Help with Blood results please: I haven’t posted... - Thyroid UK

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Help with Blood results please

51105Scot profile image
13 Replies

I haven’t posted for a while but have followed your previous advice to gradually include supplements and am no taking BetterYou D3000+K2. I have also been prescribed iron supplement for 4 months.

I am a 75 yo active lass who eats a healthy diet approved by dietician. Long term hypothyroid (30+ years) and have taken 75 mic levothyroxine for years. I suddenly lost 1.5 stone in weight totally inexplicably but am now stable at 8 stone. I have never been overweight but quite fit and it is muscle I have lost rather than fat. Have reintroduced gluten to my diet for just over two months as my GP wanted to test for coeliac. She seems to have tested for everything with these results except I know she requested T3 and this doesn’t look to have been done. I wake up tired and get more exhausted throughout the day. Suffer from brain fog. I have had 1.5 knee replacements due to wear and tear arthritis but now have painful joints throughout and ache muscles. Sometimes get blurred vision going up stiff inclines, stairs, standing up suddenly. Have borderline high blood pressure for which I take 2.5 mg Bendroflumethiazide (reacted badly to prednisolone). Have had endoscopy, colonoscopy and CT scan - all clear. Be grateful for any advise

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SlowDragon profile image
SlowDragonAdministrator

There’s a lot of tests there …but absolutely none are relevant

Only 5% of Hashimoto’s patients test positive for coeliac disease, but a further 80% find strictly gluten free diet helps or is essential

Personally I wouldn’t have bothered to get coeliac blood test done. If you already know you need to be gluten free

Eating gluten likely to upset thyroid levels and reduce vitamin levels too

Have you had coeliac blood test done now

Assuming test is negative…..Going back on strictly gluten free diet

If test is positive you might need to remain on gluten until endoscopy, but that’s apparently changed recently as the wait time was too long ….endoscopy not obligatory now

SlowDragon profile image
SlowDragonAdministrator

Bloods should be retested 6-8 weeks after each dose change or brand change in levothyroxine

Or 6-8 weeks after starting eating gluten (or stopping)

 

For full Thyroid evaluation you need TSH, FT4 and FT3 tested

plus both TPO and TG thyroid antibodies tested at least once

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high thyroid antibodies 

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis. 

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease (Hashimoto’s or Ord’s thyroiditis)

20% of autoimmune thyroid patients never have high thyroid antibodies and ultrasound scan of thyroid can get diagnosis 

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended on here that all thyroid blood tests early morning, ideally just before 9am and last dose levothyroxine 24 hours before test 

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...

If you can get GP to test vitamins and antibodies then cheapest option for just TSH, FT4 and FT3

£29 (via NHS private service ) and 10% off down to £26.10 if go on thyroid uk for code

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

monitormyhealth.org.uk/

NHS easy postal kit vitamin D test £29 via

vitamindtest.org.uk

Only do private testing early Monday or Tuesday morning. 

Watch out for postal strikes, probably want to pay for guaranteed 24 hours delivery 

SlowDragon profile image
SlowDragonAdministrator

previous post 5 months ago

healthunlocked.com/thyroidu...

Shows you have Hashimoto’s

Also ferritin deficient and folate deficient

Vitamin D inadequate

What vitamin supplements are you currently taking

Suggest you retest via Medichecks

51105Scot profile image
51105Scot in reply toSlowDragon

this blood test was at 0900 and a fasting test. Last levothyroxine 27 hours before. I took your advice and added in Vit D supplement BetterYou spray D3000+K2 and requested iron supplement from GP and finished a three month course of iron tablets six weeks ago. I was told this would be a coeliac test but it isn’t. Also told it would be full Thyroid test which it isn’t. I also asked the GP if I could do to increase my B12 level but she assured me that my current levels were fine and that they only take action if a result is out of range. She did not think being consistently at low end of range would have bearing on symptoms as the ranges were set to show sufficiency. My deterioration seemed to happen so suddenly that I feel it must have a cause other than general old age. My GP is lovely and sympathetic but feels as the tests haven’t shown any problems there can’t be anything really wrong. I would just like to get some get up and go back.

SlowDragon profile image
SlowDragonAdministrator in reply to51105Scot

well there’s no B12 or folate results here

Or vitamin D or iron or ferritin

Or coeliac blood test either

Are there any other results not on this image?

Email/contact GP

Request that GP test

B12, folate, vitamin D, full iron panel test for anaemia including ferritin.

