NHS results

[De8813]

Hi all, I've just had my blood results from a well women's health check at my Drs. Picked up a copy today as they were checking my TSH and couldn't believe they have done my free t4 and t3 on it. This is a miracle, first time in almost 20 years this has been tested. Maybe things are changing. So here are my results

TSH 0.4 (0.49-5.23)

FT4 18 (11.50-22.70)

FT3 4.5 ( 3.5-6.50

I'm on 125mcg levothyroxine since January.

Feel better back on this dose as was reduced my txt message over lock down for 12 months. My main concern is brain fog and idiopathic peripheral neuropathy which I have had about 4 years now . Have read that low T3 can cause this . So was thinking of adding T3 if you think this will help,as the neuropathy is progressing from just my feet to up my legs and now hands. I also had haemochromatosis, diagnosed last March but nothing has been done about this and MGUS which can cause neuropathy but I've been told this is not the cause as my levels are low. Complicated sorry. Any advice very much appreciated as I'm finding it incredibly frustrating lately. Thank you for listening xx

[Jaydee1507 Administrator]

Your conversion rate of T4 to T3 is 33% which is pretty bad. Low T3 isn;t good for any of us.

Have you had your vitamins checked lately? Ferritin, Folate, D3 B12?

How do you take your medication?

[SlowDragon Administrator]

Absolutely essential to test vitamin D, folate, ferritin and B12 at least annually

What vitamin supplements are you currently taking

Please add most recent vitamin results and ranges

I see you have hemochromatosis

Presumably you have autoimmune thyroid disease also called Hashimoto’s

Are you on strictly gluten free diet or dairy free diet

On levothyroxine we need OPTIMAL vitamin levels

Recommended on here that all thyroid blood tests early morning, ideally before 9am

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

List of private testing options and money off codes

thyroiduk.org/getting-a-dia...

Medichecks Thyroid plus antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

[De8813 in reply to SlowDragon]

Thanks for replying. Test was as recommended on empty stomach no levothyroxine till after. I take levo early hours ,as always wake in the night. I haven't had vitamins checked for a long time, take vitamin d betteryou +k2 in winter.Serum ferritin was 155 (13.00-150.00) jan2021Iron saturation 60%

B12 745

Serum folate 4.8

Haven't got blood results from haemochromatosis check this jan but have a telephone appointment on 25th . Thanks xx

[SlowDragon Administrator in reply to De8813]

If you didn’t adjust last dose levothyroxine to 24 hours before test, your Ft4 result is falsely low

If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test

If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal

(Similarly if normally splitting your levothyroxine as half waking and half at bedtime, adjust to take whole daily dose 24 hours before test

Splitting your levothyroxine can help improve conversion rate …something to consider once all four vitamins are tested and OPTIMAL

Folate was far too low

Test vitamin D, B12 and folate privately if GP won’t

[De8813 in reply to SlowDragon]

Thank SlowDragon I did take last dose as directed. Will try splitting dose and getting vitamins tested. I'm just feeling miserable with the neuropathy and feeling I can't think straight anymore. Will read over all the advice. Maybe I'm grasping at straws looking for something that's causing the neuropathy as doctors don't seem to be interested. Thank you xx

[SlowDragon Administrator in reply to De8813]

Low B12 and folate are EXTREMELY common

NHS only tests and treats vitamin deficiencies

On levothyroxine we need OPTIMAL Vitamin levels

Serum B12 at least over 500

Active B12 at least over 70..over 100 better

Folate and ferritin at least half way through range

Vitamin D at least around 80nmol minimum and around 100nmol maybe better

Most thyroid patients need to supplement vitamin D and vitamin B complex continuously

Come back with new post once you get results

Strictly gluten free diet frequently helps, or is essential

[De8813 in reply to SlowDragon]

Thank you SlowDragon will do. Have been reading the symptoms of folate and b12 deficiency , can tick every one. Xx

[SlowDragon Administrator in reply to De8813]

Do Medichecks or BH test early Monday or Tuesday morning, ideally just before 9am and last dose levothyroxine 24 hours before test

Stop taking any supplements that contain biotin a week before ALL blood tests

[pennyannie]

Hello De:

The accepted conversion ratio when on T4 monotherapy is said to be 1 / 3.50 - 4.50 T3/T4 -

and we generally feel at our best when we come in this ratio at around 4 or under :

So to find how well you are converting the T4 you simply divide your T3 into the T4 and I'm getting yours coming in at 4 so centre of range and good.

However there is room to increase your dose of T4 - Levothyroxine.

Your T4 as currently at around 65% with your T3 coming in at around 30% through the ranges and we generally feel at our best when our T4 is up in, or heading towards the top quadrant of its range at around 75% + as this should reflect in a T3 at around 50-60% through the range.

True your TSH may then drop further below range and your doctor may already be concerned by this little glitch, if TSH obsessed.

The TSH was originally introduced as a diagnostic tool to help identify a person suffering with hypothyroidism and was never intended to be used once the patient was on any form of thyroid hormone replacement as then you monitor and dose of T3 and T4 blood test results.

Are your ferritin, folate, B12 and vitamin D mentioned at all as these results as they need to maintained at optimal levels for optimal conversion of T4 and good health and well being ?

[De8813]

I had asked for access to my medical records but they are taking there time. Will try again thanks.

[SlowDragon Administrator in reply to De8813]

You are legally entitled to printed copies of your blood test results and ranges.

The best way to get access to current and historic blood test results is to register for online access to your medical record and blood test results

UK GP practices are supposed to offer everyone online access for blood test results. Ring and ask if this is available and apply to do so if possible, if it is you may need "enhanced access" to see blood results.

Link re access

healthunlocked.com/thyroidu...

In reality many GP surgeries do not have blood test results online yet

Alternatively ring receptionist and request printed copies of results. Allow couple of days and then go and pick up.

[De8813]

I asked receptionist (new lady so didn't know her)for print out as I always do but was refused 🤨ask for access to my medical records so I walked there filled the form in but still waiting . So walk back there today and lovely receptionist I've known for years printed it for me 🙂 . Feel they don't like us knowing xx