Are these results ok?

[STAMBRIDGE]

A FOLLOW UP TO MY PREVIOUS POST. I have the results of a full blood test that I asked for. TSH 0.05, T4 16.9, T3 4.6, VITAMIN D 73.9, VITAMIN B12 327, FERRATIN 74.5, FOLATE 4.6. SHOULD I AGREE TO A REDUCTION IN DAILY DOSAGE FROM 75 MCG TO 50 MCG? I have said I am happy to alternate 75 mcg and 50 mcg until my next blood test in 2 months' time. I feel fine on 75 mcg daily but I am told that I should reduce to 50mcg daily.

[greygoose]

I very much doubt you should agree to any sort of reduciton, but impossible to say for sure without seeing the ranges. Ranges vary from lab to lab, so we need the ranges that went with your results.

[STAMBRIDGE in reply to greygoose]

Thank you.

[STAMBRIDGE in reply to greygoose]

The GP said that my Vitamin D, Vitamin B12, Ferratin and Foliate were "Normal".

[greygoose in reply to STAMBRIDGE]

Normal is the setting on a washing machine. It has nothing to do with blood test results. Besides, if your results are 'normal', why do they want you to reduce your dose? That is illogical, because if they are 'normal', they are only 'normal' because you are taking that dose.

When a doctor says 'normal', all he means is 'in-range'. He has no idea what 'normal' means for you, as an individual. And, to just say 'normal', referring to a blood test result, is lazy doctoring, and just proves the doctor has no idea what he's talking about. The ranges tend to be so wide that it would be impossible for someone to feel 'normal' at the top of the range, and also at the bottom of the range.

But, we cannot tell how 'normal' your results are, if you don't give us the ranges.

[helvella Administrator in reply to STAMBRIDGE]

To reinforce greygoose

You just might find the article below (and the full paper which you can access) interesting and/or useful.

The normal range: it is not normal and it is not a range

1. Martin Brunel Whyte

2. Philip Kelly

Abstract

The NHS ‘Choose Wisely’ campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the ‘normal range’. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the ‘reference interval’. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual’s results—rather than defining normality itself. This article discusses the theory of normality—and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.

dx.doi.org/10.1136/postgrad...

pmj.bmj.com/content/94/1117...

[STAMBRIDGE in reply to helvella]

Thank you for your help.

[SeasideSusie Remembering in reply to STAMBRIDGE]

As you are in the UK then Vit D unit of measurement is likely to be nmol/L and the Vit D Society and Grassroots Health recommend a level of 100-125nmol/L. So although your result of 73.9nmol/L is in the "sufficient" category and your GP will be satisfied, personally I would want mine around 125-150nmol/L.

B12 we need the unit of measurement for, it will either be ng/L or pg/ml which are both the same, or pmol/L. Whichever it is it's on the low side and should be greater than 550pg/ml or 406pmol/L, 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."

Ferritin isn't bad, it should be half way through it's range so again it depends n the range.

Folate should be at least half way through range and whatever the range yours is going to be low, but give us the range and unit of measurement so that we can give you a more useful answer.

And as Greygoose says, we need the reference ranges for your thyroid results to be able to interpret those and say whether a reduction in Levo is called for or not, but at the end of the day it's how you feel that's important. I think you are being asked to reduce your dose because your TSH is suppressed, but if your FT4 and FT3 are within range then you're not overmedicated and you don't need to reduce your dose.

[STAMBRIDGE in reply to SeasideSusie]

Thank you for your help.

[pennyannie]

Hello Stambridge :

Your results are not showing any form of over medication :

I believe there is an age related guideline and at 65 my dose of T4 was reduced down by 25mcg daily despite me asking why, as I was definitely not over medicated, and that was the beginning of my becoming very unwell :

Up until 65 I was " allowed " to run with a low suppressed TSH and it was " all change " when I hit 65 ????

I'm with Graves post RAI thyroid ablation 2005 :

[STAMBRIDGE in reply to pennyannie]

Thank you for your help.

[pennyannie in reply to STAMBRIDGE]

It's just a thought ?

[Localhero]

If you feel fine on 75mcg I cannot see the logic in reducing your dosage to 50mcg. You have not given the ranges of these blood tests, however my bet is that your doctor has advised this based on your TSH, which looks low. HOWEVER, your FT4 and FT3 look reasonable. And if you feel okay with these, I personally would not change.

[SlowDragon Administrator]

TSH 0.05,

T4 16.9,

T3 4.6,

VITAMIN D 73.9,

VITAMIN B12 327,

FERRATIN 74.5,

FOLATE 4.6

Was test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

Please add ranges on these results

Ft3 looks low

How much do you weigh in kilo approx

Guidelines on dose levothyroxine by weight is approx 1.6mcg levothyroxine per kilo per day

[STAMBRIDGE in reply to SlowDragon]

Thank you. My blood test was done just after 8am. No food and only water. I weigh 8 stone 5 pounds and I am 5ft 2 in in height. I have never taken any vitamins. The only other medication I am on is Simvastatin 40mcg daily.

[SlowDragon Administrator in reply to STAMBRIDGE]

8 stone 5 pounds = 53 kilo

thecalculatorsite.com/conve...

53 kilo x 1.6mcg levothyroxine = 85mcg as likely daily dose levothyroxine required

High cholesterol levels suggests under medicated thyroid

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

Ft3 looks low

Need ranges on results (figures in brackets after each result)

Was test done by GP….or privately

If privately ……which company

B12 and folate low

Likely to benefit from taking daily vitamin B complex

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance and will help improve B12 levels too

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

Low B12 symptoms

b12deficiency.info/signs-an...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.

B12 sublingual lozenges

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

healthunlocked.com/thyroidu...

[STAMBRIDGE in reply to SlowDragon]

The blood test was carried out through the GP on the NHS.

Thank you for this. I will send an email to the GP.

[SlowDragon Administrator in reply to STAMBRIDGE]

I suggest you get hold of ranges on FT3 and Ft4

Meanwhile start improving low vitamin levels by supplementing

Refuse to reduce Levothyroxine assuming Ft4 and FT3 are not above range

Retest in 3 months

[SlowDragon Administrator]

Vitamin D at 74.5 nmol

Do you supplement vitamin D?

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, won levothyroxine we frequently need higher dose than average

Government recommends everyone supplement October to April

gov.uk/government/news/phe-...