Looking for any help interpreting latest test r... - Thyroid UK

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Looking for any help interpreting latest test results please.

HappyBadger profile image
13 Replies

Hi all,

I posted a bit ago with my last blood results and was told there was room to up a tiny bit of levo. I was feeling pretty rubbish so I told my GP I wanted to go from 100mcg to 125mcg. He was fine with it and so I stared taking 125 every night for two weeks but I felt absolutely awful. So I dropped down to 112.5 felt a bit better on it, sleeping a bit better but still feeling really tired and whenever I go for a walk by the time I get home I feel so ill. Got new bloods done this week and I also did a monitor my health private thyroid test too as I knew the GP one wouldn’t test T3. If someone can please have a look and give me any advice that would be brilliant.

I’ve been taking the same brand of Levo for about 6 years or so, did try other brands but didn’t agree with me. I also take vitamin sprays of D and also a B complete and I take a separate B12 tablet. I just can’t understand why my brain is so foggy and my energy levels are so low. If there is any kind of advice from anyone it would be greatly appreciated. Xx

These are the results from my GP

Serum vitamin B12 level 459 ng/L [197.0 - 771.0]

Serum folate level 3.3 ug/L [3.0 - 20.0]

Serum ferritin level 81 ug/L [13.0 - 150.0]

Serum TSH level < 0.05 mu/L [0.27 - 4.2

These are the results from Monitor my Health

TRIODOTHYRONINE

31/05/2022

4.3 pmol/L

FT3 levels normal (normal range 3.1 - 6.8 pmol/L)

THYROXINE

31/05/2022

20.2 pmol/L

FT4 levels normal (normal range 12 - 22 pmol/L)

THYROID STIMULATING HORMONE

31/05/2022

0.03 mu/L

TSH levels low (normal range 0.27 - 4.2 mU/L)

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SeasideSusie profile image
SeasideSusieRemembering

HappyBadger

Serum vitamin B12 level 459 ng/L [197.0 - 771.0]

Serum folate level 3.3 ug/L [3.0 - 20.0]

B12 still needs work so for now it may be a good idea to continue with the B12 supplement. Is it sublingual lozenge?

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 pg/ml to at least 450 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 pg/ml."

Folate definitely is very poor, which B Complex are you taking and how much methylfolate does it contain?

Did you leave off your B Complex for 3-7 days before the test?

Serum ferritin level 81 ug/L [13.0 - 150.0]

Appears good, but did you have an inflammation marker (eg CRP) done at the same time. Ferritin can be falsely raised if inflammation or infection is present.

TSH: 0.03 (0.27-4.20)

FT4: 20.2 (12-22) = 82% through range

FT3: 4.3 (3.1-6.8) = 32.43% through range

I just can’t understand why my brain is so foggy and my energy levels are so low.

Did you do the test as we advise:

* No later than 9am

* Water only before the test

* Last dose of Levo 24 hours before the test

* No biotin, B Complex or any other supplement containing biotin for 3-7 days before the test?

As long as test was done that way then results are as accurate as can be and show normal circulating amount of hormone.

Results show poor conversion of T4 to T3 and it's low T3 that causes symptoms.

All nutrient levels need to be optimal for good conversion to take place.

Vit D - 100-150nmol/L

B12 - top of range for Total B12 (Active B12 over 100)

Folate - at least half way through range (11.5+ with that range)

Ferritin - half way through range (but not falsely raised due to inflammation or infection)

Once you have optimised all nutrients if conversion is still poor then you may benefit from the addition of some T3 to a slightly lower dose of Levo.

HappyBadger profile image
HappyBadger in reply to SeasideSusie

Hi SeasideSusieThank you so much for your response.

The B12 I’m taking is from Holland & Barrett and are the, Timed Release Vitamin B12 Tablets 1000ug.

Do you think it would be better to go for a spray? Like the BetterYou Boost B12 oral spray 1,200μg .

The B complex I’m taking is the

BetterYou B-complete Oral Spray. I think it contains 100μg of methylcobalamin, is that the same as methylfolate? Sorry for sounding silly.

I didn’t have a inflammation marker test I had one last time but GP said normal.

I did my test at 8:15 and left 24hours after last dose of Levo. I stopped all vitamins 3 days before too.

I’ve only been taking supplements for around 12 weeks but since my last load of bloods taken my folate and ferritin has gone down. Not sure why that would’ve been.

I think I’ll persevere with the supplements for the next couple of months and re test I think.

Thank you sooooo much for shining a light for me it really does mean so much. X

SeasideSusie profile image
SeasideSusieRemembering in reply to HappyBadger

HappyBadger

The B12 I’m taking is from Holland & Barrett and are the, Timed Release Vitamin B12 Tablets 1000ug.

Do you think it would be better to go for a spray? Like the BetterYou Boost B12 oral spray 1,200μg .

