Blood test

[Labby1955]

I am totally out of my comfort zone and have not got a clue what these results mean.

My Doctor has put me on 25mg of Levothyroxine for 2 months then have another blood test.

Would like peoples voices on this plan of the Doctor.

[shaws Administrator]

Hi Labby1995 I am unable to read your highlighted parts on your photocopy.

If other members also cannot read you will have to type the results.

[Labby1955 in reply to shaws]

Ok thanks for letting me know. Will do this later

[SlowDragon Administrator]

Are these results from before starting on levothyroxine?

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

Over 65 years old, yes starting dose levothyroxine is 25mcg

Aim of levothyroxine is to increase the dose slowly upwards in 25mcg steps until TSH is always below 2

Have you had vitamin D and ferritin levels tested or thyroid antibodies?

If not request testing at next test

B12 is low

Are you vegetarian or vegan

Request GP test for Pernicious Anaemia before starting any replacement B vitamins

[Labby1955 in reply to SlowDragon]

Serum ferritin level. 23 it/L

Haemoglobin. A12 level 38

[Labby1955 in reply to Labby1955]

Sorry I have been test yearly for the past 5 years being on the border for all.

[helvella Administrator Thyroid UK]

By the way, the dose would be 25 micrograms (not mg - which is milligrams - a thousand times more)

There is a section on units in my Vade Mecum document:

helvella - Vade Mecum for Thyroid

The term vade mecum means:

1. A referential book such as a handbook or manual.

2. A useful object, constantly carried on one’s person.

Please don't get put off by the number of pages!

Not everything is in this one document - my major medicines document is still separate!

From Dropbox:

dropbox.com/s/vp5ct1cwc03bl...

From Google Drive:

drive.google.com/file/d/1ZW...

[SeasideSusie Remembering]

Labby1955

A below range haematocrit level can indicate anaemia, vitamin deficiencies, and other conditions. Your haemoglobin is fine so anaemia is probably not suggested.

B12 - does this say 200ng/L (180-1000)?

This is very low and may suggest deficiency. Many people with a level in the 300s have been found to have B12 deficiency. Do you have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.

Folate: 6.2 (>4)

This result is OK. The range of >4 means that the aim is to have a level of more than 4. If your level was less than 4 then your GP should do further investigation. However, when there is no full range which includes lower and upper limits we tend to say aim for double figures so in that respect your level is considered to be on the low side.

TSH: 6.9 (0.27-4.20)

My Doctor has put me on 25mg of Levothyroxine for 2 months then have another blood test.

Is this your first over range result? Many doctors wait until there have been two over range results, this is to rule out any non-thyroidal cause of raised TSH. Also, many doctors wait until TSH goes over 10 to diagnose and prescribe Levo.

It is normal practice to repeat test in a couple of months and adjust dose. Your TSH may have started to reduce and the aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well. Dosing by TSH alone is not enough, so if your TSH comes back within range but is still in the upper part of it's range then you will need a dose increase. If GP says you don't then ask for FT4 and FT3 to be tested as these are the thyroid hormones, TSH is just a signal from the pituitary to the thyroid to make hormone when it detects there's not enough.

eGFR: 75 (>60)

Again this means that a level greater than 60 is fine.

[Labby1955 in reply to SeasideSusie]

Thanks for the information

My B12 level is 260 ng/L