Hi all, I had a dr's blood test done back in december but unfortunetly they didn't test for everything that i normally get tested for and because i'm not feeling great i though i'd do a medichecks blood test and the results are in...
Dr's results 13th December 2021
TSH 0.01 mU/L 0.30-4.20
T4 17.6 pmol/L 9.0-19.0
B12 999 ng/L 180-900
Serum Ferritin 10.8 microg/L 10-200
Serum Folate 3.7 microg/L 3.0-200
Medichecks results May 25th 2022
TSH 0.005 mU/L 0.27-4.2
T4 27.1 pmol/L 12-22
T3 5.72 pmol/L 3.1-6.8
Thyroid Peroxidase Antibodies 303 IU/ml <34
Thyroglobulin Antibodies 21 IU/ml <115
CRP HS 3.55mg/L 0-5
B12 150 pmol/L 37.5-150
Serum Ferritin 17.6 ug/L 13-150
Serum Folate 4.71 ug/L >3.89
Vitamin D 50 nmol/L 50-200
I am taking 150mcg of levothyroxine atm, i have not taken any supplements for a while but i have bought but not started taking yet : B12 1000ug per tablet, Vitamin D3 + K2 4000IU & 200ug per tablet and Iron gummies 14mg per serving. I really struggle with Iron supplements making my stomach painful and i am vegan so liver and things like that are not an option
I would really welcome any advice as I'm fed up of feeling ill all the time.
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* water only before the test (no food or other drink)
* last dose of Levo 24 hours before test
* no B Complex or biotin supplement for 3-7 days before test
Assuming you did your test this way then:
Medichecks results May 25th 2022
TSH 0.005 mU/L 0.27-4.2
T4 27.1 pmol/L 12-22
T3 5.72 pmol/L 3.1-6.8
I am wondering if you took your Levo before this test to give such a high FT4 result.
If you left the advised 24 hours gap between last dose and test these results show that you need your FT4 way over range to produce an acceptable amount of T3 so this shows poor conversion of T4 to T3.
Thyroid Peroxidase Antibodies 303 IU/ml <34
Thyroglobulin Antibodies 21 IU/ml <115
Confirms Hashi's, I assume that you already know this.
CRP HS 3.55mg/L 0-5
As an inflammation marker the lower the better with this test. Your result is within range but towards the top end so I expect it's showing some inflammation, possibly linked to your Hashi's.
i have not taken any supplements for a while but i have bought but not started taking yet : B12 1000ug per tablet, Vitamin D3 + K2 4000IU & 200ug per tablet and Iron gummies 14mg per serving.
B12 150 pmol/L 37.5-150
You do not need to supplement with B12, you are already top of the range and this is an excellent result. If you take y our B12 tablets you will be making expensive urine, that is all.
Serum Folate 4.71 ug/L >3.89
This is far too low, the range is 3.89-19.45 and folate should be at least half way through range. I would take a good quality B Complex containing methylfolate, eg Thorne Basic B. This will improve your folate level and keep all B vitamins balanced. Always leave off B Complex for 3-7 days before any blood test because it contains biotin and this causes false results when biotin is also used in the testing procedure (which most labs do).
In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.
Your GP should do an iron panel consisting of Serum Iron, Total Iron Binding Capacity, Transferrin Saturation Percentage plus Ferritin to confirm iron deficiency. He should also do a full blood count to see if you have anaemia. You can have iron deficiency with or without anaemia.
This level of ferritin is not something you should be addressing yourself.
Your GP's recent ferritin test showing a result of 10.8 microg/L (10-200) is even worse and your GP should have acted on this result at the time.
I'm fed up of feeling ill all the time.
I think your low ferritin is a big factor in this.