Tablets aren't so well absorbed as sublingual lozenges or sprays. However, if you're level has improved from 302 to 459ng/L in 2 months then you might as well stay on them if you still have some left. Once your level has reached 550ng/L then it should be OK to just continue with a B Complex.

BetterYou B-complete Oral Spray. I think it contains 100μg of methylcobalamin, is that the same as methylfolate? Sorry for sounding silly.

No, methylcobalamin is B12. That spray contains folic acid and methylfolate is the better form. Folic acid has to be converted by the body to it's bioavailable form and not all of us do that efficiently. From the look of your results you're not getting much benefit from the folic acid in that spray and there's only 200mcg anyway. I would suggest you change to Thorne Basic B which has 400mcg methylfolate, I think you'll do much better on that. It raised my bottom of range folate level to top of range in 2.5 months with just 1 capsule daily.

I didn’t have a inflammation marker test I had one last time but GP said normal.

Normal just means that it's somewhere in range. There's a difference between an inflammation marker being at the bottom of range (no inflammation) to being at the top of the range (showing some inflammation).

HappyBadger profile image
HappyBadger in reply to SeasideSusie

Thank you I think I’m going to get the Thorne Basic B. And I’ll continue with the B12 until finished. Thank you SeasideSusie x

HappyBadger profile image
HappyBadger in reply to SeasideSusie

Just one other thing if you’ve got any advice please, is that two months ago I had a serum parathyroid hormone test done results were: (XE2xc) 2.8 pmol/L [1.6 - 6.9This time round my GP did calcium test which was:

Serum adjusted calcium concentration 2.13 mmol/L [2.2 - 2.6]

Serum calcium level 2.23 mmol/L [2.25 - 2.55]

I’m wondering if my parathyroid is starting to fail? As I’ve read somewhere that calcium levels fall when the parathyroid gland is failing. And I was thinking that’s why I feel so sluggish with muscle twitches and tiredness etc. Or am I just reading too much into nothing. Sorry for asking again.

SeasideSusie profile image
SeasideSusieRemembering in reply to HappyBadger

I'm afraid I know nothing about parathyroid, sorry.

HappyBadger profile image
HappyBadger in reply to SeasideSusie

No worries thank you

SlowDragon profile image
SlowDragonAdministrator

vitamin B12 level 302 ng/L [197.0 - 771.0]

Serum folate level 4.8 ug/L [3.0 - 20.0]

Serum ferritin level 98 ug/L [13.0 - 150.0]

Vitamins from 2 Months ago

B12 improving

Folate and ferritin dropping

Still No vitamin D result

What vitamin supplements are you currently taking

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) may be beneficial.

This can help keep all B vitamins in balance

Difference between folate and folic acid

chriskresser.com/folate-vs-...

B vitamins best taken after breakfast

Thorne Basic B or Jarrow B Right are recommended options that contains folate, but both are large capsules. (You can tip powder out if can’t swallow capsule)

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement and separate B12

HappyBadger profile image
HappyBadger in reply to SlowDragon

Hi SlowDragon, thanks for your reply.The B12 I’m taking is from Holland & Barrett and are the, Timed Release Vitamin B12 Tablets 1000ug.

The B complex I’m taking is the BetterYou B-complete Oral Spray. I did do a private vitamin D test with Monitor my Health which was :

91 nmol/L that was done a month ago.

Do you think that I’d be better off with the

Thorne Basic B or Jarrow B Right ?

Thank you so much for your help x

SlowDragon profile image
SlowDragonAdministrator in reply to HappyBadger

Do you think that I’d be better off with the

Thorne Basic B or Jarrow B Right ?

Yes.

Available online

HappyBadger profile image
HappyBadger in reply to SlowDragon

Brilliant thank you just ordered some 👍🏻

pennyannie profile image
pennyannie

Hello HappyBadger :

The accepted conversion ratio when on T4 - Levothyroxine only is said to be 1 - 3.50 - 4.50 - T3/T4 : with most people feeling at their best when their conversion comes in a around 4 or under.

So to find your conversion ratio you simply divide your T3 into your T4 and I'm getting yours coming in at around 4.7 showing you slightly outside of where most people feel ' better ' served when on T4 - Levothyroxine.

Conversion can be compromised by non optimal vitamins and minerals as already detailed, inflammation, any physiological stress ( emotional or physical ) depression, dieting and ageing.

Obviously having Hashimoto's throws another spanner in the works as your gland is likely to become further damaged and less productive as this disease progresses.

Longer term, you'll probably need to be looking at taking full spectrum thyroid hormone replacement to compensate for that lost when your gland becomes fully disabled.

HappyBadger profile image
HappyBadger in reply to pennyannie

Thank you so much for this. I really need to start reading up on it all. Thanks again xx

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