I have recently taken a private blood test and have therefore not spoken with my GP yet but have got the results back. I haven’t felt right for a while and suspected thyroid issues. Any interpretation would be greatly appreciated as I have no real idea on if these are ‘good’ or ‘bad’ results and would love an indication to work out if this is something worth pursuing with my GP or not:
So it sounds as though you are suspecting a possible thyroid problem rather than you have a diagnosis.
We always advise thyroid tests be done as follows:
* Book the first appointment of the morning, or with private tests at home no later than 9am. This is because TSH is highest early morning and lowers throughout the day.
In fact, 9am is the perfect time, see first graph here, it shows TSH is highest around midnight - 4am (when we can't get a blood draw), then lowers, next high is at 9am then lowers before it starts it's climb again about 9pm:
If we are looking for a diagnosis of hypothyroidism, or looking for an increase in dose or to avoid a reduction then we need TSH to be as high as possible.
* Nothing to eat or drink except water before the test - have your evening meal/supper as normal the night before but delay breakfast on the day of the test and drink water only until after the blood draw. Certain foods may lower TSH, caffeine containing drinks affect TSH.
* If you take Biotin or a B Complex containing Biotin (B7), leave this off for 7 days before any blood test. This is because if Biotin is used in the testing procedure it can give false results (most labs use biotin).
These are patient to patient tips which we don't discuss with phlebotomists or doctors.
Free thyroxine (FT4) = 18.9pmol/L (12-22) = 69% through range
Thyroxine (T4) = 132nmol/L (66-181) - not a particularly useful test, it's the FT4 test that is the better test
Triiodothyronine (FT3) = 5pmol/L (3.1-6.8)= 51.35% through range
A normal healthy person with no thyroid condition would generally have TSH no higher than 2, often around 1, with FT4 around mid-range-ish. None of us are tested in health for a baseline so we don't know what's normal for us; however, you have a low in range TSH (good) and FT4 is well over mid-range (good) so these results aren't suggesting any thyroid problem.
Your antibodies are well within range so don't suggest autoimmune thyroid disease (known to patients as Hashimoto's.
Vitamin D = 51nmol/L (50-120)
This is a poor result, just one point into the "adequate" category. However, The Vit D Society and Grassroots Health recommend a level of 100-150nmol/L, with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L.
As you are in the adequate category your GP is unlikely to prescribe anything but you are better off dealing with this yourself anyway.
You might want to check out a recent post that I wrote about Vit D and supplementing:
and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.
Your current level of 51nmol/L = 20.4ng/ml
On the Vit D Council's website you would scroll down to the 3rd table
My level is between 20-30 ng/ml
The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).
So now you look at how much is needed to reach 50ng/ml and you'll see that they suggest 3,700iu per day.
Bearing in mind that your only 20.4 you could also look at the 2nd table for current level between 10-20ng/ml and you'll see that one suggests 4,900iu D3 daily.
You should be perfectly OK to supplement with 4,000iu D3 daily and you could take 5,000iu if you wish
Retest after 3 months.
Once you've reached the recommended level then a maintenance dose will be needed to keep it there, which may be 2000iu daily, maybe more or less, maybe less in summer than winter, it's trial and error so it's recommended to retest once or twice a year to keep within the recommended range. This can be done with a private fingerprick blood spot test with an NHS lab which offers this test to the general public:
Doctors don't know, because they're not taught much about nutrients, but there are important cofactors needed when taking D3. You will have to buy these yourself.
D3 aids absorption of calcium from food and Vit K2-MK7 directs the calcium to bones and teeth where it is needed and away from arteries and soft tissues where it can be deposited and cause problems such as hardening of the arteries, kidney stones, etc. 90-100mcg K2-MK7 is enough for up to 10,000iu D3.
D3 and K2 are fat soluble so should be taken with the fattiest meal of the day, D3 four hours away from thyroid meds if taking D3 as tablets/capsules/softgels, no necessity if using an oral spray.
