Thank you for your feedback a few days back. I was able to change my blood test to 9am. Could you please help me interpret my test results from Medichecks (the normal range figures is what's on Medichecks).
* Please note that I took my Levothyroxine at 10am the day before, medical test fasting was at 9am next day. I did not take my multivitamins/B-vitamins for about 10 days or longer. My weight is 63.5kg. I take 75ug levothyroxine 5 days a week and 100ug 2 days a week (Brand: Mercury Pharma).
I had a very hard time one month back when I suddenly got palpitations (high HR and BP), was in A & E, and am now on bisopronolol, 2.5mg. At that time, my TSH was 5.2. My GP said they will only check in 3 months, hence I decided to do this privately. If anything is linked to above, please share. At present, my family thinks this is anxiety related. I take only 1 coffee a day, hardly any alcohol, non-smoker. I do take a lot of peppermint & chamomile tea for my bloating (not sure if relevant).
Please tell me what you think I need to do about my TSH and vitamin levels, or any observaations. Much appreciated.
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S2017
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As an inflammation marker the lower the result the better. Yours is in range but could be indicating some possible low level inflammation. My CRP is never very low, always above 2 and often between 3 and 4, this is due to my lung disease.
Ferritin 50 ug/L (Normal 13-150)
This is low but it also might be slightly elevated due to your CRP being high in range. Ferritin is raised with inflammation.
I think it's worth doing an iron panel consisting of serum iron, transferrin saturation percentage, total iron binding capacity plus ferritin. This will show if you have iron deficiency. You can have low ferritin without iron deficiency. If your GP wont do an iron panel then Medichecks do one, the "Iron Home Blood Test".
Folate-Serum 6.3 ug/L (Normal 2.9-14.5)
This is on the lowish side, folate is recommended to be at least half way through range which would be around 9 plus with that range. The fact that you left off your B Complex for so long could be the reason. The amount of biotin in a B Complex is usually around 400-500mcg and for this low level then leaving off for 3 days is said to be enough, the longer time is for stand alone biotin supplements, or hair/nail supplements, which often contain 5,000-10,000mcg.
Vitamin B12-Active 113 pmol/L (Normal 25.1-165)
This is a good result.
Vitamin D 80 nmol/L (Normal 50-200)
This isn't too bad although the Vit D Council, Vit D Society and Grassroots Health all recommend a level between 100-150nmol/L with a recent blog post on Grassroots Health recommending at least 125nmol/L.
TSH 4.11 miU/L (Normal 0.27-4.2)
Free T3 4 pmol/L (Normal 3.1-6.8)
Free Thyroxine 14.7 pmol/L (Normal 12-22)
These show that you are undermedicated and need an increase in your dose of Levo.
The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.
Your TSH is way too high, your FT4 is only 27% through range. Your FT3 is 24.32% thrugh range so well balanced with your FT4.
You should ask your GP for an increase in your dose of Levo, 25mcg now and retest in 6-8 weeks. You could use the following information to support your request:
Fine tuning of the dose could be necessary in some patients
* aim of levothyroxine treatment is to make the patient feel better, and the dose should be adjusted to maintain the level of thyroid stimulating hormone within the lower half of the reference range, around 0.4 to 2.5 mU/l. If the patient feels perfectly well with a level in the upper half of the reference range, then adjustment is unnecessary
Replacement therapy with levothyroxine should be initiated in all patients to achieve a TSH level of 0.5-2.0pmol/L.
Also, Dr Toft, past president of the British Thyroid Association and leading endocrinologist, states in Pulse Magazine (the professional publication for doctors):
"The appropriate dose of levothyroxine is that which restores euthyroidism and serum TSH to the lower part of the reference range - 0.2-0.5mU/l. In this case, free thyroxine is likely to be in the upper part of its reference range or even slightly elevated – 18-22pmol/l. Most patients will feel well in that circumstance. But some need a higher dose of levothyroxine to suppress serum TSH and then the serum-free T4 concentration will be elevated at around 24-28pmol/l. This 'exogenous subclinical hyperthyroidism' is not dangerous as long as serum T3 is unequivocally normal – that is, serum total around T3 1.7nmol/l (reference range 1.0-2.2nmol/l).*"
*He confirmed, during a talk he gave to The Thyroid Trust in November 2018 that this applies to Free T3 as well as Total T3 and this is when on Levo only. You can hear this at 1 hour 19 mins to 1 hour 21 minutes in this video of that talk youtu.be/HYhYAVyKzhw
You can obtain a copy of the article which contains this quote from ThyroidUK
Email : tukadmin@thyroiduk.org
and ask for the Dr Toft article from Pulse magazine. Print it and highlight Question 6 to show your GP.
As palpitations are a symptom of hypothyroidism then being undermedicated can cause them.
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