Thyroid test results received, further advice would be gratefully received!

[Pearlyqueen]

Following my initial post a few weeks ago and all the helpful responses I received, I’ve now got my FT3 and FT4 thyroid test results from Monitor My Health and would appreciate further advice. Bloods were taken 7.30am on an empty stomach and before taking Levo. Should I be reassured that the levels are normal and no adjustment is needed to the level of my thyroid med? I currently take 50/75 Levo on alternate days but am still symptomatic and often feel unwell.

My GP also did a full blood count due to my constant fatigue but I was told these results were normal and I’m not anaemic so no further action was needed. She did however prescribe Ferrous Gluconate to help raise my ferritin levels because of my falling hair as per my last post.

I would also welcome advice on supplements but I will post separately on that. I am so grateful to all who have given time to help me so far.

[SlowDragon Administrator]

Was this test done as early as possible in morning and last dose levothyroxine 24 hours before test

FT4: 17.6 pmol/l (Range 12 - 22) 56.00%

FT3: 4.1 pmol/l (Range 3.1 - 6.8) 27.03%

thyroid.dopiaza.org

Helpful calculator for working out percentage through range

Request dose levothyroxine is increased to 75mcg daily

Retest in 6-8 weeks

Which brand of levothyroxine are you currently taking

Do you always get same brand

Meanwhile working on improving vitamin levels

Please add vitamin D, folate, ferritin and B12 results and ranges from GP

[SlowDragon Administrator]

Link to vitamin results and advice in previous post

healthunlocked.com/thyroidu...

Have you had coeliac blood test done via GP yet

Going strictly gluten free diet may significantly improve symptoms…but don’t cut gluten out before coeliac blood test

[Pearlyqueen in reply to SlowDragon]

Thanks for your advice, I have Teva Levothyroxine every time and yes I took the blood test at 7.30 am on an empty stomach and 24 hours from last Levo. Haven’t had a coeliac test but will try to request one from GP.

[SlowDragon Administrator in reply to Pearlyqueen]

As you have autoimmune thyroid disease you should be tested for coeliac at diagnosis

nice.org.uk/guidance/ng20/i...

When you should be tested for coeliac disease

What to eat while waiting to have a blood test

Your doctor should discuss with you having a blood test for coeliac disease if you have any of the following:

problems related to your stomach or intestines (such as diarrhoea, abdominal pain, vomiting or nausea) that are long‑lasting and can't be explained by anything else

ongoing tiredness

unexpected weight loss (for example, you are losing weight but you are not on a diet)

mouth ulcers that are severe or long‑lasting

anaemia, or a deficiency in vitamin B12 or folate (also known as vitamin B9 or folic acid) that can't be explained by anything else

irritable bowel syndrome (if you are an adult)

type 1 diabetes

autoimmune thyroid disease (when a person's immune system attacks and damages their thyroid gland; the gland in the neck that produces hormones controlling metabolism, growth and development).

[SeasideSusie Remembering]

Pearlyqueen

Your results are within range so would satisfy your GP. Your FT4 is 56% through range and your FT3 is 27% through range so your conversion isn't very good and you'd probably feel better if they were reasonably well balanced in the upper part of their ranges.

Poor conversion can be due to poor nutrient levels, ferritin in particular. As you've been prescribed ferrous gluconate once your ferritin level starts to improve your conversion may improve. Some experts say that the optimal ferritin level for thyroid function is 90-110ug/L.

Remember to take your iron tablets 4 hours away from thyroid meds and 2 hours away from any other medication and supplements as it will affect their absorption. Taking Vit C with your iron tablets will help absorption of them.

I think that with your current thyroid levels and the fact that you are symptomatic then it would be reasonable for your GP to give you an increase in your dose of Levo. I would ask for 25mcg but if GP is reluctant see if you can compromise with 12.5mcg and you should retest 6-8 weeks after dose increase.

Remember to ask your surgery for a print out of any test results, never take their word for "everything is normal". Don't ask the doctor, ask the receptionist and don't accept verbal or hand written results, always get a print out. Your surgery may offer online access to results so you could register for that if they do, but you need to make sure the results are always with reference ranges.

[Pearlyqueen in reply to SeasideSusie]

Thank you for this, I’m trying to get organised with vitamin supplements and following your advice am juggling the times so that they don’t interfere with the iron and each other. Currently I have the ferrous Glucanate twice a day and I’ve just bought Betteryou D3000+K2(MK-7) oral spray. It’s recommended 3 sprays per day, should these be taken together all at once or separated throughout the day?I’ve also got a Vit B complex (2 per day) which I haven’t started yet - apart from being 2 hours away from iron, is there a best time to take these? I am trying to penetrate my brain fog and am so grateful for your taking the time and having the patience to support folks like me.

I will in future insist on printouts of all my blood tests - all this is new to me!

[SeasideSusie Remembering in reply to Pearlyqueen]

It’s recommended 3 sprays per day, should these be taken together all at once or separated throughout the day?

I believe you can take them all at once.

I’ve also got a Vit B complex (2 per day) which I haven’t started yet - apart from being 2 hours away from iron, is there a best time to take these?