For D3 I like Doctor's Best D3 softgels, they are an oil based very small softgel which contains just two ingredients - D3 and extra virgin olive oil, a good quality, nice clean supplement which is budget friendly. Some people like BetterYou oral spray but this contains a lot of excipients and works out more expensive.
90-100mcg K2-MK7 is enough for up to 10,000iu D3.
For Vit K2-MK7 my suggestions are Vitabay, Vegavero or Vitamaze brands which all contain the correct form of K2-MK7 - the "All Trans" form rather than the "Cis" form. The All Trans form is the bioactive form, a bit like methylfolate is the bioactive form of folic acid.
Vitabay and Vegavero are either tablets or capsules.
Vitabay does do an oil based liquid.
Vitamaze is an oil based liquid.
With the oil based liquids the are xx amount of K2-MK7 per drop so you just take the appropriate amount of drops.
They are all imported German brands, you can find them on Amazon although they do go out of stock from time to time. I get what I can when I need to restock. If the tablet or capsule form is only in 200mcg dose at the time I take those on alternate days.
If looking for a combined D3/K2 supplement, this one has 3,000iu D3 and 50mcg K2-MK7. The K2-MK7 is the All-Trans form
Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.
Magnesium is calming so it's probably best to take in the evening rather than risk getting sleepy during the daytime or when driving to or from work.
Active B12 = 70pmol/L (37.5-150)
Active B12 below 70 suggests testing for B12 deficiency according to Viapath at St Thomas' Hospital. As you are at that level, just check to see if you have any signs/symptoms of B12 deficiency:
If you do then list them to discuss with your 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 and if you have B12 deficiency is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.
I'm guessing you wont have so it will be OK to supplement with sublingual methylcobalamin. My suggestion would be Cytoplan B12 as it has two forms of active B12:
And to keep all the B vitamins balanced you should also take a B Complex whilst taking B12. My suggestion would be Thorne Basic B. If you look at different brands then look for the words "bioavailable" or "bioactive" and ensure they contain methylcobalamin (not cyanocobalamin) and methylfolate (not folic acid). Avoid any that contain Vit C as this stops the body from using the B12. Vit C and B12 need to be taken 2 hours apart.
When taking a B Complex we should leave this off for 3-7 days before any blood test because it contains biotin and this gives false results when biotin is used in the testing procedure (which most labs do).
I would suggest that you use one bottle of the sublingual B12, this should raise your level to hopefully 100 (Active B12), once you've reached that you can then drop the B12 and just continue with the B Complex which should maintain your level.
Were folate and ferritin tested? If so can you post those results/ranges too please.
Serum iron: 55 to 70% of the range, higher end for men - yours is 81.88% through range so is high
Saturation: optimal is 35 to 45%, higher end for men - yours is 48% so is high
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 55.56% through range so does not suggest the need to supplement.
Ferritin is recommended to be half way through range although some experts say that the optimal level for thyroid function is 90-110ug/L.
I would say that your iron panel shows you may be supplementing iron?
I’ve had some amazing help from this forum. Here is some lived experience that hopefully helps. I also had Vit D low in range in June and am taking an oral spray D3 with K2 (sends calcium to bones rather than arteries) by BetterYou, it’s taken weeks and other lifestyle changes but I am feeling a lot better. If you search the forum for Vitamin D you’ll find the links to the Vit D society advice on loading doses and maintenance doses. GP suggested doses of 1/3 of what was suggested by Vit D society, bear that in mind if speaking to the GP. My B12 was higher than yours but even so I take Thorne Basic B complex which also contains biotin. Again this was recommended by experienced folk here. Prior to being on this forum I was a bit anti supplements (believing my super healthy home grown diet should be enough) I’ve been proven wrong in that front! Also tested my grown up kids (18&20) sure enough they both now take Vit D too, they prefer the under tongue drops. You might want the GP to delve a bit deeper and look at your iron results too. Hope you get the answers you need. 💚🦋💚
This is really helpful thank you so much 😊 I have had issues with Vit D in the past and do remember how rubbish I felt at the time so definitely one for me to get back on top of!
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron
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