Blood test meaning please?

[bognorr]

Can anyone tell me what this blood result means please? Im taking 100 lethothyroxine daily. No comment from GP

\HbA1c levl - IFCC standardised39 mmol/mol- mmol/mol

Full blood count - FBC

Total white cell count7.6 10^9/L3.7 - 11.1 10^9/L

Red blood cell (RBC) count4.09 10^12/L4.32 - 5.6 10^12/L

Haemoglobin estimation131 g/l130 - 170 g/l

Haematocrit0.408 l/L0.4 - 0.5 l/L

Mean corpuscular volume (MCV)100 fL82 - 98 fL

Mean corpusc. haemoglobin(MCH)32 pg27.3 - 32.6 pg

Mean corpusc. Hb. conc. (MCHC)321 g/l320 - 350 g/l

Red blood cell distribut width13.2 %9.9 - 15.5 %

Platelet count274 10^9/L150 - 400 10^9/L

Neutrophil count4.5 10^9/L1.5 - 7.4 10^9/L

Lymphocyte count2.1 10^9/L1.1 - 4.0 10^9/L

Monocyte count0.8 10^9/L- 0.95 10^9/L

Eosinophil count0.2 10^9/L0.0 - 0.7 10^9/L

Basophil count0.1 10^9/L- 0.2 10^9/L

Nucleated red blood cell count0 per 100 wbcs- per 100 wbcs

Serum lipids

Serum cholesterol4.4 mmol/L- 5.0 mmol/L

Serum triglycerides1 mmol/L- 2.0 mmol/L

Serum HDL cholesterol level1.9 mmol/L- mmol/L

Serum LDL cholesterol level2 mmol/L0.0 - 3.0 mmol/L

Serum cholesterol/HDL ratio2.32 ratio- ratio

Serum TSH level2.39 mIU/L0.30 - 3.18 mIU/L

GFR calculated abbreviatd MDRD84 mL/min/1.73m2

[SlowDragon Administrator]

The only relevant test here is

TSH

Just testing TSH is for thyroid is completely inadequate

How do you feel?

How long have you been on 100mcg levothyroxine

Many people find different brands of levothyroxine are not interchangeable

Do you always get same brand levothyroxine at each prescription

ALWAYS test thyroid early morning, ideally before 9am, and last dose levothyroxine 24 hours before test

[SlowDragon Administrator]

The test is difficult to read - can you make ranges clearer (Figures in brackets after each result)

Red blood cell (RBC) count4.09 L. (4.32 - 5.6)

Low RBC - suggests anaemia

[SlowDragon Administrator]

Mean corpuscular volume (MCV)100 (82 - 98)

medlineplus.gov/lab-tests/m...

High MCV

If your results show that your red blood cells are larger than normal, it may indicate:

A vitamin B12 deficiency

A deficiency in folic acid, another type of B vitamin

Liver disease

Hypothyroidism

[SlowDragon Administrator]

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Do you know if you have autoimmune thyroid disease, diagnosed by high thyroid antibodies

Have you had thyroid antibodies tested when first diagnosed?

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Results above suggest folate, ferritin or B12 may be low

Low vitamin levels are extremely common, especially with autoimmune thyroid disease

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

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 and money off codes

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...

Link about thyroid blood tests

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

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

[SlowDragon Administrator]

A TSH over 2 suggests you might need dose increase in levothyroxine

You need full thyroid and vitamins tested

gponline.com/endocrinology-...

Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.

NHS England Liothyronine guidelines July 2019 clearly state on page 13 that TSH should be between 0.4-1.5 when OPTIMALLY treated with just Levothyroxine

Note that it says test should be in morning BEFORE taking levothyroxine

Also to test vitamin D, folate, B12 and ferritin

sps.nhs.uk/wp-content/uploa...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Aim is to bring a TSH under 2.5

UK guidance suggests aiming for a TSH of 0.5–2.5

gp-update.co.uk/SM4/Mutable...

What’s the range on GFR result.

Low GFR frequently improves as thyroid levels improve