Which B Complex have you got? You may only need one.

B vitamins are best taken no later than lunchtime, this is because they can be stimulating and you don't want them to keep you awake if you take them late in the day.

Did your GP do an iron panel to know that you need iron tablets? Is your GP going to monitor your levels whilst on iron tablets? Ferritin can be low even when serum iron and transferrin saturation are at good levels and taking iron tablets just to raise low ferritin isn't always a good idea, if your serum iron and saturation are at good levels then taking iron tablets can raise them too much and too much iron is as bad as too little.

[Pearlyqueen in reply to SeasideSusie]

Sorry for the late reply (had a family funeral sadly) but thank you for the information. Iron isn’t straightforward then is it. My last full blood count (posted here) didn’t show anaemia although one result Eosinophil was out of range. The results are incomprehensible to me so I’d be grateful for your thoughts. The only reason I am taking Ferrous Gluconate is to raise ferritin to try and halt my excessive hair loss. The GP has prescribed it for 3 months only with a blood test early April. I presume they’ve checked whether this is safe for me, hopefully they have. The Vit B complex supplement is probably not the best but as I’ve not taken B vits before and it was on offer at H&B I thought I would try it. Pics attached if they are clear enough for you to see. Can I just say again how grateful I am for the support and info I’ve had from this site - thank you!

Black and white print

[Pearlyqueen in reply to SeasideSusie]

Complete B from H&B

Colour

[SlowDragon Administrator in reply to Pearlyqueen]

We recommend vitamin B complex that has FOLATE in ..NOT folic acid

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)

Both available online

[Pearlyqueen in reply to SlowDragon]

Ah thank you - if I tip the powder out of the capsule what’s the best way to take it? do I put it in liquid?

[SlowDragon Administrator in reply to Pearlyqueen]

I just tip it in a cup - then tip on my hand - put powder in mouth and swallow with mouthful of water (or I use Danone probiotic drink)

Take B vitamins immediately after breakfast as slightly energising

Can make you feel a bit wired first few days - should wear off

[Pearlyqueen in reply to SlowDragon]

Thanks!!

[SeasideSusie Remembering in reply to Pearlyqueen]

Pearlyqueen

H&B own brand are generally poor supplements. That one contains cyanocobalamin whereas methylcobalamin is the recommended form, and folic acid rather than folate.

I have used Thorne Basic B for a long time and always been happy. However, it's quite expensive so I have bought some of this one to try when I've finished the last of my Thorne. The amounts of the vitamins are very similar, it's liposomal which is said to absorb better, there are no unnecessary added ingredients and better priced:

amazon.co.uk/Liposomal-Vita...

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).

[SlowDragon Administrator in reply to SeasideSusie]

Interesting brand ……But ….This looks like a (large) gel capsule…..not something I could contemplate swallowing

[SeasideSusie Remembering in reply to SlowDragon]

Depends on what you class as large I suppose. It's 1/2" long and as it's a softgel it's easier to swallow than a capsule.

[Pearlyqueen in reply to SeasideSusie]

Thanks for the information about vit B, it’s very helpful. I wonder did you also get chance to look at the blood count results posted immediately before this one and whether you had any comments or thoughts on them. re the iron levels. Thanks for your patience!

[SeasideSusie Remembering in reply to Pearlyqueen]

Pearlyqueen

There is no iron panel just a full blood count which doesn't show anaemia. The FBC does show a very minimally elevated eosinophil count which may be worth repeating in April, maybe ask GP to do a full iron panel rather than just Ferritin.

[Pearlyqueen in reply to SeasideSusie]

Yes I’ll do that - thank you. Didn’t know the iron panel was something different from the FBC.

[SeasideSusie Remembering in reply to Pearlyqueen]

Pearlyqueen

The iron panel consists of Serum iron, Transferrin saturation percentage, Total iron binding capacity and Ferritin. Iron panels is rarely done as a standard test, it's often just Ferritin on it's own. This will show if there is iron deficiency. The full blood count shows if there is anaemia. You can have iron deficiency with or without anaemia.

[Pearlyqueen in reply to SeasideSusie]

It’s complicated isn’t it - thanks for the info. I imagine my GP will be reluctant to commission any non-standard blood test - she hasn’t felt the need to explain any of my results so far except to let the receptionist tell me they were “normal”. It was the nurse practitioner who eventually spoke to me and she didn’t have the knowledge to answer any of my questions. I’ll have to be more assertive obviously!

[Pearlyqueen]

Thank you for this, I’m trying to get organised with vitamin supplements and following your advice am juggling the times so that they don’t interfere with the iron and each other. Currently I have the ferrous Glucanate twice a day and I’ve just bought Betteryou D3000+K2(MK-7) oral spray. It’s recommended 3 sprays per day, should these be taken together all at once or separated throughout the day?I’ve also got a Vit B complex (2 per day) which I haven’t started yet - apart from being 2 hours away from iron, is there a best time to take these? I am trying to penetrate my brain fog and am so grateful for your taking the time and having the patience to support folks like me.

I will in future insist on printouts of all my blood tests - all this is new to me!