Could you please help me with my blood results which I just received today before I see my consultant mid Jan?
250 H (total) Vit D 47.2 nmol/l
Vit B12 376 Ng/L norm 211-911
IRON OVERLOAD STUDIES
Ferritin 38.1 ug/L norm 10-291
CPR <4
Serum Iron 19.2 umol/L norm 10-30.4
Transferrin 2.52 go/L norm 2.5-3.8
Saturation 33% norm 16-50
Cortisol 646 nmol/L
TSH 2.94 mU/L
T4 14.5 pmol/L
I think the TSH at the moment is the highest I've had
I'm on Levothyroxine taking 50mcg one day and 75mcg on another day. I've been on those doses since beginning of August and previously on 50 since April (I think).
My hypothyroidism is a result of Subacute Thyroiditis which has started Nov 2020 (well, surfaces then but started possibly months before). I have seen be Endo a month ago and she thinks that my thyroid want functioning for at least 10 yes judging by symptoms I was suffering from for those years but which have give since I'm on thyroxin.
But for the last 2 months I've been feeling worse with fatigue, irritated, emotional, constipated, swelling in feet and face.
I would appreciate your help.
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bajmon
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Your TSH suggests undermedication but TSH can be affected by the time test was done, eating before the test, drinking coffee or other caffeine containing drinks. We always advise testing no later than 9am with nothing to eat or drink except water before the test.
What time was cortisol test done, it seems quite high, what is the range?
Vit D is low, it is recommended to be 100-150nmol by the Vit D Society and Grassroots Health. So you supplement?
B12 is low, it's recommended to be at least 550ng/L, 900-1,000ng/L even better.
Ferritin is low and is recommended to be half way through range.
Serum iron is a bit low at 45% through range, optimal is said to be 55-70% (higher end for males).
Transferrin is low which indicates lack of capacity for additional iron.
Saturation is just about OK at 33%, optimal is 35-45% with the higher end for males.
Hello, thank you for having a look at those. The test was fine on Friday at 7:40 am before I think my Levo so the last Sunday was taken 24h before. I didn't eat anything and only had glad of water to help the blood flow.
The TSH norm is 0.35-5.5
The Cortisol results doing tell me the range but please see below as this was included in Cortisol results.
NarrativeA 09:00 am cortisol of >374nmol/L excludes adrenal insufficiency providing the patient has not had recent exposure to exogenous oral steroid or oral oestrogen (OCP, HRT).
Please note - if patients are taking exogenous steroids such as prednisolone and hydrocortisone at time of sampling, these will be detected by the cortisol assay.
The test was fine on Friday at 7:40 am before I think my Levo so the last Sunday was taken 24h before.
So does that mean you "think" your last dose was 24 hours before or does it mean you don't remember how long between last dose and test?
The TSH norm is 0.35-5.5
Have you got your FT4 range, which is what I asked for. We already know that TSH at 2.94 is quite high for someone on Levo, so we need to see how far through it's range the FT4 is - and of course it's accuracy depends on knowing exactly when you took your last dose of Levo.
NarrativeA 09:00 am cortisol of >374nmol/L excludes adrenal insufficiency providing the patient has not had recent exposure to exogenous oral steroid or oral oestrogen (OCP, HRT).
Please note - if patients are taking exogenous steroids such as prednisolone and hydrocortisone at time of sampling, these will be detected by the cortisol assay.
Does any of that actually apply to you?
646 nmol/L
Standard Range
- nmol/L
You haven't given a range. Your cortisol level looks high. There are usually different ranges for different times of day, eg 6-10am will have a higher range than a sample later in the day, but even allowing for that if we look at Blue Horizon's range for 6am-10am it's 166-507nmol/L then your cortisol is of some concern, so we need the range to see how your level looks with your range.
Are you taking any supplements - this is important because if you are then your nutrient levels are too low, if you're not then we can suggest what you need.
Apologies, that's all typo. My phone changes words even when I type the correct ones, so this made no sense.
The test was done on Friday (31/12) at 7:40 am before I took my Levo so the last dose was taken 24h before. I only had glass of water in the morning before the test.
I didn't give the range for Cortisol because I wasn't given it in results. The text is entirely copied from my results and ends in nil figures for range as you see above
The T4 range is 10.5-21 with my levels at 14.5
I mentioned earlier in reply to your other question that I'm not on any supplements but only occasionally take some. Please see in other answers.
So your FT4 is only 38% through it's range, so along with your TSH level they show that you are undermedicated and need an increase in your dose of Levo, 25mcg now and retest in 6-8 weeks.
You haven't replied to my post with any information about supplements.
