Help needed with results : Hi everyone I’m back... - Thyroid UK

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Help needed with results

jm2450 profile image
29 Replies

Hi everyone I’m back again and more worried. Recent results are showing things may be more worrisome than just my thyroid. Can anybody help interpret what may be going on here? I’m mostly worried about the folate and the iron.

My iron is showing as 207 ug/L (13-150)

And my folate is is 3.36 (>3.89) but I have been taking a folate supplement for about 2 months? I’m so confused. I’ve been suffering from palpitations and stomach pains which I’m now wondering if it’s related to iron being high?

My thyroid test came back as -

TSH 2.61 (0.27-4.2)

T4 16.8 (12-22)

T3 4.09 (3.1-6.8)

Currently on 62.5 Levo. I’m worried about the folate and iron. Why would I not have gone up at all in folate?? How is this treated? And why is my iron so high? Please help :(

29 Replies
jm2450 profile image
jm2450

Just to add, I have been supplementing with methyl folate not folic acid. Which is why I don’t understand my results coming back lower than a few months ago.

greygoose profile image
greygoose in reply to jm2450

Have you been taking a B complex? Or just the methylfolate? The Bs all work together, so they need to be kept balanced.

Did you get your CRP and ferritin tested at the same time as the iron?

jm2450 profile image
jm2450 in reply to greygoose

I’ve just been taking methyl folate by itself. My CRP is 3.37 which has gone up (0-5). Sorry it was my ferritin that came back as 207 ug/L. Is that not iron?

greygoose profile image
greygoose in reply to jm2450

Ferritin is a protein that stores iron. Serum iron is a separate test. Your CRP is in-range but highish. And, your ferritin isn't that high, so there could be a connection. I wouldn't worry about it unless it goes higher.

Try taking a B complex that contains methylfolate. Thorne do a good one: Thorne Basic B.

jm2450 profile image
jm2450 in reply to greygoose

Ahhh okay. Why did medichecks tell me that my iron is high!? If they only test Ferritin?My last results from June 2021 iron related with the NHS was -

Serum ferritin - 164 (10-204)

Serum Transferrin - 2.26 (1.80-3.82)

Transferrin Saturation 15.85 (16-45)

Would you say I need to get a full iron panel retest?

And if I take a B complex does that usually deliver methyl folate more effectively? My folate has actually gone down and I’ve been supplementing every day.

greygoose profile image
greygoose in reply to jm2450

I'm not an expert on iron - it's a very complicated subject. I see your Transferrin Sturation is below range, so something could be up. Hopefully, someone who knows more about it will come along and help - humanbean ?

You can only try with the B complex, see what happens - maybe you didn't get a very good one? Or maybe you were taking it with something that blocked absorption?

jm2450 profile image
jm2450 in reply to greygoose

Only other thing I was taking was vitamin D. I was taking the methyl folate sublingually though usually with water. Maybe that’s a problem I don’t know…..Maybe I should get a full iron panel done at the GPs.

greygoose profile image
greygoose in reply to jm2450

If the methylfolate didn't say it was specifically designed to be taken sublingually, then that might have been a problem, yes.

It certainly wouldn't hurt to get a full iron panel, if you can. :)

jm2450 profile image
jm2450 in reply to greygoose

It was liquid form of methyl folate so sublingual. Have managed to get a full iron panel booked in! But re the folate they have no idea as usual!

greygoose profile image
greygoose in reply to jm2450

I have no experience with liquid folate - didn't even know it existed! Doesn't seem very efficatious, does it! :) Try the B complex and see what happens.

jm2450 profile image
jm2450 in reply to greygoose

It’s either not very efficacious or is it possible my body can’t absorb it? Although it seems to absorb other supplements so I’m not sure that’s the case. My B12 is okay. Vitamin D has also come up. So not sure on the folate. I will try a B complex and see if any effect and see what the iron panel brings out if anything. How come you don’t think it’s very high? The medichecks woman scared the hell out of me saying I need to get all sorts checked 😂

greygoose profile image
greygoose in reply to jm2450

Yes, I think they get a kick out of scaring the hell out of people - or maybe they're just covering their backs, just in case. Thing is, you can't just take one result of anything in isolation. There's always something else that needs to be taken into consideration to get the full picture. With ferritn, that something else is CRP levels, and yours is on the high side. CRP is an inflammation marker, and high levels of inflammation are known to raise ferritin levels. Get your thyroid optimised, the inflammation should drop and so will the ferritin.

I've never heard of anybody who just couldn't absorb folate. But, trying another form of it will give more infomation.

jm2450 profile image
jm2450 in reply to greygoose

If thyroid is optimised does inflammation lower because thyroid is less inflamed? How does it impact inflammation in that way? Sorry just trying to understand! Is Hashimotos not inflammatory in itself?

greygoose profile image
greygoose in reply to jm2450

Well, any infection is inflammatory. But CRP is non-specific. It doesn't tell where the inflammation is, just that there is some. I'm afraid I can't tell you much more than that.

jm2450 profile image
jm2450 in reply to greygoose

Thank you for your help!

greygoose profile image
greygoose in reply to jm2450

You're welcome. :)

SlowDragon profile image
SlowDragonAdministrator in reply to jm2450

Low transferrin saturation

forthwithlife.co.uk/our-ser...

