Hi Penny and Greygoose,
I put a query in the forum, I believe 5 week ago about my male friend with strange blood results. Both of you had asked me the to post his latest results. It came through today from the physician:
HbA1c 6.3. Range < 5.6
Free T4 16.7 9.1 - 24.4
Free T3 5.08 3.13 - 6.76
TSH 5.03 0.30 - 4.64
Ferritin 411 16.4 - 293.9
He is still waiting for the results of TPOab and TgAB blood test
As per previous post
healthunlocked.com/thyroidu....
His next step is to test thyroid antibodies, vitamin D, folate, ferritin and B12
Yes he has as per their request the results will be posted on 17th when it arrives.
Thank you. I have passed it on. I have realised that you also advised on that post. Thank you all for your help.
Please advise
I put a query in the forum and Penny and Greygoose replied, I believe 5 week ago about my male friend with strange blood results. Both of you had asked me the to post his latest results. It came through today from the physician:
Sorry noticed error in my earlier post. I have corrected it here
HbA1c 6.3. Range < 5.6
Free T4 16.7 Range - 9.1 - 24.4
Free T3 5.08 Range - 3.13 - 6.76
TSH 5.03 Range - 0.30 - 4.64
Ferritin 411 Range - 16.4 - 293.9
He is still waiting for the results of TPOab and TgAB blood test
So, his TSH has dropped slightly - but still saying hypo. And his FT4 has risen slightly. It's now 49.67% through the range. Which is more or less euthyroid BUT, it's taking a lot more TSH than is normal to get to that level.
FT3 has risen quite a bit, now 5.08% through the range. A failing thyroid will often step up its production of T3 to keep the person alive.
So, still looks like primary hypo, but antibodies could tell us more. But it just looks like his remaining half thyroid is struggling to make up the difference for the missing half, and he should be on thyroid hormone replacement, because this is more likely to get worse rather than better with time.
But, what about symptoms? I know he has hypertension, which could well be due to being hypo, how does he feel apart from that? Was there any particular problem that prompted him to get tested?
His reply to my query on his symptoms :
•I get stressed and muddled easily. Very short fuse. Simple tasks like looking for an email stresses me.
•I find it stressful to do a few simple things at a time.
•Slow in mental thinking. Feeling mentally exhausted.
•I am unable to complete my set tasks. I tend to procrastinate. Lacking concentration, enthusiasm and energy on things that I used to love to do.
•I am working slower to complete my set tasks. At the worst, my work efficiency is down nearly 80%.
•Poor in digestion. Increased in belly-fat. Feeling hungry easily.
•Having bad sleep problems. Feeling tired all the time. When I sit down on my sofa, I doze off. But when I make it an effort to lie down in bed to sleep, I find it difficult to sleep. When I do fall asleep, it takes me hours to do so.
• My sleep has improved slightly after my doctor had prescribed Hypertension tablets to bring down my BP to about 130/80 (heart rate about 60 pulse per min at rest), and when I started to take B12 and B complex,. I still suffer from disturbed sleep at night. I tend to wake up in the night to pee.
•I usually feel cold in my hands and feet while I am sleeping in the middle of the night. So, I would wear warm clothes to cover both my hands while I sleep at night even when temp is 25°C.
•I am not able to cope with the cold of the air-conditioned offices. My fingers go numb in reddish/purplish.
•I find it difficult to hold my pee in. Tend to want to pee more often than usual.
•I tend to be anxious and worry, and I am often depressed.
The supplement I am taking are :
B12, B Complex, D3, 5-HTP ( 100 mg) Silymarin complex
Medication:
Amlodipine ( 10 mg )
Telmisartan ( 80 mg )
Well, that does seem like a lot of symptoms. But, the trouble with hypo symptoms is that they are non-specific. All of them could be caused by other things. And, doctors - who know very little about thyroid - would far rather put them down to 'something else' rather than admit to them being possibly hypo symptoms.
To those doctors I would say: which is the more likely scenario? That the patient has 36 separate diseases, all with one symptom? Or that the patient has one disease with 36 symptoms?
I think he should be allowed at least a trial of levo to see if it helps. And, by a trial I don't mean 3 months on 25 mcg levo! Which most doctors seem to think is a fair trial. It isn't. I would say a couple of years, increasing levo every six weeks until the patient feels well - which I think he will.
You don't say how old he is. If he's over 60, doctors are going to want to start him on 25 mcg - which is rediculous, but there you are. If he can get started on 50 mcg, I don't doubt that would be better.
As to his supplements, did he get tested for vit D, vit B12, folate and ferritin before starting them? If so, what were the results.
You say he's taking B12, B Complex - which is good. But, how much B12?
And, vit D. But, is he also taking the cofactors: vit K2-MK7 and magnesium? How much vit D does he take?
