Another Medichecks set of results for your expertise please as my brain fog can't make sense of them.

[Murray58]

My TSH results through my GP swing from 0.03 mu/L to 8 mu/L over the years and back. In November 21 result was 0.0 mu/L and I was on 150/125 Levothyroxine alternate days. GP decided I should reduce dosage and put me down to 125 mg and retested in January when it came back as 0.1 mu/L so reduced me again to 100mg and in April I was retested and was 0.23 mu/L. I was not happy with the reduction without other testing but was refused further tests. So I did the Medichecks panel. I did 24 hours without Levothyroxine and a fasting morning test (11am as could not get an appointment for blood draw earlier). This is what has come back. Any advice would be very helpful. I am on low carb high fat way of eating. T2 diabetes in remission with HbA1c at 35 after 5 years without meds. Not totally gluten free but 98% and no symptoms of coeliac detected. Cholesterol is fine - agreed I did not need statins. I used thyroid.dopiaza.org/ to calculate the Thyroid test ranges.

TSH: 1.4 mU/l (Range 0.27 - 4.2) 28.75%

FT3: 3.45 pmol/l (Range 3.1 - 6.8) 9.46%

FT4: 17 pmol/l (Range 12 - 22) 50.00%

Ferritin 16.12 mg/L (Range 0-5)

Folate Serum 6.73 ug/L (Range 3.89-19.45)

Vitamin B12 – Active 81.3 pmol/L (Range 37.5-150)

Vitamin D 72 nmo/L (Range 50-200)

I also had the antibody tests done too Thyroglobulin Antibodies and Thyroid Peroxidase Antibodies but I am going to have them redone as the first is off the scale and I realised that I tested two weeks after an infection laid me low for three days so may well have impacted the numbers.

Medichecks doctor's report said my Thyroid levels are fine - but I have a range of under active symptoms that do not feel fine.

You are doing a great service to all of us Thyroid people. Thank you. I read other posts but I cannot translate their findings and the advice to my own circumstances.

[SeasideSusie Remembering]

Murray58

Ferritin 16.12 mg/L (Range 0-5)

Can you please check this. The range 0-5 is for the CRP test. So is this result for CRP or is it for Ferritin in which case the range is 13-150.

TSH: 1.4 mU/l (Range 0.27 - 4.2)

The percentage through range isn't useful for TSH. We hypos, generally, feel best when TSH is 1 or below.

FT3: 3.45 pmol/l (Range 3.1 - 6.8) 9.46%

This is very low in range.

FT4: 17 pmol/l (Range 12 - 22) 50.00%

Probably too low for some people on Levo only. Generally we hypos feel best when it's in the upper part of it's range, probably over 60%, maybe around 70% or even more is better for most of us.

Low T3 causes symptoms so all in all your results show that you could do with an increase in your Levo which should increase your FT4 which in turn should also increase your FT3.

Folate Serum 6.73 ug/L (Range 3.89-19.45)

This is quite low. Folate is recommended to be at least half way through it's range so that would be 12 plus with that range.

Vitamin B12 – Active 81.3 pmol/L (Range 37.5-150)

Not too bad but we generally say for Active B12 a level of 100 plus is the aim.

Vitamin D 72 nmo/L (Range 50-200)

On the low side. The Vit D Society and Grassroots Health both recommend a level of 100-150nmol/L with a recent blog post on Grassroots Health recommending at least 125nmol/L.

Do you take any supplements at all? All these levels need improving.

I realised that I tested two weeks after an infection laid me low for three days so may well have impacted the numbers.

We should wait a few weeks after any acute infection before testing because the infection may affect thyroid levels, it's not restricted to thyroid antibody levels.

[Murray58 in reply to SeasideSusie]

Yes I mixed it up Ferritin is 156.0 ug/L (Range 13-150. The 16.12 is the CRP HS (Range 0-5).

