate folate instead during that week
As a vegetarian you likely need to supplement separate B12 everyday
The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3
Also extremely difficult to maintain optimal iron and ferritin on vegetarian diet
Likely to need iron supplements, but essential to do full iron panel test for anaemia before starting any iron supplements….and to retest 3-4 times a year when supplementing
Iron is extremely toxic in excess, you can have low ferritin and high iron …..unlikely as a vegetarian….but always test before and regularly if supplementing
Eating iron rich foods eg pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
Thyroid disease is as much about optimising vitamins as thyroid hormones
So question really is how do you feel? T3 isn’t particularly high in range. If you feel ok stick with meds as they are, if not look for a dose increase. Best to have the full picture of tsh t4 and T3 really so you can see what’s going on. And state what dose you’re taking of what and when.
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