Why is he taking 5-HTP ( 100 mg) Silymarin complex?
Thank you all for your help. Here are his answers :
No, he didn’t get tested for Vit D, B12, folate and ferritin before starting on them. Hence no results to show for that.
B12, B Complex - which is good. But, how much B12?
500 mcg B12 per day with food.
How much vit D does he take?
Vit D3, 250 mcg (10,000 IU), 3 to 4 tablets per day with food.
4) Is he also taking the cofactors: vit K2-MK7 and magnesium?
He is not taking these vitamins. How much of these should he take?
Before changing anything, he should get vit D, vit B12, folate and ferritin tested.
It's a very, very bad idea to start taking these supplements without knowing levels first. For example, if he is B12 deficient, 500 mcg B12 isn't going to do him much good. But he won't know that unless his levels are checked first.
So, have I understood correctly about the vit D: 30,000 to 40,000 IU a day? That's rather a lot, I think - but again, depends on his levels. You can over-dose on vit D because it is fat soluble. As he's taking vit D, he should also get his calcium checked.
So, at 62, doctors are going to want to start him on a miserable 25 mcg levo - if they agree to start him at all. But, he should make sure he doesn't stay on that low dose for more than six weeks - four weeks, if possible. Low doses like that can make people feel worse, rather than better.
He is taking 5 HTP to help him sleep and the silymarin complex to support the liver. He will reduce the Vit D 3 as per your advice.
But no. I didn't advise reducing the vit D! I said to get tested to find out how much he needs to take. If it's very low, he might actually need more. As I said above, he shouldn't change anything until he gets his levels checked.
Apologies, I will pass on your advise. I have advised him to become a member. It would mean he can write directly to all of you. He feels overwhelmed easily and hopes to do so at the later date (God willing).
Yes, that would be easier all round. 
Dear all,
I hope you will give us some insight on how to discuss treatment with Endo.
Here are the latest blood test results for my male friend.
Serum iron 16.78. 10 - 30
Transferrin 2.74. 1.8 - 2.7
UIBC. 45.67. 28 - 64
TIBC. 62.45 umolL
%Transferrin Saturation 26.9. 16 - 60
Vitamin B12 560 pmol/L 187 -1059Folate 13.3 nmol/L 5.3 – 20.7
Ferritin 411.1 ng/mL 16.4 – 293.9
Total Vit D /25-hydroxyvitamin D 175 nmol/L 50 - 125
Thyroid Function Studies
Thyroxine 88 nmol/L 64 – 167
Free T4 16.7 pmol/L 9.1 - 24.4
T3 1.65 nmol/L 1.49 – 2.60
Free T3 5.08 pmol/L 3.13 – 6.76
TSH 5.03 mIU/L. 0.30 – 4.64
Anti-Thyroid peroxidase 1.6 IU/mL < 34
(Anti-TPO/AMC)
Anti-Thyroglobulin (Anti-TG) 1.1 IU/mL < 115
I'm sorry, but I'm afraid 'Dear all' aren't going to see this question, because you just answered to me, on a 5 day-old thread. I would advise you copy and paste this into a new question.
I'm really not the right person to ask about talking to doctors. I'm more of a bull-in-a-china shop type person, which doesn't go down well with most doctors. But if more people see this question, the more tactful types will be able to answer it.
Thank you, could you advise what the new blood results show?
They don't show anything much at all. The TSH is still too high, so the thyroid is struggling to make 'normal' amounts of thyroid hormone. But, I doubt it would be high enough to interest most doctors, who don't understand much about thyroid.
Vit D is high - is he supplementing?
Ferritin is high. But, I can't see any inflammation markers. Did he have CRP tested on this batch of tests?
B12 and folate are good.
Antibodies are negative.
Hi, He did have a CRP test the results were - Anti-Thyroid peroxidase 1.6 IU/mL < 34
(Anti-TPO/AMC)
Anti-Thyroglobulin (Anti-TG) 1.1 IU/mL < 115
No, those are antibody tests, not inflammation markers.
CRP = C Reactive Protein.
C Reactive Protein - 7.01mg/L. 5.0
C Reactive Protein - 7.01mg/L. Less than - 5.0
OK so that's very high. So, could account for his high ferritin. But what about the vit D? Is he supplementing vit D?
Yes he is supplementing D3 10,000/- a day. I have passed your advice to him.
OK, so he should ease off the vit D a bit, now, because it's over-range.
How much Levothyroxine should be on ? He is seeing Endo 21st
At his age, they'd start him on 25 mcg, whether it was the right dose or not. He wouldn't have much choice - if they even decide to treat him, that is.
Tq. We will wait until Endo’s appointment. Do I have to post the update of the appointment?
I forgot to include his age - 62 years
pennyannie greygoose
I have alerted them …..