[Murray58 in reply to Murray58]

I took 4000 IU D3 + 100ug K2 every day all through winter and dropped to twice a week in the Spring. I am going to try and take your words and have a conversation if I can with my GP again. She said you can do a private test if you want but I can't interpret the results. I asked for an endo referral last year and she did it but it was refused and she was told she can handle it and not all patients have stable TSH as the thyroid fluctuates! From what you say though I may wait a few weeks and repeat the Medichecks test to see if the infection played a part. My first ever attack of gout in my big toe. Meanwhile I have some spare 25mg tablets

[SeasideSusie Remembering in reply to Murray58]

Murray58

Vitamin D 72 nmo/L (Range 50-200)

I took 4000 IU D3 + 100ug K2 every day all through winter and dropped to twice a week in the Spring.

Do you also take magnesium, another important cofactor of D3 (as well as Vit K2-MK7)? Magnesium helps the body convert D3 into it's usable form.

You may be able to make a decent amount of D3 naturally from the sun during the summer months (unless you already know that you're one of those people who don/t).

If this was my result I think I'd be continuing with your dose maybe 3-4 times a week and retest at the end of October to see whether you need to adjust dose for the winter.

For your sub-optimal B12 and low folate I would consider supplementing with a good quality bioavailable B Complex containing methylfolate and methylcobalamin (avoiding one that contains B12 as this can stop the body using the B12). Consider Thorne Basic B.

When taking B Complex we should leave this off for 3-7 days before any blood test as it contains biotin and this can cause false results.

[Murray58 in reply to SeasideSusie]

No I have not been taking magnesium but will and have made a note to buy some Thorne Basic B. Thank you and note the need to leave it for 3-7 days before tests.

[SeasideSusie Remembering in reply to Murray58]

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.

naturalnews.com/046401_magn...

drjockers.com/best-magnesiu...

[SeasideSusie Remembering in reply to Murray58]

Murray58

The 16.12 is the CRP HS (Range 0-5).

CRP is an inflammation marker. This results shows inflammation and I expect it's this high due to your recent infection (unless you have another condition which raises inflammation).

Ferritin is 156.0 ug/L (Range 13-150).

Ferritin will be raised when inflammation is present. Due to your CRP being so high I imagine your Ferritin is showing higher than your normal level would be so this result can't be interpreted as a true reflection of your normal ferritin level.

[Murray58 in reply to SeasideSusie]

Thank you - I think I am going to up my own dosage by 25mg to 125 and retest in 6 weeks. And load up on some B complex too and restart the Vit D/K2. I do have other autoimmune conditions which tend to be inflammatory so it is hard to tell what's what. May I come back with the next lot of results for your take again?

[SeasideSusie Remembering in reply to Murray58]

Yes, you are welcome to post any new results for comment 😊

[Murray58 in reply to SeasideSusie]

These?

Thorne Research - Basic B Complex - B Vitamins in Their Active Forms - 60 Capsules and

Thorne Research - Magnesium Citramate - Magnesium with Citrate-Malate

[SeasideSusie Remembering in reply to Murray58]

Yes to the Thorne Basic B.

Magnesium you need to check out the most suitable form for you by looking at the links in my other post.

[SlowDragon Administrator]

I am going to up my own dosage by 25mg to 125 and retest in 6 weeks. And load up on some B complex too and restart the Vit D/K2.

Good plan ….plus magnesium at least 4 hours away from levothyroxine

Do you always get same brand levothyroxine at each prescription

Suggest you go absolutely strictly gluten free too

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

Roughly where in U.K. are you

After next test likely ready to see thyroid specialist endocrinologist for T3 prescribed alongside levothyroxine

Email Thyroid U.K. for list of recommended thyroid specialist endocrinologist and doctors who will prescribe T3

[e-mail]

[Murray58 in reply to SlowDragon]

Hi SlowDragon, Thanks for your advice. The Levothyroxine is always Northstar. I did send for the email list some time ago. I am in Southampton and there is no-one very near and because of a blood cancer I am not travelling far at the moment - been shielding since March 20. Noted the timing re magnesium. Been reading the links from SeasideSusie and at least 3 of the types of magnesium would fit for me but will try Malate to start with - I could do with some energy.

[SlowDragon Administrator in reply to Murray58]

Beware Northstar 25mcg tablets are Teva

Whereas Northstar 50mcg and 100mcg are Accord

Some private endocrinologist in the list are still doing consultations on zoom so no need to travel

Will pm you