High ferritin levels can be deceiving…..often high due to inflammation

Iron can be low

SlowDragon profile image
SlowDragonAdministrator

FT4: 16.8 pmol/l (Range 12 - 22)

Ft4 only 48.00% through range

FT3: 4.09 pmol/l (Range 3.1 - 6.8)

Ft3 only 26.76% through range

thyroid.dopiaza.org

Results show you are under medicated

Most people when adequately treated will have Ft3 at least 50% through range

Vitamins are low because you are not on high enough dose levothyroxine

Why are you on such low dose levothyroxine?

Approx how much do you weigh in kilo

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

jm2450 profile image
jm2450 in reply to SlowDragon

So if thyroid is not optimal you don’t absorb vitamins or something? Or does it lower vitamins? I am going to increase to 75 but I’ve been scared to as having a lot of palpitations which are now being investigated with heart monitor. I guess I still have this thing about getting too much but I guess palpitations can be from undermedication too?

SlowDragon profile image
SlowDragonAdministrator in reply to jm2450

When hypothyroid (or on too low a dose levothyroxine) we frequently develop LOW stomach acid, this leads to poor nutrient absorption and low vitamin levels as direct result

Are you male or female and approx age and weight in kilo

Which brand of levothyroxine are you currently taking

Many people find they can’t tolerate Teva brand

Try splitting your levothyroxine dose…50mcg at bedtime and 25mcg waking….or vice versa

Palpitations can often be due to being under medicated

How low was vitamin D

How much vitamin D are you currently taking

Are you also taking magnesium supplement…..must be minimum 4 hours away from levothyroxine….best taken immediately after dinner….assuming taking levothyroxine at bedtime

jm2450 profile image
jm2450 in reply to SlowDragon

Female, 36, approx 100kg. I’m currently taking Accord. Take my dose in the morning at the minute. My vitamin D was 20 nmol/L back in April which is deficient, it is now 53 nmol/L. I take vitamin D + K in the morning. I use magnesium oil in the evening 200mg. Does splitting dose help with palps? I am having full iron panel done now as want to see what’s going on. But I fear they will have no clue as usual! I’m still also clueless as to why methyl folate supplement hasn’t appeared to have any effect…. I guess because it needs to be in a B complex capsule form?

SlowDragon profile image
SlowDragonAdministrator in reply to jm2450

So vitamin D was extremely deficient

Did GP prescribe a total of 300,000iu over 6-8 weeks

Aiming for vitamin D at least around 80nmol minimum and around 100nmol maybe better

Low folate

….it’s important to supplement all B vitamins together

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 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

jm2450 profile image
jm2450 in reply to SlowDragon

With the MTHFR gene, what is the way around this? If it’s supplementing with methyl folate then that’s what I’ve been doing and no luck! Obviously I don’t know if I have the gene. Maybe the way I was taking the folate didn’t work for me and like another poster pointed out I wasn’t taking B12 with it.

SlowDragon profile image
SlowDragonAdministrator in reply to jm2450

Low vitamins are because you are not on high enough dose levothyroxine

Exactly what vitamin supplements are you currently taking

Which folate supplement

As I have already said ….we need a good quality vitamin B complex that has all B vitamins in it

jm2450 profile image
jm2450 in reply to SlowDragon

Im currently taking better you vitamin d and k 3000, I use better you magnesium oil as I also have leg pain/restless legs so that’s 200mg, and I am taking bio me methyl folate liquid supplement 400 which clearly hasn’t had any effect at all on my folate level. I intermittently take sublingual b12 because my b12 is fairly high so didn’t want to take too much.

jm2450 profile image
jm2450 in reply to SlowDragon

Checked out my MTHFR genes today on my 23andme and I only have one Heterozygous gene, so it seems my ability to covert folate may be slightly diminished but not much

SlowDragon profile image
SlowDragonAdministrator in reply to jm2450

Your on extremely small dose levothyroxine for your weight

Likely to need several further increases in levothyroxine over coming months

Jazzw profile image
Jazzw

Have you been taking B12 too? I think the body uses up quite a lot of folate while making use of B12.

How much methyl folate have you been taking?

I wonder too whether you’re still at the stage where your gut is recovering from being hypothyroid. Being hypothyroid reduces the ability of your gut to absorb vitamins and minerals, from food as well as supplements. So it might be that it’s just going to take a bit longer for your body to absorb all that it needs.

jm2450 profile image
jm2450 in reply to Jazzw

No I haven’t been taking b12 as my b12 was okay and fairly high. But if I should be taking them all together maybe that’s why folate level hasn’t moved….. I’ve been taking 400mcg a day apparently…… in sublingual form which I always thought was better absorption?? Clearly not! It may be that my gut is recovering I don’t know. I have had some gut issues over the last few months on and off but nothing ever been resolved with it!

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