follow on from my post yesterday finally have full test results. There also full blood count results but I guess they’re not relevant
Test results 9 nov 22
Thyroid ft4 13.1 (12-22)
TSH 2.49 (0.27-4.20)
Ferritin 9.1 (13-150)
Transferrin 3.49 (2.0-3.6)
Iron 12.6 (10-30)
Saturation % 14.4 (<55)
Cholesterol 7.4 (2.8-5.0)
HDL 2.74 (1.0-2.5)
LDL 4.07 (1.0-3.0)
I’m not sure what to do with this information tbh. I’ve got the iron fumarate tablets & they seemed to do the job last time
Thanks
jeffbird
Thyroid ft4 13.1 (12-22)
TSH 2.49 (0.27-4.20)
Your FT4 and TSH definitely show thatyou need an immediate increase in your dose of Levo, 25mcg now, retest in 6-8 weeks, possibly another increase after that. 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 your GP is reluctant to increase and says your results are in range, show her the following:
From GP online
gponline.com/endocrinology-...
Under the section
Cardiovascular changes in hypothyroidism
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.
Ferritin 9.1 (13-150)
Transferrin 3.49 (2.0-3.6)
Iron 12.6 (10-30)
Saturation % 14.4 (<55)
Ferritin is dire and other results suggest iron deficiency but you have been prescribed ferrous fumarate, take iron with Vit C to aid absorption and help prevent constipation. Iron must be taken 4 hours away from your thyroid meds and 2 hours away from any other medication/supplements as it affects their absorption.
You have a very long way to go with your ferritin and it may take a long time. Some experts say the optimal level for thyroid function is 90-110ug/L. If your GP stops your prescription once your level gets into range you must continue, either ask for prescription to be continued or buy yourself, regular monitoring is needed when taking iron tablets, preferably a full iron panel so that you can check serum iron and saturation percentage levels as well as ferritin.
Once your ferritin level is optimal it's a case of maintaining it, not necessarily stopping supplementing altogether or your level may plummet again, so maybe a maintenance dose of iron to ensure you eat plenty of iron rich foods and regularly test level.
Cholesterol is high due to undermedication and still hypo. This should sort itself out once optimally medicated thyroid-wise.
thanks for your reply. I specifically asked the gp yesterday about whether thyroid could be causing high cholesterol and she said no. its a lottery at my practice as to who you get to speak to as its allocated by phone calls on the day. I was diagnosed by another gp who I only saw once, and Ill see if I can call back and request to speak to her specifically
jeffbird
I specifically asked the gp yesterday about whether thyroid could be causing high cholesterol and she said no.
You could show her these two articles, the second one from PubMed which should at least be acceptable if she doesn't like information from ThyroidUK.
thyroiduk.org/related-condi...
ncbi.nlm.nih.gov/pmc/articl...
thanks I was actually just looking for some evidence myself, so this is very helpful.
GP needs to read NHS guidelines
nhs.uk/conditions/statins/c...
If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.
Suggest you print it out and highlight this and drop letter into GP
thanks this is useful too!
You need vitamin D, folate and B12 levels tested
Is GP testing these?
If not request testing or test privately
perhaps test vitamin D now
NHS easy postal kit vitamin D test £29 via
B12 and folate - extended test kit £69
onlinedoctor.superdrug.com/...
Or could wait until ready to retest thyroid levels 6-8 weeks after increase in levothyroxine
medichecks.com/products/adv...
OK I'll look into that too, thanks
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