Thank you, I am not on any supplements. Occasionally I'll take VitD which I have 4000IU from Solgar, also sometimes I'll take Complete Vit B and magnesium 250mg both from Holland& Barrett but that is very rarely. My last Wendy told me to take D after summer was over but only small dose so I wasn't really ever advised any supplements. This new Endo is meant to be great but she didn't test T3, antibodies out Folate. She checked iron for her kids that I'm stuffering from again.
I am not on any supplements. Occasionally I'll take VitD which I have 4000IU from Solgar, also sometimes I'll take Complete Vit B and magnesium 250mg both from Holland& Barrett but that is very rarely.
Vit D 47.2 nmol/l
Vit B12 376 Ng/L norm 211-911
OK, so with those results for
Vit D - to reach the level recommended by the Vit D Society and Grassroots Health (100-150nmol/L) you would need to supplement with 4,000-5,000iu D3 daily (regularly) and then retest in March.
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:
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. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
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.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The company has told me the K2-MK7 is the Trans form
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.
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."
I would avoid H&B own brand supplements, they are cheap for a reason and the Complete B. They contain the wrong and cheapest form of ingredients, eg cyanocobalamin instead of methylcobalamin, folic acid instead of methylfolalte, B6 as Pyridoxine Hydrochloride instead of Pyridoxal-5'-Phosphate.
My preference for 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).
I would retest vitamins in 3-4 months. If B12 is still as low as it is now it might be then worth adding some extra B12 for a short while as well as the B Complex, but see if a decent B Complex will improve your B12 first.
She checked iron for her kids that I'm stuffering from again.
Sorry, I don't know what that should be.
Ferritin - as you don't have iron deficiency then you shouldn't take iron tablets as these can raise your serum iron and saturation too high. 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
According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.
Hi Bajmon, Having trouble with your phone - should be able to fix that - so annoying. It's doing 'autocorrect', so you need to turn that off. It may be a bit different depending upon what type of phone you have.
Google for 'how do i stop my phone from changing my words' or 'how to turn off autocorrect on iphone' or whatever your phone is. I put that in and it came up with how to do it. Hope that helps.
Cortisol is high because you are under medicated for thyroid. Adrenals try to compensate for lack of thyroid hormones. Should see levels drop over coming months as dose levothyroxine is increased slowly upwards
Vitamin D
250 H (total) Vit D 47.2 nmol/l
Vitamin D
GP/endo should prescribe 1600iu daily for 6 months
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Look at increasing iron rich foods in diet
Eating iron rich foods like liver or liver pate once a week plus other red meat, 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.
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
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.
Recommended on here that all thyroid blood tests should ideally be done as early as possible in morning and before eating or drinking anything other than water and last dose levothyroxine 24 hours before test
This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)
Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins
Thank you, I am not on any supplements. Occasionally I'll take VitD which I have 4000IU from Solgar, also sometimes I'll take Complete Vit B and magnesium 250mg both from Holland& Barrett but that is very rarely. My last Wendy told me to take D after sunset was over but only small dose so I want really ever advised any supplements. This new Endo is meant to be great but she didn't test T3, antibodies out Folate. She checked iron for her kids that I'm stuffering from again. So tests were taken at 7:40 am before any food or Levo. My antibodies were always give before. The Levo I'm taking is 59mcg from NorthStar and additional 25mcg every other day which is from Teva. I read on this forum before that two brands should not be mixed but I was told that NorthStar didn't make 25 or 75.
Significant minority of people only have high TG antibodies. NHS refuses to test TG antibodies if TPO are negative. So would need to test privately
Guidelines on dose levothyroxine by weight is to increase dose slowly upwards in 25mcg steps until on approx 1.6mcg levothyroxine per kilo of your weight. So unless extremely petite likely to need further 25mcg increases in dose levothyroxine over coming months
How much do you weigh in kilo
vitamin D has dropped since these test results ……in part because you are still under medicated thyroid wise….so you need to increase dose vitamin D
Thank you. Since the illness started I put on works a lot in the last year and in the last 10 years when not diagnosed I was slowly losing energy and putting on weight very slowly. I note weight 62kg with 158cm hight and last year this time I way about 55kg where my normal weight would potentially be 49kg because I'm quite petite built as the day, think bone built. So I'm not happy how I look and i miei putting on weight which is unusual judging by my family.O might reporter those bloods privately at one of those suggested brands and do a full check.
50/75 is a pretty low dose so why not try 75 every day for 6 weeks at least the get another blood test. I tend to go by symptoms more than results and you’ve got classic hypo symptoms. Best wishes.
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