I've just had my latest Medichecks results and I wonder if you could advise as my symptoms (mood, motivation, sleep) are still not great. I followed the protocol (early test, no T4 for 24 hours, fasting, no biotin). My TSH has gone from over to low normal, fT4 slightly over and fT3 still middle of the range. Vitamin D has gone up to a healthy value.
I have some T3 (5 and 20) I can add as an experiment - what are your thoughts?
The results also include Testosterone results which seem to suggest I'm doing fine (it was low in previous tests). I shall pass these results to a TRT clinic, but I think they are OK. That's a blessing as TRT is lifelong, expensive (and seems to need regular injections), but it's also a shame as it's not an answer to my symptoms!
I hope my spreadsheet makes sense, the ranges are the same for all dates. Many thanks to you all x
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Decant
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On the face of it this looks like poor conversion. However, optimal nutrient levels are needed for good conversion and
Ferritin: 139 (30-400)
Ferritin is recommended to be half way through range and yours is 29.5% so this could be improved.
Folate: 5.72 (>3.89)
Medichecks range is 3.89-19.45. Folate is recommended to be at least half way through range which would be around 12 plus so this could be improved.
Active B12: 70.8 (37.5-150)
As a level below 70 suggests testing for B12 deficiency, and you're only just over that, and we suggest over 100 for Active B12, this level could do with improving.
Vit D: 121nmol/L
This is nicely within the range recommended by the Vit D Council, Vit D Society and Grassroots Health, i.e. 100-125nmol/L, so you need to maintain this level.
Apart from Vit D all the other nutrients are too low and my suggestion would be to optimise them before considering adding T3.
However, if you want to experiment then I would reduce Levo by 25mcg to get your FT4 down into range then a couple of weeks later add in 5mcg T3. Wait 8 weeks and retest, but work on nutrient levels at the same time. I wouldn't go higher at this stage because optimising your nutrient levels may help conversion. Just my opinion, others may say different.
I can't comment on your sex hormones, nor your serum cortisol/DHEA results I'm afraid.
No, I'm afraid not. Iron is complicated. You'd need to have an iron panel to see where your serum iron, saturation and total iron binding capacity lie as well as ferritin. I doubt very much that you have iron deficiency, the iron panel will tell you that. If you have good serum iron and saturation then taking iron tablets is the last thing you'd need because they would raise these levels and could lead to toxicity. I'm sure you just have lowish ferritin.
You can help raise your level by 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
I shall also do as you suggest about the T3, and then retest in 2 months, maybe 3 as it's getting expensive!
If all you want to do is check TSH, FT4 and FT3 then the cheapest is £26.10 which is a home fingerprick with Monitor My Health, an NHS lab at Exeter Hospital which offers this to the general public. It's the one I use for a basic test, then once a year I do a full thyroid/vitamin panel to check everything.
When interpreting iron panel results we tend to refer to optimal levels as suggested by rt3-adrenals.org/Iron_test_... which are:
Serum iron: 55 to 70% of the range, higher end for men - yours is 56%
Saturation: optimal is 35 to 45%, higher end for men - yours is 38%
Total Iron Binding Capacity (TIBC): Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 35% so at the lower end of the range
So your results don't show the need for iron supplements, you just have low ferritin.
I'll be organising another round of the same blood tests soon. I stopped B complex last week in anticipation of this.
Biotin only needs to be stopped for 3-7 days before a blood test, 7 days is for high dose found in stand alone supplements, hair/nail supplemnts, etc, and that would be around 5mg or 10mg.
The amount in a B Complex is usually around 400-500mcg so 3-4 days is enough. Folate can drop quite quickly if you need it to improve or maintain your level, so I personally wouldn't leave my B Complex off for any longer than is necessary.
Can those (in-range but low) iron numbers explain low energy, low motivation, brain fog, etc?
I wouldn't have thought so (but can't guarantee it), they're basically good apart from what might be classed as low ferritin, but even so my 49 year old son's ferritin level is 71 (15-300) and he doesn't have any symptoms of fatigue, etc, even though he has a very physical job. As always, it's down to the individual. I would go full steam ahead on iron rich foods if you want to try and raise your ferritin level. You can have up to 200g liver per week (no more due to high Vit A content).
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