thyroid test results after a 25mg increase, could someone have a look for me ..

[Spoticus]

My results from Medichecks test done on 4th August & I will pop up previous results from 11th March underneath each result , all the same range . Unfortunately I waited a long time for an early appointment which was 9am but the lady & her baby ahead of me had some sort of problem & my test was not done until 9-38 am.last Levothyroxine the day before at 7am. I had been on 50mg for years & managed to get an increase to 75mg which I’ve been taking for around 12 weeks , so interested in your Thoughts on these results. I’d like to say I’m feeling fine but not a lot has changed & my Gp surgery is on it’s 3rd set of doctors all of which are locums & they apparently have 11 other surgeries to run so I’m not getting far with investigating my iron deficiency either.

CRP HS. 0-59 mg/L. 0-5

0-79

Ferritin 32-5 ug/L 13-150

23-8

Folate 3ug/L 3-89 - 19-45

7-13

B12 active 46-7 pmol/ L 37-5 - 150

47-8

Vitamin D 70nmol/L 50-200

53

TSH 0-27 mu/L 0-27 - 4-2

3-08

Free T3 5-05 pmol/L 3-1 - 6-8

4-58

FREE Thyroxine 17-7 pmol/L 12-22

16-9

Thyroglobulin Antibodies 18 iu/ml 0- 115

11

Thyroid Peroxide Antibodies <9 iu/ml <34

9

I didn’t do an iron panel this time as I’m trying to find out whether it’s my thyroid that’s responsible for all the Symptoms I have because when i research them it would seem Thyroid, B12 & iron Deficiency are very similar. Every doctor I have spoken to either doesn’t listen or wants to go back to starting point again, I’ve done 3 stool tests since last December all clear & I managed to get them to test for H pylori last week to make sure that hadn’t come back luckily it’s clear . One said if the test came back clear he’d refer me to Gastroenterologist, haven’t seen him since & another did an intrinsic factor test which came back normal, no sign of him since the last one did the C25 test for Cancer that was clear. They will not entertain B12 problem & because my ferritin is increasing they are happy with that and ignore the fact that haematology said my ongoing iron deficiency needs investigation. It’s Exhausting..

[Jazzw]

Well the good news is that the raise in levothyroxine has definitely improved your thyroid blood tests.

The test result that is strikingly poor is your ferritin level. It was already very low, it’s now lower. That’s not surprising given how undermedicated you previously were (for your hypothyroidism) but it’s going to need some help to rise a bit. One of the simplest things to try is taking daily vitamin C (it helps with absorption of iron from your diet). But you may want to consider some form of iron supplementation now

Your folate is coming up a bit but your B12 levels are rather low—an active B12 result should really be above 70 and yours is well below.

Has your doctor ever considered testing you for pernicious anaemia (that’s B12 deficiency anaemia, nothing to do with iron deficiency anaemia)? I suspect, just like your ferritin levels, the most likely culprit for low B12 levels will be being left on too low a dose of levothyroxine for too long, but supplementing might help get your levels up faster.

[Jazzw in reply to Jazzw]

Edited to add—actually, I’ve got your results the wrong way around. Your folate is in your boots now! What’s going on there?

[Spoticus in reply to Jazzw]

To be honest I’ve no idea what’s going on either, I have been taking one Ferrous fummerate daily since December as my ferritin was 7 at the time . I’ve taken it in the past as my ferritin seems to have consistently dropped since 2018 & the tablets cause Constipation when I take a higher dose . I did tell the Doctor that I had lots of Symptoms of B12 deficiency & asked for a test , he did intrinsic factor which came back negative. My problem is my GP surgery is not working right since Covid & is actually getting worse, local MP involved now .

[helvella Administrator in reply to Spoticus]

According to many posts on the Pernicious Anaemia Society forum, something like 50% of of Intrinsic Factor antibody tests are false negatives.

(Positives seem good and reliable.)

Therefore, it can take several IFab tests before a positive result is seen and a negative does not mean you do not have Pernicious Anaemia.

[Spoticus in reply to helvella]

I did read that but try telling the Doctor that! . It’s like talking to a brick wall . That’s why I want to make sure it’s not my hypothyroidism first x

[waveylines in reply to helvella]

And you may never test psoitive on intrinsc factor test Helvella despite being b12 d. That is also quite common. Symptoms and signs definately backed PA though. And b12 jabs made a massive difference.

[helvella Administrator in reply to waveylines]

Of course! I think we'll find multiple reasons for B12D which are not PA - as well as the test being imperfect.

