Can you help with new thyroid blood test results, please

[Me1157]

Taken fasting over 24 hours since last dose of meds. On 2.5 grains of NDT and starting to feel human again. Does anyone have any advice on how to reduce the iron in my body. I don't take any iron and haven't for about six months now. My inflamation is also high...perhaps now I'm feeling better my ability to back into my exercise will work too. thanking you in advance for your help.

Inflammation

CRP HS 4.87 mg/L (Range: 0 - 5)

Iron Status

Ferritin X 187.00 ug/L (Range: 13 - 150)

Vitamins

Folate - Serum 16.28 ug/L (Range: > 3.89)

Vitamin B12 - Active 114.000 pmol/L (Range: 37.5 - 188)

Vitamin D 75.00 nmol/L

<25 Deficient

25 - <50 Insufficient

50 - 75 Adequate

>75 - 200 Optimal

(Range: 50 - 200)

Thyroid Hormones

TSH X <0.005 mU/L (Range: 0.27 - 4.2)

Free T3 5.59 pmol/L (Range: 3.1 - 6.8)

Free Thyroxine 13.800 pmol/L (Range: 12 - 22)

Autoimmunity

Thyroglobulin Antibodies 15.600 IU/mL (Range: < 115)

Thyroid Peroxidase Antibodies <9.0 IU/mL (Range: < 34)

[SeasideSusie Remembering]

Me1157

over 24 hours since last dose of meds. On 2.5 grains of NDT

Why such a long gap? Always advised here when on NDT or T3 is to leave 8-12 hours between last dose and blood draw, splitting dose and adjusting time the day before if necessary. This is because of the short half life of T3 and when on NDT or T3 the FT3 is the most important result. Leaving any longer than these suggested times gives a false low FT3 result.

Ferritin is also raised when inflammation is present and as your CRP is close to the top of the range this could be why your ferritin is also high.

Folate and B12 are fine.

Vit D is recommended to be 100-150nmol/L according to the Vit D Society and Grassroots Health, with a recent blog post on Grassroots Health recommending at least 125nmol/L.

Your thyroid results are what one would expect to see when on NDT, i.e. low TSH and FT4 but you need to take into account that your FT3 is showing a false low result.

The most important question is how do you feel? If you feel fine then leave things as they are but next time it would be better to follow the advice about timing of last dose to get a more accurate FT3 result.

[Me1157 in reply to SeasideSusie]

Thank you Susie, I honestly thought 24 hours fasting was right on all thyroid meds. I'm feeling a lot better than I was and hopefully can shift back into a good routine again.

[SeasideSusie Remembering in reply to Me1157]

24 hours is for Levo only.

[Me1157 in reply to SeasideSusie]

I'll split my dose the day b4 next time!

[pennyannie]

Hey there ;

Well if you feel better than you did from when you posted 2 months ago I think that's all that really matters, isn't it :

Your ferritin is slightly high, which could be driven up by your high inflammation level :

If supplementing iron, maybe cut down a bit :

Don't knock yourself out with exercise, start slow with gentle stretching and walking, it's a slow build, and the more you expect of your body when you have Graves, the less you'll get.

[Me1157]

I'm feeling much better thank you

[grumpyold]

I have haemochromatosis, so I too, have to keep an eye on my ferritin levels. Mine are just a tad lower than yours at the moment but my CRP isn't raised so mine aren't due to inflammation.If you drink tea with meals, the tannin helps prevent iron absorption.

Vitamin C increases iron absorption so I steer clear of it.

You might consider blood donation. (I can't due to other health issues.)

[Me1157 in reply to grumpyold]

They won't take my blood either. I'll try going back to tea with my meals - thx for the suggestion!

[Me1157]

Hi Jonathan, I'm mostly gluten and lactose free. In the past, going to the gym 4 mornings a week sorted out most of my inflamation. Since COVID, I haven't gone as I worry about my immune system. I'll try what you suggested as it may be a good alternative for me. Thank you!

[radd]

Me1157,

Ferritin isn't always a good indicator of iron levels in the presence of possible inflammation, or having health conditions that may (indirectly) be altering iron mechanisms. Therefore, you will need an iron panel to assess true iron levels.

Great you have no thyroid antibodies. NDT needs stopping just 8-12 before testing to achieve an average level. You FT3 looks a little high if previous dose was 24 hours before and TSH is suppressed.

Glad you are feeling better.

[Me1157]

I'll get one next time I do the blood work thx for your suggestions