I have been dithering about having a private blood test following the return of my pre-medication symptoms - bloated tummy, constipation, lethargy, low mood as I had covid mid March. I put these symptoms down to post covid recovery.
Eventually I had the sense to be tested with Medichecks and here are my results. I followed all the advice about stopping vitamin supplements, early morning test, no Levothyroxine for 24 hrs etc.
CRP HS <0.3 mg/l 0-5
ferritin 68ug/l 13-150
folate serum 13.99 >3.89
Vitamin B(active) 66.1 pmol/l 37.5-150
Vitamin D 64 nmol/l 50-200
TSH 1.28 mu/l 0.27-4.2 25.70% through range
Free T3 3.94 pmol/l 3.1-6.8 22.70% through range
Free T4 17.3 pmol/l 12-22 53% through range
Thyroglobulin 134 <115
Thyroid Peroxidase antibodies 37 <34
I can see I need vitamin D which is what the Medichecks doctor chappie said but could some kind, knowledgable person please explain to me what the rest of the results mean? Many thanks.
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Hi SlowDragon, thank you for your reply . I have always taken Teva Levothyroxine. I took a multivitamin until a few weeks prior to my blood test. After reading on the forum that multivitamins weren't the best form of supplement, I had decided that if I needed vitamins I would seek to improve my levels with individual vitamins. I haven't had a coeliac blood test done and no I haven't tried a strictly gluten free diet. I eat very little bread and usually sourdough if I do indulge. Regarding the increase in levothyroxine, I am a small frame and weigh 45kg ( weight was 43kg in November last year) . Am I in danger of exceeding the weight / Levo dose ratio?
You haven't said what supplements you normally take so it's hard to know what to suggest for your nutrient levels.
CRP HS <0.3 mg/l 0-5
This is an inflammation marker so the lower the result the better. Yours is an excellent result.
ferritin 68ug/l 13-150
Not bad. Ferritin is recommended to be half way through range so that would be about 82 with that range. Some experts say the optimal ferritin level for thyroid function is 90-110ug/L so if you want to give your level a boost then eating iron rich foods should help, eg eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet
This is a pretty good result. Medichecks range is 3.89-19.45 and it's recommended that folate is at least half way through range, so 12 plus with that range.
Vitamin B(active) 66.1 pmol/l 37.5-150
This is low. Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital:
If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results.
If you don't have any signs/symptoms of B12 deficiency then if you take a good quality B Complex containing methylcobalamin (not cyanocobalamin) this should help raise your level. ConsiderThorne Basic B.
Vitamin D 64 nmol/l
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 3,000-4,000iu D3 daily. However, as we are fast approaching summer you may be able to make Vit D naturally from the sun so it may be best to take 3,000iu daily and then 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. Both are imported German brands and often available on Amazon or Ebay and can be purchased direct.
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.
FT4 and FT3 could be higher, I think an increase in your Levo may be beneficial so it's worth trying a 25mcg increase and retest in 8 weeks after levels have settled on the increased dose.
Thyroglobulin 134 <115
Thyroid Peroxidase antibodies 37 <34
Confirm Hashimoto's. Did you already know this?
Hashi's is where the immune system attacks the thyroid and gradually destroys it.
Fluctuations in symptoms and test results are common with Hashi's.
Most doctors dismiss antibodies as being of no importance and know little or nothing about Hashi's and how it affects the patient, test results and symptoms. You need to read, learn, understand and help yourself where Hashi's is concerned.
Some members have found that adopting a strict gluten free diet can help, although there is no guarantee.
Gluten contains gliadin (a protein) which is thought to trigger autoimmune attacks so eliminating gluten can help reduce these attacks.
You don't need to be gluten sensitive or have Coeliac disease for a gluten free diet to help.
Thank you for your comprehensive reply SeasideSusie. I have some reading and research to do !!My supplements are zero at the mo, I did take multivitamins prior to the blood test but want to now follow the advice on this forum of taking specific vitamins separately.
I had suspected Hashimoto's (again after reading on the forum) so wasn't greatly surprised to see it confirmed.
Meant to ask SlowDragon the same question - should I get my vitamin levels optimal before I increase my Levo? If my calculation is correct I'm already taking a little over according to my weight. The GP did mention being cautious with regard to my size when I had my last increase.
If my calculation is correct I'm already taking a little over according to my weight.
Please do not make the mistake that dose must be by weight, it is not set in stone. That is only used, in some circumstances, as a guide to starting Levo when first diagnosed then adjustment is made as necessary for the individual. Some people need more, some need less. We just need what we need regardless of what we weigh.
should I get my vitamin levels optimal before I increase my Levo?
Your levels aren't dire, your ferritin is higher than mine has ever been without inflammation falsely raising it, your folate is good, your Vit D needs boosting (but summer is coming and you may naturally make Vit D from the sun so that may boost it) and you need testing for B12 deficiency, so if those were my results then no, in my non-medical opinion, I wouldn't wait, I'd increase Levo now.
Marvellous thank you I have a plan. I shall speak to my GP on Monday with a request to increase my Levo (hah!!) and test for B12 deficiency. I have looked at your useful info on vitamins and my goodness it's mind blowing isn't it? There is so much information that can get so confusing. Thank goodness we have this forum to share our knowledge and experience 😀
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