Blood results : Might anyone have any thoughts... - Thyroid UK

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Blood results

Quinc profile image
9 Replies

Might anyone have any thoughts please? Do I need to act on these results?

Fresh blood results all normal although I am still suffering from daily fatigue and brain fog.

I am currently on Levo 25 - reduced from 50 last year as I was having heart flutters.

TSH 2.57 mU/L normal [down from 4.55 Feb 1st]

Serum T4 level 10.7 pmol/L normal

I had asked for B12 and Vit D but were not included.

They did a full blood count including potassium, sodium and creatinine .. all normal.

Does this suggest I might try and change anything? Might fatigue etc be something else entirely?

Thanks so much for any thoughts ... these results are on patient access but not explained in person.

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Quinc profile image
Quinc
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9 Replies
SeasideSusie profile image
SeasideSusieRemembering

Quinc

We need reference ranges for your results please, we can't interpret them without as ranges vary from lab to lab.

We do know that your TSH is probably too high, generally hypo patients feel best when TSH is arond 1 or below but we have no idea whether your FT4 is low in range, below range, mid range or whatever. From most ranges we see on the forum it's either low in range or below range but you need to confirm the range for us to be sure. However, just looking at your TSH and your symptoms tells us you are likely to be undermedicated and in need of a dose increase. 25mcg is a starter dose and if 50mcg is too much then increase gradually in small increments, eg 6.25mcg or 12.5mcg at a time.

I suggest you ask for ferritin to be tested, or an iron panel, low levels bring their own symptoms which can be similar to hypo symptoms, and we need a good level of ferritin for any thyroid hormone to work properly.

Quinc profile image
Quinc in reply toSeasideSusie

Thanks & apologies… I am still only coming to terms with all these figures ….

The TSH range they suggest as normal is 0.30 - 4.20 ( mine is currently 2.57)

The Serum T4 normal is between 9.0 - 23.0 ( mine is 10.7)

The serum Ferritin is 194 Ug/L … they suggest normal is between 20 - 300.

Much appreciated…. Q

SeasideSusie profile image
SeasideSusieRemembering in reply toQuinc

Quinc

So FT4 is only 12.14% through range which is extremely low. This result, along with your TSH plus fatigue and brain fog all point to undermedication so you need an increase. As I said, because you experienced palpitations on 50mcg you could take it slowly with your increases. However, palpitations can be a symptom of hypothyroidism so maybe your were undermedicated on 50mcg and would have eventually settled given time and the right dose of Levo.

Ferritin is good providing that there is no inflammation. CRP is always helpful when tested at the same time as ferritin as CRP is an inflammation marker and ferritin rises with inflammation.

Quinc profile image
Quinc in reply toSeasideSusie

Thank you. Does seem like I need to up the Levo (sadly) … would it be ok to take 25 last thing at night and 25 first thing in the morning?

SeasideSusie profile image
SeasideSusieRemembering in reply toQuinc

No problem as long as it's one hour before or two hours after food and water only for an hour before taking your dose, 4 hours away from Vit D, calcium, magnesium, iron, HRT, PPIs, and 2 hours away from any other medication, so that nothing interfere's with Levo's absorption.

SlowDragon profile image
SlowDragonAdministrator

Highly unlikely to find 25mcg dose levothyroxine high enough

How old are you approx and roughly how much do you weigh in kilo

Standard starter dose of levothyroxine is 50mcg and dose is typically increased slowly upwards in 25mcg steps over 6-12 months until on full replacement dose

Levothyroxine doesn’t top up failing thyroid it replaces it

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Do you always get same brand levothyroxine at each prescription

For full Thyroid evaluation you need TSH, FT4 and FT3 plus both TPO and TG thyroid antibodies tested.

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

Low vitamin levels are extremely common, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)usually diagnosed by high thyroid antibodies

Have you had thyroid antibodies tested

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. Both are autoimmune and generally called Hashimoto’s.

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally before 9am last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks has 20% off if order before 31st May

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins by DIY fingerprick test

bluehorizonbloodtests.co.uk...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

About 90% of all primary hypothyroidism in Uk is due to autoimmune thyroid disease .

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

List of hypothyroid symptoms

thyroiduk.org/if-you-are-un...

Come back with new post once you get results

Quinc profile image
Quinc in reply toSlowDragon

Many thanks … I’ll get a private test done then.I am around 80 kilos and 69 years old vegetarian and active

SlowDragon profile image
SlowDragonAdministrator in reply toQuinc

What vitamin supplements are you currently taking

As vegetarian you presumably take B12 and/or vitamin B complex daily

Remember to stop taking any vitamin supplements that contain biotin a week before all blood tests- eg vitamin B complex

As vegetarian it’s extremely difficult to maintain GOOD iron and ferritin results

SlowDragon profile image
SlowDragonAdministrator in reply toQuinc

Optimal vitamin levels are

Vitamin D at least around 80nmol

Serum B12 at least 500

Active B12 at least 70

Folate and ferritin at least half way through range

Come back with new post once you get results

Only do private testing early Monday or Tuesday morning, ideally before 9am and last dose levothyroxine 25 hours before test

Palpitations are frequently linked to low iron/ferritin

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