So I managed to persuade GP to take a few more blood tests as suggested on here in an earlier post. Not all of them but a least a few of them!
TSH...3.35 Another test not performed so this result is from Feb 22
No T3 or T4 test done!
B12...... 406ng/L (211-911)
Ferritin...101 ng/mL (11-307)
Folate ...436ng/mL (3.8-25)
Vit D....47 nmol/L - I have now been prescribed a booster dose for 6 weeks followed by a maintenance course after that and another blood test in 4 months.
TPO....334 kU/L (0-30) - Results came through today and they have given me an appointment to follow up on this result.
On the phone conversation with GP regarding Vit D she also mentioned my liver function was borderline. I don't know if this has anything to do with all this as well?
For my GP appointment I would be grateful for any advice as to what I should be asking for please? Should I ask to be referred to an endocrinologist as I have never seen one?
Thank you in advance for your help here it is very much appreciated.
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KnittingSam
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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
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Have this printed off too …..many GP’s unaware of the connection
Which brand of levothyroxine are you currently taking
Do you always get same brand levothyroxine at each prescription
High thyroid antibodies confirms autoimmune thyroid disease
If not already on strictly gluten free diet GP should do coeliac blood test BEFORE you consider trialing strictly gluten free diet
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial. This can help keep all B vitamins in balance and will help improve B12 levels too
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)
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months, then once your serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
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