Symptoms of low ferritin include:
◾Weakness
◾Fatigue
◾Difficulty concentrating
◾Poor work productivity
◾Cold hands and feet
◾Poor short-term memory
◾Difficulty remembering names
◾Dizziness
◾Pounding in the ears
◾Shortness of breath
◾Brittle nails
◾Headaches
◾Restless legs
Symptoms of iron deficiency include:
◾Persistent fatigue
◾Pale skin
◾Shortness of breath
◾Headaches
◾Dizziness
◾Heart palpitations
◾Dry skin
◾Brittle hair and hair loss
◾Swelling or soreness of the tongue or mouth
◾Restless legs
◾Brittle or ridged nails
Vitamin D 50 nmol/L 50-200
This is just into the "adequate" category and is far too low but will satisfy your GP because it's "within range".
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.
Vitamin D3 + K2 4000IU & 200ug per tablet
That is too much Vit K for that amount of D3. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
Also if it's a tablet this causes a couple of problems - tablets are the least absorbable of all forms of D3 and both D3 and K2 need fat for absorption. There is unlikely to be any fat in the tablet so whatever dietary fat you take the tablet with then both vitamins will compete for the fat. Each vitamin needs it's own fat for absorption so unless it's an oil based softgel or liquid then these two vitamins should be taken at different times of the day.
Besides K2-MK7 another important cofactor of D3 is magnesium as this helps the body convert D3 into it's usable form. 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.
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.
Also remember that iron should be taken 2 hours away from other supplements and 4 hours away from thyroid meds.
D3 and magnesium should be taken 4 hours away from thyroid meds. Other supplements 2 hours away from thyroid meds.
Hi SeasideSusie, thank you so much for all the information. I've been in this group for years but i still don't really understand the results and what i should and shouldn't be doing.
Yes i did the test at 8am no levo since the morning before, am i on the right dose of levo as i wondered if i might be overmedicated?
I did do a previous test with medichecks on 13th May but only the TSH 0.01, T4 25.2 and T3 5.28 results came back, they said the sample was spoilt so i had to do another one.
I've just checked and in December my Dr did do a FBC, i have no idea what it means but 4 of the things checked came back abnormal!
I wonder why the vitamin d is sold with too high of a k2? i will see if i can send it back along with the b12 and the iron.
I'm still trying to understand everything you've given me and i'm sure i'll have more questions but thank you again
am i on the right dose of levo as i wondered if i might be overmedicated?
As we now know that you left the required time gap between Levo and blood test, then as I said you need a high over range FT4 to produce a decent amount of FT3, so this shows poor conversion.
With such a dire ferritin level your T4 is unlikely to be able to convert to T3 well enough, and getting ferritin up to a decent level may make all the difference. So this should be your first step - discuss your ferritin level with your GP, provide the evidence that NICE consider this to be iron deficiency, ask for an iron panel to confirm iron deficiency and the GP should treat and monitor your levels regularly.
As your FT3 is within range then technically you are not overmedicated and you should be able to stay on this dose. Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He confirmed, during a talk he gave to The Thyroid Trust, that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw
You can obtain a copy of the article by emailing ThyroidUK at
tukadmin@thyroiduk.org
print it and highlight question 6 to show your doctor if he wants to reduce your dose.
Once your ferritin level is optimal and if this improves your conversion, then you may find that your over range FT4 produces a higher FT3 and then it might be necessary to reduce your dose of Levo.
Don't forget that you need to optimise your Vit D and folate levels as well, all key nutrients need to be optimal for thyroid hormone to work properly.
I've just checked and in December my Dr did do a FBC, i have no idea what it means but 4 of the things checked came back abnormal!
If you post the abnormal results I'll see if I can comment on them.
SeasideSusie, this probably is a stupid question but I've managed to get a bloodtest booked at my dr's but not until 8th June, i have some ferrous fumerate 210mg tablets, should i start taking them or should i just wait for the test results?
Personally I would wait. If you start taking them now and GP does further testing then you will get a different result from what it is now. You want your GP to diagnose and treat appropriately (including regular monitoring of iron panel).
Iron tests should be done after a 12 hour fast so early appointment for test is better than fasting during the day for a later appointment.
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