How are my bloods, please?

[HowNowWhatNow]

Hello

Have been on T3 for the last few weeks. Half a tablet a day. Plus 150 mcg levothyroxine, which was my usual levo dose before the endo added in T3.

And here are my results:

Ferritin - 10 (13-150) [LOW]

My GP says, on this result, “just out of normal range”.

TSH - 0.61 (0.27-4.2)

Before taking T3, my TSH was in the 2-3 range in general.

Free T4 - 18.1 (11-21.2)

No T3

(This was the second time I went to get my blood tested in a month. The first time I went my phlebotomist left T3 off, so the only reason I went to get these done today was =T3. The only result not to so far come back = T3. After the first time I called the GP and had at least 2 conversations with the receptionist about how to get T3 done this time. They said that instead of going to the community phlebotomist, I had to go to the hospital.I was there at 8 am this morning. The hospital seem to have again left T3 off, despite my specifically getting the very nice phleb to check she was testing T3, today. Bloods were only taken today so I’ll give them the benefit of the doubt - maybe T3 will come in tomorrow. Each time I have to go / have to call the GP about it is an extra cost for the NHS that could have been averted).

Serum TIBC - 62 (50-72)

Transferrin - 22% (20-50%)

Serum iron - 13.5 (14-30) [LOW]

B12 - 391 (197-771)

Serum Folate - 12.8 (3-20)

White and red blood counts all normal

Haemoglobin 132 (115-155)

Am curious to know how the thyroid result is please. I know that without T3, it’s all very ambiguous.

thanks so much

[SlowDragon Administrator]

No point testing until been on T3 at least 6-8 weeks

Are you normally splitting T3 as 2 x 1/4 tablet

Day before test did you cut tablet into 1/4 and take 1/4 tablet waking and 1/4 tablet maximum of 12 hours before test

Obviously without Ft3 result it’s meaningless

GP needs to prescribe iron

B12 too low but not low enough for GP to prescribe

Are you currently taking vitamin B complex and/or separate B12

You also need vitamin D tested

[HowNowWhatNow in reply to SlowDragon]

hi

Thanks x 1000000!

I am taking T3 as one pill. At the same time of day as the levothyroxine.

And I took the last batch less than a day before the test, but more than 12 hours.

I am taking B Complex (a brand recommended here) but didn’t for a week or two before this test so as not to cloud results.

I sent off for a postal Vitamin D test earlier this year and my result for that was fine. Helped by the Vit D spray I was recommended here. I found it v hard to produce enough blood for that test so will not do it more than once a year.

I took OTC iron all summer that I thought was gentle but it made me very unwell… several digestive symptoms, muscle spasms, stomach acid, burning throat, etc etc.. Am going to have to go down the infusion route to get iron right. I had my first one a year ago (when my ferritin was 3) but became iron deficient again within 7 or 8 months of taking it. I eat meat. Had beef consommé for lunch and then mince, plus an orange for Vit C, for dinner. Unintentional paleo diet.

Does anyone here in my iron shoes get iron infusions on the NHS?

[SlowDragon Administrator in reply to HowNowWhatNow]

Is T3 a tablet or capsules?

If tablet, suggest you split your dose - 5mcg waking and 5mcg mid-late afternoon

Assuming NHS not going to give you Ft3 result, you need to test privately

Think you are based in London?

Loads of test options

Blue horizon run this walk-in clinic

bloodtestslondon.com/

Likely to need further 5mcg dose increase in T3 after blood test

Three x 5mcg dose T3. Waking, mid afternoon and bedtime

[SeasideSusie Remembering in reply to HowNowWhatNow]

HowNowWhatNow

I sent off for a postal Vitamin D test earlier this year and my result for that was fine. Helped by the Vit D spray I was recommended here. I found it v hard to produce enough blood for that test so will not do it more than once a year.

I'm just wondering who you are using for your Vit D test. Is it a lab where you have to fill a microtainer?

