my daughter had been taking armour for over 10 years , levo made her poorly!
she has had this full test done but the foliate and ferritin needs to be done again ,, She is taking 1 grain in the morning and 1 in the eve ,,, I’m thinking her t3 is a bit bottom and tsh ! Would really appreciate your thoughts ,,Dr not interested ,, she is on her own it feels !
Val-55
Presumably she didn't take any supplement containing biotin before the test (B Complex, hair/nail supplement, etc)?
Did your daughter take her Armour the day before the test as we advise, ie last dose 8-12 hours before the test? I can see that she splits it but the time of the last dose should be adjusted the day before if necessary.
Assuming that it was close the time we advise then it looks like she is undermedicated.
One might expect a suppressed TSH when on NDT (but it's not compulsory 
) and we can see that it's low in range.
However, her FT4 is below range and because there is T4 in Armour we'd expect to see the FT4 level in range.
FT3 is lower than expected if optimally medicated on Armour, one would expect to see it in the upper part of the range.
However, we are all different as to where we feel optimally medicated so really it depends on whether she feels well on this dose with these results. Don't go by numbers, go by how one feels. As long as FT3 stays in range then that should be OK.
Her raised TPO antibodies confirm Hashi's, presumably she knows this? She could, of course, be going through a Hashi's hypo swing at the moment.
Vit D is just about OK at 99nmol/L, the Vit D Council, Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L and with the summer being here she may top up her level naturally. She should test Vit D again at the end October to see if she needs to supplement during the winter.
B12: 222pmol/L = 300.81pg/m.
This is very low.
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."
Does she have any signs of B12 deficiency – check here:
b12deficiency.info/signs-an...
b12d.org/submit/document?id=46
If she does then list them to discuss with her 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.
Folate and Ferritin - are they sending out a new test kit for these? Very important that these are tested. Folate works with B12 and a good ferritin level is necessary for thyroid hormone to work properly.
Thankyou for reply , oh dear yes she was taking a b complex with biotin has that recked the test somehow ?
Val-55
The biotin it contains causes false results when biotin is also used in the testing procedure and most labs do. As it's a Blue Horizon test I expect the testing lab was Eurofins County Pathology and they do use biotin.
It has been discussed on the forum before where Medichecks has given information about this. Medichecks also use Eurofins County Pathology to carry out the tests. They have given a couple of conflicting answers:
Because biotin is an ingredient used in many lab hormone test kits this can interfere with the measurement of thyroid hormones
It does this in an inconsistent way, causing falsely elevated results from some labs, and falsely low results from others. We recommend stopping biotin for one week prior to blood tests.
and I queried it with them and they answered:
I have discussed your query with our medical director he has advised the below:
Biotin supplements.
Biotin can affect the results of any test which relies on antibodies to perform the measurement. It is wise to assume that any hormone or vitamin test will be affected, which means that the majority of our test panels can be affected by biotin supplements.
The issue with Biotin only affects people who take high dose biotin supplements. The manufacturers of the laboratory tests define this as 5000 mcg per day or more.
We are recommending people do not take high dose biotin supplements for 24 hours prior to having their blood drawn.
If they are taking high dose biotin for medical reasons (e.g. multiple sclerosis) then a shorter washout period of 8 hours can be used.
Then there is this:
thyroid.org/patient-thyroid...
biotin use can result in falsely high levels of T4 and T3 and falsely low levels of TSH
So all we know is that biotin can affect results, we're not sure exactly how, but it would seem that low dose biotin (about 400mcg) such as in a B Complex is probably best left off for about 3 days or more, and high dose biotin such as in a stand alone supplement or hair/nail supplement (5-10mg) is best left off for a week.
However, whichever way her results may be a bit inaccurate, I doubt it would make much difference to the fact that she is likely to be undermedicated BUT when did she take her last dose of Armour before the test - as in number of hours - that will have an effect on her FT4/FT3 levels, and how does she feel?
Thanks for your reply ,, she took armour 1i grain at 4pm previous day ! She will get the foliate and ferritin done first then I will re post ,,, looks like she needs to up a bit along with B12 probably . Armour has got so expensive ,,, and the alternative brands don’t seem to be about any more and have quality issues it seems 😳Really appreciate your advice Thankyou
Val-55
she took armour 1i grain at 4pm previous day !
So how many hours before the test? Presumably longer than 12 hours so a false low FT3.
looks like she needs to up a bit along with B12 probably .
She needs to check signs/symptoms of B12 deficiency and get tested for B12 deficiency and pernicious anaemia before doing anything about supplementing B12 - she may need B12 injections. Many people with B12 in the 300s have been found to need B12 injections.
Also she needs to stop the B Complex as continuing with this will mask signs of B12 deficiency.
After further testing for B12 deficiency she either needs B12 injections or B12 suppement and then she can restart the B Complex.
She is taking vitality b complex !
This one?
vitaminexpress.org/uk/vitam...?
Each capsule contains
2,2 mg Vitamin B1 (as Thiamine-HCI) [Thorne Basic B 110mg]
2,8 mg Vitamin B2 (as Riboflavin-5-Phosphate) [Thorne 10mg]
32 mg Vitamin B3 (as Niacinamid) [Thorne 130mg + 10mg Niacin]
12 mg Vitamin B5 (as Pantothenic Acid) [Thorne 110m g]
2,8 mg Vitamin B6 (as Pyridoxal-5-Phosphate) [Thorne 10mg]
5 mcg Vitamin B12 (as Methylcobalamin) [Thorne 400mcg]
150 mcg Biotin [Thorne 400mcg]
400 mcg Folate (as Quatrefolic®) [Thorne 667mcg DFE giving 400mcg]
So although the Vitality B Complex contains the correct bioavailable forms of active ingredients, you can see how little amounts there are compared with Thorne Basic B.
No she is not vegan but has been taking a b complex ,, biotin ,, this messes it up ? Took armour day before ! Thankyou
Exactly which vitamin B complex?
Her B12 is far too low
She needs to be taking a separate B12 supplement as well
supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)
This can help keep all B vitamins in balance and will help improve B12 levels too
Difference between folate and folic acid
chriskresser.com/folate-vs-...
Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.
thyroidpharmacist.com/artic...
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 she stops vitamin B complex, she might want to consider taking a separate methyl folate supplement and definitely continue separate B12
Low B12 symptoms
b12deficiency.info/signs-an...
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex (to balance all the B vitamins) initially for first 2-4 months.
once serum B12 is over 500 (or Active B12 level has reached 70), stop the B12 and just carry on with the B Complex.
B12 sublingual lozenges
amazon.co.uk/Jarrow-Methylc...
cytoplan.co.uk/shop-by-prod...
healthunlocked.com/thyroidu...
High thyroid antibodies confirms autoimmune thyroid disease also called Hashimoto’s
Is she on strictly gluten free diet
Thankyou for your advice . She is taking vitality b complex ! We will get the ferritin and foliate re done , leaving off all b complex then look at increasing armour a little and add b12 ,, does a low ferritin usually mean b12 levels low too ? Regards Val
This one, Val-55? If so, it doesn’t seem to have particularly high amounts of B vits in it. Which might be why her B12 levels are rather low.
Not sure that the Biotin amount will have been enough to have affected the test much either (if this is the brand of B vits).
So it could just be she needs a raise in Armour dosage.
Thankyou for your reply ,,, yes doesn’t look like much biotin in it ,,, she is getting her iron panel redone then will address raising her armour a bit ,,, how much should she use half grain ,,? Then test again or not ?
Have Hashimoto’s; can anyone help with recent iron blood tests please? 
Advice on recent blood test results
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Recent Test Results Advice Please 
