Latest blood test results, where do I start?!

[CTun]

Afternoon everyone,

I posted recently and went away to get some more blood tests, I've now got the bulk of the recent results.

I'm on the waitlist for a total thyroidectomy but until then I'm just trying to improve my symptoms (mainly lack of patience, irritability, low libido, fatigue, anxiety etc) and it's hard to know where to start! I've been on 10mg of CBZ for quite a while now, my specialist just keeps saying I'm 'in range' and isn't helping beyond that really.

If anyone has any pointers it would be really appreciated!

Since my original post I've started using the recommended VitD mouth spray, so hopefully this will increase.

Recent blood test 28th Jan – done at 9am fasted

(some say to see specialist):

Ferritin: 155 ug/L - 33.00-490.00 ug/L

TSH: 2.9 mIU/L - 0.27-4.20 mIU/L

FT4: 17.1 pmol/L - 12.00-22.00 pmol/L

FT3: 5 pmol/L - 3.10-6.80 pmol/L

Thyroid Peroxidase Antibodies: 57 IU/mL - <34.00 IU/mL *see specialist

Cortisol: 341 nmol/L *see specialist

Vit B12: 641 ng/L - 180.00-900.00 ng/L

Vit D: 69 nmol/L

Folate: 15.5 ug/L - 2.50-19.50 ug/L

C Reactive Protein: <1 mg/L - <6.00 mg/L

Magnesium: 0.83 mmol/L - 0.70-1.00 mmol/L

Serum Sodium: 143 mmol/L - 133.00-146.00 mmol/L

Serum Potassium: 4.8 mmol/L - 3.50-5.30 mmol/L

Serum Creatinine: 112 umol/L - 59.00-104.00 umol/L *see specialist

Blood test from 20th Dec 21

TSH 3.55 (0.27-4.2) ft4 17.7 (12-22) (10mg CBZ)

TRabs: 2.1 IU/L 0 – 0.9

I've attached an image with all of my other previous results.

My coeliac test came back negative.

Thanks in advance!

[SlowDragon Administrator]

Have you had testosterone levels tested ….might be low

Are all tests done early morning

TSH likely too high and Ft3 too low

Can you tweak Carbimazole dose downward

Suggest trying strictly gluten free diet

Have you had cholesterol levels tested

High cholesterol suggests hypothyroid

[CTun in reply to SlowDragon]

No I’ve not had testosterone checked for a while, but I’ll get on it!

Nor cholesterol, happy to do it though.

All of the tests I posted for 28th Jan were done at same time, 9am.

I’m happy to go gluten-free if you think that’s worth a try.

With my dose, do you think drop to 5mg until my next blood tests?

Thank you

[SlowDragon Administrator in reply to CTun]

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal

Always worth trialing strictly gluten free diet for 3-6 months.

Likely to see benefits. Can take many months for brain fog to lift.

If no obvious improvement, reintroduce gluten see if symptoms get worse.

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

[SlowDragon Administrator in reply to CTun]

Don’t know anything about reducing Carbimazole (I have Hashimoto’s)

PurpleNails might pop along ….or others on Carbimazole

[CTun in reply to SlowDragon]

Thank you 🙏🏼

Do you know much about whether my cortisol looks normal? It’s been flagged as a problem but can’t get an answer from my specialist yet…

[SlowDragon Administrator in reply to CTun]

No range on cortisol

Cortisol has distinct diurnal variation…..highest in morning…what time was test

Recommend this test

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[CTun in reply to SlowDragon]

I got the full print out of results, most had ranges but cortisol didn't for some reason.

It was done at 9am.

Thanks for the recommendation. I'll get this checked along with testosterone and cholesterol

[PurpleNails Administrator]

FT3 5 pmol/l (Range 3.1 - 6.8) 51.35%

FT4 17.1 pmol/l (Range 12 - 22) 51.00%

No wonder your endo is happy both FT4 & FT3 are well balanced and practically mid range. Endos usually prefer it on the lower side so there plenty margin to catch it early if levels do begin to rise, but you have symptoms so they are likely too low for you.

You have been on 10mg carbimazole for a while and your TSH was rising until recently & it is good you have a TSH which respond. Often they don’t and thyroid levels can get very low and the TSH stays undetectable.

Most say they feel well if FT4 is in top third of range & FT3 at least half way. So there’s a little room to tweak down the dose but I wouldn’t do it by much.

You might have to get a pill cutter and take 7.5mg ( 3 quarters) every other day. Even a tiny fraction can make all the difference as the effect is cumulative. I always found more the 2.5 a day too big an adjustment.

[CTun in reply to PurpleNails]

Thank you 🙏🏼

So you think from 10mg daily to 7.5mg EOD?

Only double checking as 7.5mg daily is a small drop and every other day is a bit of a bigger drop!

And do you know / think cortisol looks about right? It was flagged as a problem…

[PurpleNails Administrator in reply to CTun]

Drop by 2.5mg on EOD but keep taking 10mg on other days so like this:

Mon 10mg

Tues 7.5mg

Wed 10mg

Thurs 7.5mg

Fri 10mg

Sat 7.5mg

Sun 10mg

So the weekly reduction is 7.5mg over the week.

The following week you can either do same or start the week on 7.5 in which case the reduction over the week would be 10mg.

What is the range given for cortisol? There will be a variable range dependant on the time the blood test was taken.

Cortisol should be higher in morning and declines throughout day.

[CTun in reply to PurpleNails]

Understood, thanks!

I got the full print out of results, most had ranges but cortisol didn't for some reason.

This test was done at 9am. I'll ask my doctor and get a more comprehensive test for this as recommended by SlowDragon.

[Gingernut44 in reply to CTun]

I think PN means 10mg one day, 7.5mg the next 😊