Latest results 06/10/22.. what are your thoughts?

[Bambam22]

I posted, a number of months ago  my journey with hypothyroidism, the NHS and medichecks report from August 2022

You were all amazing and armed me with knowledge to get more support from the NHS. It worked in part.

GP agreed to run MMA, full bloods and ferritin 25th august 2022 as my active B12 was on the lower end 50.8 ug/l

Test returned total B12 280ng/L (187-883). GP would offer no support. Started taking Bio active B12 as suggested on the forum.

Folate 10.5 ng/L (3.1-20.5)

Ferritin 33ng/ml (15-204) no treatment

I have remained symptomatic with fatigue, muscle and joint pain, hair thining to name but a few. GP refused to up my medication until thyroid bloods were done again. Despite this consultation requesting full thyroid panel and the promise of a rerun of B12. TSH was only tested. Bloods taken 3rd October

NHS TSH result 7th october 2.40 mU/L (0.4-4.9)

I ordered an advanced test from medichecks to coincide with the GP test as I lacked faith and had blood drawn on 5th october. My results were returned today 7th October.

CRP HS 0.97 mg/L (0-5)

Ferritin 39.9 ug/L (13-150) this has fallen since first medichecks but increased when compared to NHS test in august.

Folate 13.07ug/L (>3.89)

VIT B12 active 60.9pmol/L (37.5-150) this is an increase since first medichecks. I am supplementing thornes and B12 sublingual.

Vitamin D 123nmol/L (50-200) big increase since first medichecks. Supplementing with oral spray D3000 +K2.

TSH 2.41mU/L (0.27-4.2) This is an increase from 1.41 and causes me the most concern as I am still symptomatic.

Free T3 4.09pmol/L (3.1-6.8) slightest of increase since first medichecks

T4 20.9pmol/L (12-22) slight increase since first medichecks.

Thyroglobulin antibodies 42 IU/mL (<115) this is amazing drop from 212 seen in my first medichecks.

Thyroid Peroxidase Antibodies 126 IU/mL (<34) this is a further drop from 185 medichecks and 995, NHS June 2022.

I have worked so hard on diet and lifestyle, removing gluten, sugar and cow milk products. Meditation, breathing exercises, supplementing, sleeping patterns (albeit this is completely horrendous) and hydration.

I am 50mcg of levothyroxine.

Should I go completely dairy free?

Is there anything else I can do?

How can I best influence the GP to up my medication?

Any observations and help are most welcome.

[SlowDragon Administrator]

TSH 2.41mU/L (0.27-4.2)

This is an increase from 1.41 and causes me the most concern as I am still symptomatic. 

Free T3 4.09pmol/L (3.1-6.8) slightest of increase since first medichecks 

T4 20.9pmol/L (12-22) slight increase since first medichecks.

Was test done early morning and last dose levothyroxine 24 hours before test…..because Ft4 is right at top of range

Have you increased iron rich foods in your diet

Red meat every day. Liver or liver pate once a week. Black pudding. Orange juice to help increase absorption etc

[Bambam22 in reply to SlowDragon]

Bloods drawn 9.00am delayed taking levothyroxine until afterwards. So does that makes my T4 reading interesting ?

I have moved from plant based eating back to eating chicken, a little beef, some pork and more recently fish. I have a meat source protien once a day but not always red meat.

[SlowDragon Administrator in reply to Bambam22]

Well you can’t really increase your levothyroxine much until Ft4 level drops a bit

Meanwhile working on improving vitamins

Suggest you test again in another 6 weeks

[Bambam22]

Thank you.

Maybe I need to look at managing menopause now 😁

[SlowDragon Administrator in reply to Bambam22]

likely to need increase in levothyroxine very soon

Getting vitamins optimal frequently helps increase TSH, lower Ft4 and increase Ft3

[humanbean]

1) Ferritin 33ng/ml (15-204) no treatment

2) Ferritin 39.9 ug/L (13-150)

Ferritin is a test of your iron stores. Both the above results are far too low for good health. Low iron can cause dreadful fatigue.

According to NICE a result of less than 30 mcg/L confirms the diagnosis of iron deficiency. See this link and find the section on interpreting ferritin levels :

cks.nice.org.uk/topics/anae...

Note that people can be iron deficient with or without anaemia, and iron deficiency needs to be treated with or without anaemia.

Your ferritin level isn't quite at the deficient level but it is extremely close.

On this forum we suggest that people should have a ferritin level that is roughly between 50% and 70% through the range.

So for your first test above an optimal result would have been approximately 110 - 135 ng/mL.

For the second test an optimal level would have been approximately 85 - 110 mcg/L.

...

However... Iron is a complicated nutrient and you cannot just rely on a ferritin result as a reason to supplement iron.

The body doesn't just contain iron as ferritin, it also has "free" iron in the bloodstream, usually referred to as serum iron.

When people take iron they can't tell what is happening without regular testing :

1) Ferritin could go up, serum iron could stay roughly the same.

2) Ferritin could stay the same, serum iron could go up.

3) Serum iron and ferritin could both rise to sensible levels, and with regular testing the patient could stop taking iron altogether or might need a lower maintenance dose if they tend to lose iron and/or ferritin as soon as they stop supplementing.

Anyone planning to take iron supplements should first do an iron panel, and then repeat them every few weeks to be sure their supplementation isn't doing undesirable things. Doctors do iron panels occasionally, but with an in-range ferritin I suspect they would refuse.

There is a private test which can be done with a finger-prick sample of blood :

medichecks.com/iron-tests/i...

Also read this page for other info and some discount codes :

thyroiduk.org/help-and-supp...

If you got an iron panel done you could post the results and ask for feedback.

For info on optimal levels this link is useful, but the optimal for ferritin is rather more nuanced than given on that link.

rt3-adrenals.org/Iron_test_...

...

You should read this link on what can go wrong with iron supplementing :

healthunlocked.com/thyroidu...

If you decided to go ahead and supplement iron this reply to another member gives you a lot of options :

healthunlocked.com/thyroidu...

Good luck.

[Bambam22 in reply to humanbean]

Thank you really appreciate your advice humanbean. I will look into it and read your wonderful links.