Hey there again :
SlowDragon has your back as well - in fact everybody on this forum offers well meaning support :
I think it's best not to write to individual people on here - we all give what we can and we are not all here all of the time - what you choose to read or ignore is up to you :
Can't add much to what has already been written, antibodies plus the vitamins and minerals is needed to be run so we can see exactly what is going on.
Didn't the specialist ask for a full blood tests to include antibodies and the vitamins and minerals, prior to consultation, and has he seen this person yet ?
I apologise profusely for this. I had assumed wrongly that the ‘case’ is usually followed up by the advisers who first answered the post. Once again terribly sorry for the error.
No worries - maybe I shouldn't have said that - apologies back to you :
It doesn't matter I don't think there is a hierarchy as such :
Everybody counts and everybody has something to offer :
There is always an Admin presence and other forum members " chip in " when and if they feel they can offer something more, likely from their own experience.
He will be seeing the Endo on 21st. Jan. As per all your advise he asked for all tests from the physician. He is still waiting for the results of the ViT D, Folate, B12, TPOab and the TgAB blood test. Are there any other that needs to be done? His ferritin is very high. Thank you all so much for your help.
The high ferritin could be being driven by high inflammation, that should be given when having a full thyroid blood panel - but then I pay privately for my blood tests.
As these are ad hoc through the NHS he needs inflammation as well, if it hasn't been run as well as folate, B12 and vitamin D plus thyroid antibodies as listed.
P.S, Just looked at the above blood test and the HBa1c is above range - I think this is to do with blood glucose levels and a check for diabetes - I 'm not able to help there.
Hi Penny, sorry to be so uninformed but what does “that should be given when having a full thyroid blood panel “ mean. And what inflammation test does he need done ? He is paying for all his tests.
I've just looked back at the previous post and his inflammation marker - CRP - was over range then, which maybe the reason for the high ferritin level above.
Well I get private bloods from Medichecks - it's called an Advanced Thyroid Function Test - other companies refer to it being a " thyroid bundle " or similar and this contains all the 10 different blood analysis we ask for from one blood sample , generally needing to a venous blood draw.
So we see all the results together and can more easily join up the dots.
Would you be kind enough to list these tests individually as he can ask his private physician.
The full thyroid blood panel is usually a venous blood draw for 10 separate blood analysis and breaks down as :-
A TSH,
Free T3,
Free T4,
inflammation,
thyroid antibodies,
ferritin,
folate,
B12 and
vitamin D;
I believe He had all but the one for inflammation done. He will get the iron panel that was requested.
There's an inflammation reading on the previous post:
It's written as a CRP reading and over range. which might explain the high ferritin :
Ferritin How high is very high
Ideally would run a full iron panel test to see if iron is also high in case of hemochromatosis
Or if only ferritin is high, that’s likely caused by inflammation
Males have higher ferritin generally than females
His Ferritin 411 Range - 16.4 - 293.9
Not very high
Medics only look hard at iron/ferritin if ferritin is up around 800 or higher
But a full iron panel might be useful….can have lowish iron despite high ferritin
I hope these are the tests results that you are looking.
His haematology profile :Haemoglobin 14.1 range 13.0 - 18.0
Red cell count 5.0. “ 4.5 - 6.5
Haematocrit ( PVC). 43% range 38 - 52
MCV. 87 fl. range 80 - 100
MCH 29 pg. range 27 - 32
MCHC. 33 g/ dL. “ 31 - 37
RDW 13.3 %. “. < 15.6
Platelet count 272. “. 150 - 400
MPV. 9.1 fL. “. 7.0 - 12.0
White blood cell count 5.8 “. 10/. uL
Diabetes mellitus screen
glucose 8 mm/hr. “. 6.9. “. 3.9 - 6.1
I think we have crossed wires :
I thought you wanted a full list of the blood tests we ask for as a full thyroid panel :
I am not qualified to make any comment on the above blood test results you have just posted.
Yes I did. I believe someone asked for full blood profile.
OK - but you have replied to me, so I get pinged by HU to respond :
and whoever asked for these results will not be notified that you have responded to their request so likely will not look back for the answer :
It's likely SlowDragon - let's try and clear this up as it does get confusing when new, especially doing it for someone else :
Your friend is diabetic but he knows that, right? (The frequent urination and high blood pressure) . That is his most serious issue right now. His HbA1c can be brought down with a low carb diet and exercise. He made need to be on statins as well, as diabetes leads to hypertension and high blood cholesterol. If diet and exercise fails to be bring his HbA1c down, he will need to put in Metformin. Untreated diabetes leads to complications including glaucoma, circulation and nerve issues , heart problems, stroke etc.
Mino40 thank you. No he does not know that he is diabetic. I will pass your advice on to him.
Confusing results and symptoms 
Confusing test results
Results are in.. and I'm even more confused.
Test results confusing
Confusing Iron Results
