Blood test results , finally

[Spoticus]

Managed to get results from December, I noticed Vitamin D has not been done although the Gp said it would be & the only results for Thyroid I have put First although I had taken my 50 mg levothyroxine that morning .I had not been on this site before & did not know what was recommended . I am taking one tablet of 210 mg daily iron tablet prescribed by Gp since she got my results. I was about to book blood tests from Medicheck , can you advise me on which tests are best going on these results & what to ask my Gp for . It’s a long list so may have to add an extra post

Serum TSH 2.0mu/l 0.27-4-20

Serum Ferritin 9ug/L 13 - 150

Vitamin B12 212pmol/L 145-569

Serum Folate 15.7 nmol/L 8.8-60.8

Haemoglobin 108 g/L. 120-150

Total white cell count 8.10 10*9/L 4.00-10.00

Platelet count 437 10*9/L 150-410

Haeomatocrit 0.344 0.360-0.460

Red blood cell count 3.94 10* 12/L. 3.80-4.80

Mean Corpuscular Volume 87.3 Fl 83.0- 101.0

Mean Corpuscular Haemoglobin 27-4 pg 27.0-32.0

= = Hb. Conc 314 g/L 315-345

Neutrophil Count 6.20 10* 9/L 2.00-7.00

Lymphocyte Count 0.98 10* 9/L 1.00-3.00

Monocyte Count 0.60 10* 9/L 0.20-1.00

Eosinophils Count 0.26 10* 9/L 0.02 0.50

Basophils Count 0.06 10* 9/L 0.00 - 0.10

Sorry it’s so long , would like any advice as to what I need testing

Angela

[SlowDragon Ambassador]

Looking at previous posts you have been left on just 50mcg levothyroxine for 14 years!

(50mcg is only the standard STARTER dose of levothyroxine)

Just testing TSH is completely inadequate

Being under medicated for thyroid frequently causes low stomach acid and leads to poor nutrient absorption and low vitamin levels as direct result

Ferritin is extremely deficient

How long have you been taking iron supplements

SeasideSusie or humanbean may pop along and comment

Ferritin under 30 is deficient

Ferritin under 10 should/could warrant iron transfusion

B12 and folate are too low

Again likely due to being under medicated thyroid wise

Request full testing for Pernicious Anaemia before starting any B12 or vitamin B complex

Also request coeliac blood test as possible reason for vitamin deficiencies

GP should test vitamin D as well

[Spoticus in reply to SlowDragon]

Thanks for checking them out for me , these tests were done on 8/12/21 & think I started iron tablet a week after these results. I asked why my results would be so low as it’s occurring quite regularly & she asked me if I was bleeding anywhere. Not that I had noticed? Had a stool test which was ok & when I mentioned that previous Gp said don’t take aspirin for a while she wasn’t concerned about that either. I found this forum quite by accident & must admit I didn’t realise how important thyroid function was as the Gp had been saying for a few years before I was eventually diagnosed that I was always just on the cusp . Blood tests done after starting levothyroxine apparently were fine ,then I started Menopause & any problems I had were put down to that .

[SlowDragon Ambassador in reply to Spoticus]

Levothyroxine doesn’t “top up “ failing thyroid…..it replaces it

Essential to be on high enough dose levothyroxine

guidelines on dose levothyroxine by weight

Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

gp-update.co.uk/Latest-Upda...

Traditionally we have tended to start patients on a low dose of levothyroxine and titrate it up over a period of months. RCT evidence suggests that for the majority of patients this is not necessary and may waste resources.

For patients aged >60y or with ischaemic heart disease, start levothyroxine at 25–50μg daily and titrate up every 3 to 6 weeks as tolerated.

For ALL other patients start at full replacement dose. For most this will equate to 1.6 μg/kg/day (approximately 100μg for a 60kg woman and 125μg for a 75kg man).

If you are starting treatment for subclinical hypothyroidism, this article advises starting at a dose close to the full treatment dose on the basis that it is difficult to assess symptom response unless a therapeutic dose has been trialled.

BMJ also clear on dose required

bmj.com/content/368/bmj.m41

See also at approx 16 mins into this YouTube clear info of dose levothyroxine

youtu.be/8Xy5i2pMtNA(Not working as expected?)

[SlowDragon Ambassador]

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

List of private testing options

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

[abirose311]

I completely agree with SlowDragon! Just testing TSH does not give any clear picture of your measure of thyroid hormones, it only shows the level of Thyroid Stimulating Hormone being produced by your pituitary gland.

Some of us who have been on long term thyroid replacement, stop producing TSH altogether! My TSH has been 0.01 when my T4 was at bottom of the scale and T3 below scale. So I think your TSH is high, despite being in range.

Given that vitamin D is extremely important in these virus ridden times, (one endocrinologist working on the Covid frontline, reported that all the patients admitted in his hospital with Covid complications, were found have low levels of Vitamin D), I think it's very poor that your doctor (or lab) didn't test it. I would ask again..

[Spoticus in reply to abirose311]

Thanks for this information abirose, I have been in touch with my Surgery & was told it was the dispensing pharmacist who prescribed my iron tablets not the Doctor who obviously didn’t think it important!! Still got bypassed when I called this week to the Nurse Practitioner who has referred me to haematology . Thought I would take what I could get in the hope I get the right blood tests, just hoping it doesn’t take too long . I did stress my Symptoms seemed to indicate that my medication wasn’t right for my hypothyroid & that I should have realised that sooner but had put most of it down to menopause. She didn’t even talk about it and worryingly one of my Daughters has tested positive for Covid & my other daughters partner has as well today, I had my Granddaughter after School yesterday . Think I ought to just take higher dose of Vitamin D just in case..

[abirose311 in reply to Spoticus]

And Zinc! I've read that it Zinc plays a role in preventing viral replication, which is why it's in a lot of over the counter cold remedies.

My son had covid. He wasn't really ill. Caught from a workmate, he failed employers flow test, (and another here while he double checked. He was asymptomatic for two days, then two days of intense nasal congestion and loss of taste, then he had a cough which lingered for over a fortnight. I pumped him full of D3/K2 sublingually, (K2 helps D3), Vitamin C split doses, and Zinc.

[abirose311 in reply to abirose311]

I forgot one medication which might be important, I gave my son CBD oil to take, for its anti-inflammatory properties. I could equally have given him turmeric , another great anti-inflammatory

[Spoticus in reply to abirose311]

I have most of them except Zinc & cbd oil, turmeric it is then . Thanks