Low Adjust calcium and changed ranges for T4 an... - Thyroid UK

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Low Adjust calcium and changed ranges for T4 and TSH

Foggy73 profile image
11 Replies

Hello. I have received my TFT and Bone Profile results as I have been feeling exhausted, fatigued, brain fog, emotional and weight gain etc for a while. My results are:

Serum calcium level = 2.28 (range 2.15 - 2.5)

Serum adjusted calcium concentration = 2.10 (range 2.25 - 2.5)

T4 = 13.6 (range 11.1 - 22.0)

FT3 = 4.4 (range 3.1 - 6.8)

TSH = 0.89 (range 0.27 - 4.2)

I have a couple of questions:

1. I am on Adcal and have been for years due to my low Adjusted calcium, but hasn’t been this low before. Would this level make me feel as bad as I do?

2. The T4 range has been changed so the range is lower than it used to be. The old range was 12 - 22 and the TSH range has also been changed and used to be 0.3 - 4.2. Is there a reason that this has been done? Should I still persue an increase in Levothyroxine as I’m lower end of normal and have terrible symptoms or could this all be down to the low Calcium?

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SeasideSusie profile image
SeasideSusieRemembering

Foggy73

2. The T4 range has been changed so the range is lower than it used to be. The old range was 12 - 22 and the TSH range has also been changed and used to be 0.3 - 4.2. Is there a reason that this has been done?

Ranges do change occasionally. It may be due to new equipment and how it's calibrated, ranges also to some extent are based on local population but I don't know how often that would be checked. Your result with the new range will be the same - percentage-wise - as it would have been with the old range, ie your FT4 is 20.73% through the range, with the old range your result would have been 14.073

Should I still persue an increase in Levothyroxine as I’m lower end of normal and have terrible symptoms or could this all be down to the low Calcium?

With FT4 at 20.73% through range and FT3 at 35.13% through range, your conversion of T4 to T3 is good but your FT4 is very low and I would be pushing for an increase in your dose of Levo to bring it over half way through range and see how you feel then.

Foggy73 profile image
Foggy73 in reply to SeasideSusie

Thank you. I am speaking to my GP tomorrow about the low Calcium which im sure he will increase my Adcal for, but I also want to ask to increase my Levothyroxine a little bit, as I want to feel better, as I feel dreadful and have done for months.

SlowDragon profile image
SlowDragonAdministrator

You need vitamin D, folate, ferritin and B12 levels tested

Low vitamin D leads to low calcium levels

Adcal has very little vitamin D in it.

When did you last test vitamin D

How much levothyroxine are you currently taking

Ft4 is too low and shows you need dose increase in levothyroxine

Foggy73 profile image
Foggy73 in reply to SlowDragon

Thank you. I will ask for the Vit D, folate, ferritin and B12 to be done. I did ask the nurse who took the bloods to done Vit D m, but she didn’t. It’s been a year or two since Vit D done and even when Adjusted Calcium was low Vit D was ok.

I take 100mcg Levothyroxine as I take Liothyronine too.

SlowDragon profile image
SlowDragonAdministrator in reply to Foggy73

NHS easy postal kit vitamin D test £29 viavitamindtest.org.uk

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol. Some CCG areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with thyroid disease , improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice a year via NHS private testing service when supplementing

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function. There’s a version made that also contains vitamin K2 Mk7. One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with hashimoto’s we frequently need higher dose than average

Vitamin D and thyroid disease recommends Vitamin D at least around 100nmol

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Great article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon profile image
SlowDragonAdministrator in reply to Foggy73

Was test done early morning, ideally before 9am and last dose levothyroxine 24 hours before test

How much T3 do you take

Day before test did you split T3 into 2 or 3 smaller doses spread through the day and take last dose T3 approx 8-12 hours before test

Foggy73 profile image
Foggy73 in reply to SlowDragon

The test was done at 12.40pm as I can’t do an early morning appt due to a complex situation with my daughter.

I take 10mcg of Liothyronine.

I take my Levothyroxine and Liothyronine about 6.30am each day. I didn’t take anything the morning of the blood test to avoid spiking, so it was about 30 hours from last tablets to blood tests.

SlowDragon profile image
SlowDragonAdministrator in reply to Foggy73

No wonder Ft3 result is lower than expected after 30 hour gap

Suggest you do a private Monitor My Health finger prick test at home (just for yourself)

Test early morning ideally before 9am

Day before test split T3 into 2 doses taking last 5mcg dose 9pm

With private testing Only test early Monday or Tuesday morning

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

Foggy73 profile image
Foggy73 in reply to SlowDragon

Thank you. I will try and get an earlier BT with the NHS. Previous T3 blood tests have been around the same even with earlier blood tests. Will the T4 make much difference having a 30 hour gap? Again it has been around this same figure with previous earlier tests.

SlowDragon profile image
SlowDragonAdministrator in reply to Foggy73

Ft4 will be slightly lower yes …..probably 2-4 points higher if tested after 24 hours

I don’t think you should change dose of levothyroxine until tested correctly

Foggy73 profile image
Foggy73 in reply to SlowDragon

Ok. Thank you.

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