There is a much easier way, a dried blood spot test which just requires 4 drops of blood on a type of absorbent paper. This test is offered by NHS lab based at City Hospital in Birmingham and is the easiest and probably the cheapest of all the postal tests at £29:

vitamindtest.org.uk/

[HowNowWhatNow in reply to SeasideSusie]

Thanks, yes this is the one I did. I don’t know why but getting the 4 drops out was like the proverbial blood and stone.

Weird because I also have something called Factor XII deficiency that in theory makes your blood clot less well.

[SeasideSusie Remembering in reply to HowNowWhatNow]

Oh wow, that's surprising! Have you ever done any of the private tests requiring a sample in a microtainer?

[HowNowWhatNow in reply to SeasideSusie]

I don’t know what one of these is.

[SlowDragon Administrator in reply to HowNowWhatNow]

Medichecks or Blue horizon DIY finger prick test requires about 12 drops of blood into small test tube….sounds like you might find that impossible

[SeasideSusie Remembering in reply to HowNowWhatNow]

The little tube to collect blood sample. The number of drops depends on how large drops you produce, I can sometimes fill one with 14 drops, sometimes it takes 20 if the drops are smaller.

Microtainer tube

[HowNowWhatNow in reply to SeasideSusie]

I could not produce that much from my veins! Thank you for explaining.

[Redditch]

The results are good ferritin is a bit low but should come up. FT3 is a widely fluctuating marker especially if you're taking T3.

T3 is the rocket fuel that powers humans. A normal human converts T4 into T3 as it needs it. You don't know if that has just happened or is about to happen so a normal person's FT3 could be very different in two tests 4 hours apart. If you take T3 your FT3 after you've taken it will be very high and just before it will be very low.

Not sure what a blood level is going to tell you. If you feel good you're on enough. If you don't feel good you're not.

[HowNowWhatNow in reply to Redditch]

Thank you.

My main symptoms at the moment - those causing me trouble - don’t seem to be thyroid-related, but I’m trying to get my thyroid levels right so it’s one less thing to think about. I feel better on T3 than not. I feel like myself. Rocket fuel seems about right.

Looking back at my B12 levels over the last few years, they were way too low for too long. So I really appreciate the work of this forum in bringing its importance across to me. And if you haven’t yet started taking B12, what are you waiting for?

[Redditch in reply to HowNowWhatNow]

your TSH has come down. Most of us feel decent on a TSH of lower than 2. Doctors get really jumpy if it gets really low because they worry about heart issues but recent studies in Cardiff say it's only worrying with a very high FT4. Personally my TSH is practically nothing but my T4 is only ever 11 or 12.

[HowNowWhatNow in reply to Redditch]

thank you.

are you on Levo only?

[SlowDragon Administrator]

B12 and folate

With B12 below 500 you need separate B12 as well as vitamin B complex

Only stop taking vitamin B complex 5-7 days before test

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

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 drops 

healthunlocked.com/thyroidu...

B12 sublingual lozenges 

amazon.co.uk/Jarrow-Methylc...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

[HowNowWhatNow in reply to SlowDragon]

thank you!

[SlowDragon Administrator]

low iron and ferritin

Presumably you previously had referred to haematologist?

There’s nothing on your profile

Are you male or female and approx age?

If pre menopause, heavy periods?

was previous iron transfusion private?

theironclinic.com/iron-defi...

theironclinic.com/ironc/wp/...

Helpful info on iron infusion and supplements 

healthunlocked.com/thyroidu...

Flow chart for criteria on NHS

secure.library.leicestersho...

[HowNowWhatNow in reply to SlowDragon]

thank you!

[HowNowWhatNow in reply to SlowDragon]

female, in my 40s, pre menopause

[SlowDragon Administrator in reply to HowNowWhatNow]

Heavy periods?

[HowNowWhatNow in reply to SlowDragon]

Yes.

Have had gynae procedure done this year to remove a polyp (and rule out endometrial cancer) but it hasn’t made a difference.

I was given a Mirena coil at the same time but as I had so many other symptoms ongoing I had it removed - one fewer variable.

[SlowDragon Administrator in reply to HowNowWhatNow]

Have you been assessed for fibroids or endometriosis

healthline.com/health/how-t...

