Good morning all. I will try to include all the info this time. I am currently taking 50mcg levothyroxine and 20 mcg of liothyronine. If I put BH results first and then GP, the layout might work better
BH
CRP 0.91 (<5.0) mg/L
Ferritin 249 (High) (13 - 150 ) ug/L
magnesium 0.98 (0.66 - 0.99) mmol/L
9am cortisol 318 (166-507) mmol/L
TSH 2.24 (0.27 - 4.20) mU/L
T4 total 78.2 (66 - 181) nmol/L
Free T4 13.7 (12.0 - 22.0) pmol/L
Free T3 4.78 (3.1 - 6.8) pmol/L
Antithyroid pyroxidase abs 13 (<34) IU/mL
Anti thyroglobulin abs 14 (<115) IU/mL
Vit D (25 OH) 145 (optimal 75 - 200) nmol/L
Vit B12 371 (145 -569) pmol/L
Serum folate 34.50 (8.83 - 60.8) nmol/L
GP
Serum ferritin 192 (15 - 200) ug/L
TSH 1.79 (0.35 - 4.94) mu/L
Folate 12.8 (3 - 20) ug/L
B12 422 (180 -640)
Ferritin 192 (15 - 200)
I have to go back into the system to find that last 2 measurements, sorry. Urgency to post this in case it messes up again and I lose it all. Back in a mo
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OllyTojo
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Main symptoms are loss of hair (a lot), sleep apnoea, hard, grainy thyroid (endo said at some point my thyroid has been struggling but all bloods OK now - I'm not convinced as T4 seems pretty low to me), loss of outer half of eyebrows, swollen tongue.
If I try to increase levo, I get hyper symptoms.
I am really scared about my hair (very apparent now - this has been going on for years but accelerated past 2 years) and the apnoeas which are dangerous. I saw that they can often be caused by underactive thyroid. My tongue is very swollen and blocks the airway - also a symptom I believe
Thank you so much for the help on here. I really appreciate it.
Thanks for clarifying, I'll explain as best I can.
BH: CRP 0.91 (<5.0) mg/L
This is an inflammation marker, the lower the better. Yours is nice and low. No problem with inflammation showing.
**
BH: 9am cortisol 318 (166-507) mmol/L
This is sitting nicely within range, not low, not high, so it doesn't suggest any problem.
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BH: magnesium 0.98 (0.66 - 0.99) mmol/L
Testing magnesium is unreliable. About 99% of magnesium is stored in bone, muscles and soft tissues, leaving about 1% in the blood. So testing what's in the blood isn't giving an accurate picture of our magnesium status.
A red cell magnesium test is the better indicator of magnesium status, not the standard serum magnesium test.
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Vit D (25 OH) 145 (optimal 75 - 200) nmol/L
This is a good level. The Vit D Society and Grassroots Health both recommend a level of 100-150nmol/L with a recent blog post on Grassroots Health recommending at least 125nmol/L.
Do you supplement?
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BH: Ferritin 249 (High) (13 - 150 ) ug/L
GP: Ferritin 192 (15 - 200) ug/L
Ferritin can be raised when inflammation or infection is present. If this was the case here one would expect to see your CRP raised also, so I would discount inflammation or infection causing the high levels.
Despite the difference in ranges, the BH ferritin result is disproportionately higher than the GP result. This could be down to different equipment, we never can seem to get to the bottom of this when it's been questioned before.
If you're not supplementing, do you eat a lot of high iron foods, particularly liver, liver pate, black pudding and red meat? If not it might be worth mentioning to your GP that even though it's in range it seems very high and maybe you can have the test repeated in, say, 3 months and if level remains high hopefully GP will want to look into it.
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BH: Vit B12 371 (145 -569) pmol/L
GP: B12 422 (180 -640) ng/L
So here we have to convert them to both the same unit of measurement.
So there is a bit of a difference in your B12 level with GP measuring 422ng/L and BH's works out at 502.7ng/L. Again different machines may have something to do with it.
According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:
"We believe that the 'normal' serum B12 threshold needs to be raised from 200 ng/L (or pg/ml) to at least 450 ng/L (pg/ml) because deficiencies begin to appear in the cerebrospinal fluid below 550".
"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 ng/L (pg/ml)."
