Ferritin seems good, do you supplement? Bear in mind that ferritin is also an inflammation marker and may be falsely raised as your CRP is showing inflammation.
Magnesium - 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. Red cell magnesium is an expensive test and not routinely done.
Cortisol - depends on time of test but if done between 6am and 10am it's rather low in range but doesn't suggest Addison's disease. It may be worth doing a 24 hour salive cortisol plus DHEA test with either Regenerus or Genova Diagnostics:
A normal healthy person with no thyroid condition would generally have TSH no more than 2, often around 1, with FT4 around mid-range-ish. Your TSH is close to top of range and FT4 is very low at just 9% through range. FT3 is 40.27% through range and as this is the active hormone that every cell in our bodies need our body will keep making this as long as possible.
These results show that you are on your way to hypothyroidism and if your TSH goes over range or FT4 goes under range then with all the symptoms that you are experiencing it's reasonable that your GP should offer you a trial of Levothyroxine.
Thyroid antibodies are both low so these results don't suggest autoimmune thyroid disease (Hashimoto's) but it's possible to have Hashi's without raised antibodies.
Vit D: 43nmol/L
This is very low and comes into the "insufficient" category and possibly the cause of your joint and muscle aches and pains.
Your GP may be willing to prescribe D3 but would only be 800iu or 1,600iu which isn't enough to help raise your level.
The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
To reach the recommended level from your current level, you could supplement with 4,000-5,000iu D3 daily.
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
For Vit K2-MK7 I like Vitabay or Vegavero brands which contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The company has told me the K2-MK7 is the Trans form
Magnesium helps D3 to work. We need magnesium so that the body utilises D3, it's required to convert Vit D into it's active form, and large doses of D3 can induce depletion of magnesium. So it's important we ensure we take magnesium when supplementing with D3.
Magnesium comes in different forms, check to see which would suit you best and as it's calming it's best taken in the evening, four hours away from thyroid meds if taking magnesium as tablets/capsules, no necessity if using topical forms of magnesium.
◦Serum folate of less than 7 nanomol/L (3 micrograms/L) is used as a guide to indicate folate deficiency.
◦However, there is an indeterminate zone with folate levels of 7–10 nanomol/L (3–4.5 micrograms/L), so low folate should be interpreted as suggestive of deficiency and not diagnostic.
You should discuss this with your GP as you need either folic acid prescribing or supplementing with methylfolate if you have folate deficiency, if not then supplement with a good quality B Complex to keep all B vitamins balanced, one containing methylcobalamin not cyanocobalamin and methylfolate not folic acid.
Thank you for your detailed, as ever, response. I really do appreciate it.
I did my blood test at 4:40am - I couldn't sleep as I hadn't taken my meds so I could do the test.
I occasionally take a multivitamin, but not consistently, and hadn't for a month before this test. My fortin levels some years ago were very low, but I can't tolerate iron tablets so the general multivitamin was for that.
Ditch the multivitamin, it wont contain enough of anything to help your low levels and the iron in it will affect the absorption of the other active ingredients.
Stick to what you need as detailed above.
Don't start all supplements at once. Start with one, give it a week or two and if no adverse reaction then add the next one. Again, wait a week or two and if no adverse reaction add the next one. Continue like this. If you do have any adverse reaction then you will know what caused it.
Actually I have checked back to my B12 diagnosis in Aug 2018, my B12 was 92 (147 - 840) and folate was 3.4 (3.1 - 19.9). The Dr did tell me to order 5mg folic acid which I did and took until I finished the 100 capsules. I didn't think I would need to carry on. It wasn't in methylfolate form. I haven't had my b12, folate or vitamins tested since then.
As you have B12 injections there is no point in retesting. Do you have PA? If so injections will be for life as your body can't absorb B12 from food. Obviously this test bundle included it but no point in GP retesting, it's going to be high after a jab and low coming up to a jab.
After the folic acid, which one would hope your GP tested your level, the idea is to maintain that level. Once we've addressed any nutrient deficiency it's advised to take a maintenance dose and test once a year to check levels, it's usually down to us to check. With Vit D we should test twice a year as we often need to take more in winter when we can't make Vit D naturally.
I tested negative to PA, although I have been told it isn't unusual to get a false negative. There is a lot of food intolerance in my family, particularly with dairy. I suspect I may have issues caused by this or leaky gut. Either way, I've been having b12 jabs every 12 weeks since the initial loading doses.
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Medichecks results - interpretation please
Help interpreting results please
Help interpreting results please.
Lab results interpreted please!
