I would greatly appreciate if anyone could look over my blood test results and offer any advice.
Serum TSH level 6.67 miu/L [0.27 - 4.2]
Serum vitamin B12 level 432 ng/L [130 - 800]
Serum folate level 16.6 ng/ml [4 - 27]
Serum ferritin level 85 ng/ml [13 - 150]
Serum vitamin D level 92 nmol/L [30 - 300]
My TSH level at my last test in 2018 was 10.14 miu/L [0.35 - 5] so, I was surprised to see that it’s lowered since then.
Is that normal? I, perhaps naively, thought it would of carried on increasing without medication.
I ended up having the blood test at 12pm. Which after booking it, became informed, via this site, this wasn’t the best time. I mentioned to the doctor about my concern of TSH levels changing throughout the day, but he was (to my frustration!)very dismissive of the fact.
One other query - I thought my B12 level would of been higher as I use a B12 spray at 1200µg everyday. I did stop this a week before, but surely levels wouldn’t decrease by much? Likewise with the vitamin D. As I supplement with a spray at 3000iu with k2 daily.
Thank you for reading and I look forward to any thoughts.
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Seatreeleaf
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It's really amazing how doctors - who are, after all, supposed to have a certain level of intelligence - cannot get their heads around the idea that TSH varies throughout the day. I think it's willfull ignorance. They do it on purpose to get the lowest possible TSH level, whilst we are wanting to test early to get the highest!
So, if the blood was drawn at 12 pm, your TSH would have been at its lowest. It would possibly have been over 10 at 9am. You just can't second-guess the TSH.
Did you have your vit B12 tested before you started supplementing? What was the result? If you have Pernicious Anemia, the body can't hold on to B12, so levels can drop pretty quickly. You don't need to leave it off for a week, just don't use it the day of the test.
Yes, exactly. We really shouldn’t have to battle them, it’s especially trying when you are not feeling mentally at your strongest.
I’m really grateful for this forum for the support and excellent advice, it’s been invaluable.
This is the first time my B12 levels have been tested. I started using the spray a little over a year a go, thought it may help with my feeling so tired all the time. I assumed as I was taking quite a high dose it would of been further up the range.
Well, it's a shame you didn't have the B12 tested before you started supplementing, because you might have Pernicious Anemia. But, now there's no point in testing for it. With PA, you body can't hold on to the B12, so levels drop very quickly.
1200 µg is not a high dose. When mine was very low, I used to take 5000 µg. So, you coud increase your dose.
Vitamins and minerals will only help you if you need them. More is never better. Which is why one should always get them tested before supplementing. If you don't need them, you're just wasting your money.
Yes, I regret that I should of tested prior to supplementing, but I was keen and perhaps rather rash to try a higher dosage to see if it’d improve my energy levels and decrease daytime fatigue. I’ve taken B12 in multivitamins from when I was a child. So it may of been difficult to get a true reading.
I used to eat a vegetarian diet, but for about six years now, have been eating meat a few times a week and I eat dairy products regularly.
If as you say with Pernicious anaemia levels drop quickly. Could I stall taking the B12 spray and retest at a future date?
Ah ok, thank you. I’m not sure it’s worth my halting B12 supplementation, especially at present, as I’m tapering off a medication and the withdrawals are making me feel pretty awful, I don’t want to add to that.
I’ve also read, that even if my levels were to drop significantly it can be difficult to be prescribed injections on the NHS and a lot of people seem to be self supplementing.
I had a full blood count test and all seems fine. Would this pick up any sign of pernicious anaemia?
Can I ask how you maintain good B12 levels, are there any supplements you can recommend?
I’m going to give increasing the dosage a go, as the consensus seems to be healthy levels should be above 550.
Thank you, all your help is very much appreciated.
I’ve been feeling increasingly tired during waking hours but suffer with insomnia too, so great combination! My cognition has deteriorated, lack of sleep probably being the main culprit there.
This has been gradually getting worse for about the last 4-5 years. To top it off my hairs been thinning. Which led me to think I may have something up with my thyroid.
I’ve got a phone appointment with the doctor in a couple of weeks. So I’m hoping either they’ll prescribe me medication, or I can get retested in six weeks time with an earlier appointment.
I’m just a bit perplexed where the TSH has dropped. I assumed as time had past and without treatment, it would of raised further. But maybe with a morning test it’ll jump back up again.
It’s highly likely your TSH will rise again if you can get an early morning test. If your GP will not test T3 and T4 levels, I would look at the links from SlowDragon to test privately. Many members (including myself) monitor thyroid levels via private tests and antibody testing will also show if your thyroid condition is auto immune (aka Hashimotos).
I wasn’t made aware that my TSH level in 2018 was high. It was only when I recently decided to check my previous blood test online I discovered this. The doctor had assessed it as ‘satisfactory, no further action’.
I took a print out of it to my appointment last week, and the doctor agreed it was high but understandably seemed very careful not to make out the other doctor (who still works at this practice) had made a mistake.
This is the first time I’ve had my vitamins tested. I take a B12 spray (1200µg), a vitamin D (3000iu) and K2 (75μg)spray and an iron (14mg) with vitamin c (60mg) supplement daily.
By rights, you should have been put on Levo with this latest result ,because you've now got two over range TSH tests ... but the TSH appearing to 'get better' will have thrown a spanner in the works ... GP will now want to 'wait and see' for a bit longer. According to the wording in NHS guidelines, they don't 'have to' treat subclinical hypo until TSH is over 10 .. (less than 10 and it's still in the 'you may consider' treatment box)
TSH usually falls to lowest around 1-2 pm ... so yes ,it would probably have been a bit higher at 8/9 am .... however from the charts i've seen on the normal daily variation in people on research studies , the daily variation ranges from 'not much at all' for some people ,up to 40/50 % higher (maximum) for others .. so i would be surprised if yours was actually over 10 on that morning when it was 6.7 at midday .... and it could well have been 'only' 7.5/8 ish .
If GP refuses to start treatment yet because he thinks TSH is getting better , then pragmatically , the best thing you can probably do is 'use their own ignorance against them' .....make sure you get another test in 6 weeks time (NHS should allow this without too much arguing , because your TSH has been significantly over range twice now) .. and then make absolutely certain your next NHS blood test is 9/9.30 at the latest, so TSH will almost certainly be higher than 6.7 ... then say "look ...it's got worse , so please treat my symptoms now ".
I’ve got a phone appointment with the doctor in two weeks time. Apparently he wants to discuss my thyroid results. I don’t know whether that’ll mean prescribing medication or future retesting.
If the latter, then I’ll insist on it being in six weeks time and as early in the morning as possible.
“According to the current TSH reference interval, hypothyroidism was not diagnosed in about 50% of the cases in the afternoon.”
“Further analysis demonstrated inadequate compensation of hypothyroidism, which was defined in 45.5% of the morning samples and in 9% of the afternoon samples”
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