blood test follow-up

[lutepavan]

Hello to all,

Five months ago, I posted to ask about some blood test results. Here's the post: healthunlocked.com/thyroidu...

Since then, I've been trying to improve the ferritin, D3, B12, folate etc. levels with a change of diet and with supplements, and I wanted to run some more test results past you.

In those five months, D3 has gone from 76.20 nmol/L to 88.30 nmol/L (though it was briefly as high as 98.60 nmol/L in November). From what SeasideSusie said in her helpful reply at the time, I know that I'm aiming for 100-150nmol/L, so it seems I'm headed in the right direction. Currently taking 2000 iu of D3, but perhaps should go back to 3000 iu? I'm also taking Magnesium and K2-MK7.

Ferritin has gone from 38.20 ug/L (Range: 30 - 400) to 67.4 ug/L (range 30-400), and was even briefly at 103 in November. (No idea why it's dipped down again, but doctor currently investigating borderline anaemia at the moment, so it must be related.) I think @seasidesusie suggested that halfway through range would be a better place to be, so I guess I still have a long way to go.

Active B12 was 90.000 pmol/L (Range: 37.5 - 188) five months ago, and yesterday's local hospital blood test gives a reading of 430 ng/L [180-2000] -- obviously a different measuring system, and I'm not sure how to compare. But I can say that my last Medichecks test, in February, reads 143.000 pmol/L (Range: 37.5 - 150). If someone can tell me what yesterday's 430 ng/L reading means, I'd be grateful, but in general B12 seems to be going much better. I believe I should be aiming for at least 100 pmol/L. I guess I may have got there (?).

Finally folate: five months ago it was 5.37 ug/L (Range: > 3.89), and yesterday's (non-Medichecks) test reads >24.0 ug/L [1.5-20] -- different range! FYI, February Medichecks reading on folate was 16.46 ug/L (Range: > 3.89). Is this excessive? Does it matter?

Most recent thyroid readings were:

TSH 2.70 mU/L (Range: 0.27 - 4.2), but since then I've gone up from 75 mcg levo to 100 mcg, and would imagine that TSH has dropped (next test in May).

T4 16.100 pmol/L (Range: 12 - 22)

T3 3.13 pmol/L (Range: 3.1 - 6.8)

I've been taking Thorne Basic B complex and eating red meat after years of being vegetarian. Also taking magnesium, selenium, K2-MK7, E, zinc, fish oil, and (off and on) N-acetyl l-cystein and l-glutamine.

I guess my question is whether I'm on the right track, and also whether I should be considering taking T3 as well as levothyroxine, because conversion doesn't seem to be happening very efficiently (T3 has been going down, not up).

Thanks, as ever, for your help!

[SlowDragon Administrator]

Obviously you won’t know yet if you need T3 added

75mcg is only one step up from starter dose

How long had you been left on 75mcg

Bloods should be retested 6-8 weeks minimum after increasing to 100mcg

Which brand of levothyroxine are you currently taking

Do you always get same brand levothyroxine at each prescription

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

As a bloke you’re looking for ferritin at least over 100

Approx how much do you weigh in kilo

Guidelines on dose levothyroxine by weight is likely approx 1.6mcg per kilo of your weight

[lutepavan in reply to SlowDragon]

Thank you, SlowDragon

<<How long had you been left on 75mcg>>

about a year

<<<Bloods should be retested 6-8 weeks minimum after increasing to 100mcg>>>

In that case, I'll move the May Medichecks test to April. I don't think I can afford it before then.

<<<Which brand of levothyroxine are you currently taking>>>

They put me on Mercury Pharma a month or so ago, 100 mcg, but yesterday when I collected the refill, it was TEVA 100 mcg. I used to take TEVA 75 mcg with no noticeable ill effects, so I wasn't too worried about switching. Should I be?

<<<Do you always get same brand levothyroxine at each prescription>>>

This is the first time they've unexpectedly switched brands on me. I can of course take it back to the chemist if you think it's advisable.

<<<Always test thyroid levels early morning, ideally before 9am and last dose levothyroxine 24 hours before test>>>

I always do.

<<<As a bloke you’re looking for ferritin at least over 100>>>

Thanks. I'll keep working on that. There's an iron issue going on here which the doctor is trying currently to get to the bottom of.

<<<Approx how much do you weigh in kilo>>>

62-63 kg.

<<<Guidelines on dose levothyroxine by weight is likely approx 1.6mcg per kilo of your weight>>>

Sounds like 100 mcg to me!

Many thanks for these clarifications.