[HowNowWhatNow in reply to SlowDragon]

Would they show up in a pelvic U/s or hysterectomy or endometrial biopsy?

I think the pelvic U/s result said clear of fibroids. The hysterectomy picked up an ovarian cyst which didn’t show on the U/s.

[SlowDragon Administrator in reply to HowNowWhatNow]

Being hypothyroid tends to result in heavy periods and you have been inadequately treated

Hopefully now with addition of T3 things might improve

Being anaemic tends to also result in heavy periods.

Push hard for iron transfusion on NHS

[HowNowWhatNow in reply to SlowDragon]

Thanks.

I’ve just found out that the hospital lab - in a major London teaching hospital - my GP practice uses for all blood tests no longer measures T3. At all.

I can hardly believe this is true but it has now been confirmed to me by several people at the practice.

They say that only a different local hospital tests T3, but my GP surgery cannot order tests from it.

Who does one complain to about this? The CCG?

[SlowDragon Administrator in reply to HowNowWhatNow]

Just test privately….it’s not worth the battle

I haven’t done an nhs test in 8 years

[HowNowWhatNow in reply to SlowDragon]

Sad situation.

Apparently they do test T3 - someone has since explained - but only if their T4 is low. If not, even GPs can’t ask them to test it.

[SlowDragon Administrator in reply to HowNowWhatNow]

when I moved house and area (on levothyroxine plus T3 prescribed on NHS) my lovely new GP was puzzled I got private blood testing done

She assured me at my first appointment at new surgery NHS would of course test TSH, Ft4 and Ft3 especially as I was prescribed T3 ……and would retest vitamin D, folate and B12 as these had previously been deficient

So, to keep her sweet, I did test (stopped vitamin B complex) booked early appointment……results following week……just TSH 🤷‍♀️

So now GP is completely on board and supportive of my testing privately

[HowNowWhatNow in reply to SlowDragon]

Am glad you have a lovely GP

Would be good to know more from thyroid patients about which areas of the U.K. / CCGs / hospitals deal well with thyroid related health.

Am I right in thinking Norfolk does well?

[SlowDragon Administrator in reply to HowNowWhatNow]

increasing numbers of prescriptions for T3 on NHS each month (as cost has reduced )

England….Now just under 60,000 prescriptions per year ….up from 57,000 2-3 years ago

openprescribing.net/analyse...

Article in Lancet on reduction in prescription numbers as price increased

thelancet.com/journals/land...

[Tythrop in reply to SlowDragon]

amazed that you have a non-defensive GP .

[SlowDragon Administrator in reply to Tythrop]

GP completely onboard with the gut and thyroid connection. Advises all her thyroid patients to try gluten free diet now (after testing for coeliac first)

Also 2 of the practice nurses at surgery are on dairy free diet, (not for thyroid reasons) ….but again dairy is recognised as possible thyroid issue

[HowNowWhatNow in reply to SlowDragon]

And my only infusion has been private - paid for by medical insurance.

I have had numerous new health problems in the last two years at the same time as being iron deficient - eg. 3 days in NHS hospital with suspected heart problems and when I asked the doctors on my ward if they can order an iron infusion, they looked at me as if I was mad.

[SlowDragon Administrator]

Are you on strictly gluten free diet or dairy free diet?

[HowNowWhatNow in reply to SlowDragon]

GF with lapses every 14 days or so. Not through design, just forgetfulness.

Lactose free.

Are you both GF and dairy free.

[SlowDragon Administrator in reply to HowNowWhatNow]

So you need to be more vigilant

It takes weeks/Months for gut to recover each time we eat gluten

What brand levothyroxine are you currently taking

What brand T3

Do you always get same brand at each prescription

[HowNowWhatNow in reply to SlowDragon]

Thanks.

Diet-wise, I’ve had major issues with sugar of late. Cutting that down to almost nothing has been very helpful.

Levo: always Mercury. Teva makes me feel awful, as for many.

T3: Thybon Henning / Sanofi.