[waveylines in reply to helvella]

I think mine is probably PA given at least the daily jabs I need and my medical history has a strong link to PA.......just the intrinisc test is rubbish!! 🤣😂

[SlowDragon Administrator]

Are these the most recent results

Ferritin 32-5 ug/L 13-150

Folate 3ug/L 3-89 - 19-45

B12 active 46-7 pmol/ L 37-5 - 150

Vitamin D 70nmol/L 50-200

TSH 0-27 mu/L 0-27 - 4-2

Free T3 5-05 pmol/L 3-1 - 6-8

FREE Thyroxine 17-7 pmol/L 12-22

Exactly what vitamin supplements are you currently taking

Looking at previous posts you had testing for Pernicious Anaemia …….

If Active B12 is 46 that’s EXTREMELY low

Folate at 3 below range

Ferritin extremely low

Are you vegetarian or vegan?

[Spoticus in reply to SlowDragon]

Hi Slow Dragon yes they are results from a week ago , i am taking 3000 vitamin D with K2 and iron tablets with Vitamin C . I have not taken any B12 as I was hoping to get tested and didn’t want to skew any results. Unfortunately the intrinsic factor test was negative so that stopped that in its tracks. I cannot seem to get anywhere , it doesn’t help that I have never spoken to or seen the same doctor twice . The only one that was concerned referred me to haematology in March after seeing my iron panel test from Medicheck but they referred me back to Gp for them to investigate. She left as well. I think I need to write to them with all my symptoms as they won’t discuss more than one thing at a time & hopefully they might look into it properly . What’s your thinking? I’m not a vegetarian and have been upping iron rich foods.

[SlowDragon Administrator in reply to Spoticus]

So low folate and B12

Ideally…get this advanced B12 test before starting any B supplements

Are you anywhere near London to go in person….if not I think they are now doing postal testing again (postal was suspended for a while recently)

nutris.viapath.co.uk/pages/...

Alternatively…..it’s likely that your low vitamins are because you were inappropriately left on ridiculously low dose levothyroxine

You could start supplementing to improve low B12 and folate with a daily vitamin B complex

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 start to 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 recommended vitamin B complex that contains folate, but they 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 continue separate B12

Eg Jarrow Methyl folate 400mcg

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 your 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...

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

If B12 levels don’t improve on supplements ….this is good Indicator of PA and you would then need injections

[SlowDragon Administrator in reply to Spoticus]

Keep working on low ferritin with lots of iron rich foods

Retest thyroid levels again in another 8-10 weeks

FT4: 17.7 pmol/l (Range 12 - 22) 57.00%

FT3: 5.05 pmol/l (Range 3.1 - 6.8) 52.70%

Currently very good conversion rate

Likely to see Ft4 reduce and TSH increase …..then be ready for next dose increase in levothyroxine in few weeks/months ….perhaps at 75mcg and 100mcg on alternate days initially

Approx how much do you weigh in kilo

[Spoticus in reply to SlowDragon]

I shall get myself weighed today and get back to you later x

[Spoticus in reply to SlowDragon]

I weighed myself and I’m 71. 8 kg bit of a shock, I knew I had put on weight all on my tummy unfortunately. The last time I was 62 kg . As I’ve been on the 75 mg now since April, would you suggest I go for another increase now ? Thankyou for the information I will try & get the B12 test you mentioned as I have more than a few of those Symptoms and some that do worry me ..

[SlowDragon Administrator in reply to Spoticus]

Yes

Request increase to 75mcg and 100mcg alternate days

Retest in another 6-8 weeks

[waveylines]

Definate room for a further increase of levo thyroxine and you are wise to optimise this. Your vit D level is low really.....best to get that up to around a 100 and that maybe partly to blame for fatigue and aching joint symptoms. Iron and b12 can be on the low side in untreated, under treated hypothyroidism and famous scottish doctor who I saw said they would come up once the thyroid is optimally treated. In my case he was right.....though a few years later my b12 bottomed and I ended up on b12 jabs for life. However we are all diffiernt and some people need support with thir iron as well.

Have you tried gluten free...... some people find that helps too. Im one of those who is gluten intolerant which has cuased gluten ataxia. It took over a year for my digestive track to recover.......just a thought. Your GP can test for coliacs but not gluten intolerance.....that has to be at one of the two centres in England. The tests are different to coliacs.

[Spoticus in reply to waveylines]

I shall try Gluten free & see if that helps and am hoping it is levothyroxine I need as it may be easier to get . B12 seems to be a Red Rag to Doctors lately.

[waveylines in reply to Spoticus]

Usually its best to follow it for 6months before deciding. Am afraid the breads etc are a lot more pricey...lol.

I've never understood why doctors are so scared of prescribing b12 jabs if you self inject. Its cheap as chips for them.....and can be life changing for those in need. Xx