So taking either the 422 or the 502ng/L, you are below what is recommended and if those were my results I'd be looking at supplementing to improve.
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BH: folate 34.50 (8.83 - 60.8) nmol/L = 49.4% through range
GP: Folate 12.8 (3 - 20) ug/L = 57.6% through range
I don't have the information to convert these to the same unit of measurement so have used percentage through range.
Folate is recommended to be at least half way through range. Yours is just about there but wouldn't hurt to go a bit higher.
Taking into account both B12 and folate, if these were my results I'd be taking a B Complex which will improve both levels. Look for one that contains both methylfolate and methylcobalamin. My choice is Thorne Basic B. If you look for a different brand then choose one without Vit C as B12 and Vit C need to be taken 2 hours apart as the Vit C can stop the body from using the B12.
**
TSH 2.24 (0.27 - 4.20) mU/L
T4 total 78.2 (66 - 181) nmol/L
Free T4 13.7 (12.0 - 22.0) pmol/L
Free T3 4.78 (3.1 - 6.8) pmol/L
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.
Your TSH would be too high for most hypo patients. Your FT4 is just 17% through range and your FT3 is 45.4% through range. So your TSH and FT4 are telling us you are undermedicated.
Your thyroid antibodies are nice and low which, with those results, do not suggest autoimmune thyroid disease (Hashimoto's) but as fluctuations are possible it doesn't mean that tested another time they would be the same, they could be higher with another test. Plus we can have Hashi's without raised antibodies.
Wow! Thank you. I have noted it all down and will process. I have created a thyroid notebook and will be recording all the information coming through and making a plan. I feel I have to take it into my own hands now. I can't afford to lose any more hair and Endo has been saying for a few years now, it's all good now. I feel super empowered by the information here. I'm curious as to how I'll be feeling down the line and how much hair I can grow back!!
In answer to your questions:
Yes I do supplement with vitamin D - 4,000 iu per day with vit K2
I do eat red meat but not a massive amount and I never eat liver, pate or black pudding. Both labs did flag up the ferritin and suggested it be rechecked at 3 months. So thank you. I'll remind the GP
My antibodies have been consistently at this level over the years. So there's another reason for u/active.
I forgot to say that when taking B Complex we need to leave this off for 3-7 days before any blood test as it can cause false results. Just something to keep in mind when doing future tests.
Your 4,000iu D3 has given you a good level. It might be an idea to reduce dose during the summer. Those of us who can make Vit D naturally from the sun can make up to 10,000iu a day if skin is exposed, no sunscreen, for about 20 minutes a day. If you know you make Vit D naturally during the summer months then maybe stop supplementing or reduce to 2,000iu dose during the summer then retest in October/November to check your level and that should tell you if you need to increase your dose during the winter months. We should test twice a year when supplementing.
grainy thyroid (endo said at some point my thyroid has been struggling but all bloods OK now - I'm not convinced as T4 seems pretty low to me)
Your endo doesn't know much about thyroid, does he! If your blood are 'ok now' - which I would dispute - it's because you're taking levo and quite a high dose of T3, not because your thyroid is no-longer struggling. If you stopped the thyroid hormone replacement, your thyroid would probably give up the ghost completely.
And, if your results are 'ok' for this endo, I dread to think what he would call a serious case of hypo. You're right, your FT4 is low, but that could just be because you're taking T3 - which lowers FT4 levels. This may or may not be a problem, because people need different levels of FT4 to feel well when they're on T4+T3.
But, what would worry me is your FT3 which is not even mid-range although taking 20 mcg T3. Do you always take it on an empty stomach, two hours after a meal or one hour before? Do you always take it well away from other supplements and medication - apart from levo, of course, you can take the two together? I would say you're not absorbing it very well, or you are a very, very poor converter and need an increase in T3 dose. It's low T3 that causes the symptoms.
Thank you greygoose. I have been taking my t3 3 x day half an hour before food. I will pay closer attention to the timings. It's highly likely absorption and conversion. But with the t3, I let it dissolve under my tongue. Perhaps this makes not a jot. Really appreciate this information. A picture (and plan) is forming. Thank you 😀
Ah. A lot of people that appear to have poor absorption say they dissolve their T3 sublinugally. It is not a method I would recommend. All thyroid hormone tablets are designed to be swallowed, and need stomach acid for maximum absorption.
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