Coeliac blood test

Thyroid test - TSH, Ft4 and Ft3

SlowDragon profile image
SlowDragonAdministrator

Presumably you know to always take levothyroxine on its own, on an empty stomach and then nothing apart from water for at least an hour after

No other medications or vitamin supplements within 2 hours

Iron, magnesium, calcium, vitamin D tablets or PPI or HRT at least 4 hours away minimum from levothyroxine

Vitamin D mouth spray …..at least an hour away ideally

Are you currently, or were you prescribed folic acid for folate deficiency?

Iron and ferritin levels should have been retested before stopping iron supplements

Please add any recent results

Test vitamin D levels twice a year when supplementing

How many sprays per day are you taking?

Have you retested since started taking vitamin D

Are you currently taking any magnesium supplements?

51105Scot profile image
51105Scot in reply toSlowDragon

yes careful on medication timings. I take my levo at approx 0500 am, blood pressure at 0700 and nothing else until 0900. I take three puffs of Vit D supplement as per their recommendation. The Doctor only prescribed me 3 months iron supplements and then see if I maintain an improved level. I don’t take a magnesium supplement and there seem so many to select from?

Text
SlowDragon profile image
SlowDragonAdministrator in reply to51105Scot

FT4: 15.6 pmol/l (Range 9 - 21)

Ft4 is only 55.00% through range

Ft3 likely to be less than 50% through range

No ferritin result on iron test

Obviously need to test folate and B12 again

Were you prescribed folic acid?

Or are you now taking daily vitamin B complex?

Previous Medichecks results in June 7/6/22

CRP HS <0.3 range 0-5

Ferritin 24.5 range 13-150

Folate serum 3.37 range >3.89

B12 active 75.2 range 37.5-150

Vitamin D 67 (insufficient, 50-75)

Thyroid hormones

TSH 3.19 RANGE 0.27-4.2

FT3 4.30 range 3.1-6.8

Ft4 15.8 range 12-22

 Thyroglobulin antibodies 84 range <115

Thyroid peroxidase antibodies x 97 range <34

Magnesium supplements best taken afternoon or evening. Minimum four hours away from levothyroxine

(Some people take levothyroxine at bedtime, or increasing number of members split their levothyroxine dose….half dose waking up and half dose levothyroxine at bedtime)

If levothyroxine at bedtime….magnesium at least 4 hours before

Calm vitality magnesium powder cheap and easy to use. Helpful if tend to suffer constipation. Best start on low dose and increase until get desired effect. Too much can cause diarrhoea.

or

Thorne magnesium capsules. Don’t upset gut. Large capsules…..can tip powder out into small cup of cold water and drink

51105Scot profile image
51105Scot in reply toSlowDragon

thank you so much for your advice. I have never been prescribed folic acid. I think I will get a private test. The doctor advised against vitamin B complex as I was within range. I suffer from a sore tongue and the corners of my mouth split and I have very dry itchy skin but the GP suggests it is common at my age. I will start on the magnesium supplement and have noted the timing. Thanks again as I couldn’t make any sense of this test.

SlowDragon profile image
SlowDragonAdministrator in reply to51105Scot

B12 and folate work together

Being deficient in one means the other may not be able to be used

So you could have symptoms of B12 deficiency and/or folate deficiency

Both low folate and low B12 are very common with Hashimoto’s/hypothyroidism

pubmed.ncbi.nlm.nih.gov/186...

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

Folate deficiency symptoms

nhs.uk/conditions/vitamin-b...

Folate and hypothyroidism

palomahealth.com/learn/foli...

On levothyroxine we must have GOOD vitamin levels

Many, many members on here supplement vitamin B complex daily

But test FIRST before starting on supplements, especially as you were already folate deficient 5 months ago and GP was obligated to prescribe folic acid but did not do so

51105Scot profile image
51105Scot in reply toSlowDragon

Will study the references and find a private test asap. I suppose GPS have to cover such a vast area they can’t know everything but with thyroid problems being so common and the difficulties I am having equally so looking at the posts you would think they would be trained more in that area. Thank goodness you are both so knowledgeable and generous with your answers. So, so grateful.

waveylines profile image
waveylines

My b12 was technically in range but I felt exceedingly ill at 238. My symptoms were as you described plus pins & needles, weak muscles, robotic feel when going up/down stairs, blurred vision, had to turn tele up, sensations of something crawling on me, poor memory, bowel incontinence. B12 supplements didn't work for me and ended up on b12 injections. I tested negative for PA......but that test misses 50% of cases. Xx

51105Scot profile image
51105Scot in reply towaveylines

thank you for this reply. I do have all those symptoms but my GP told me B12 in range should not be supplemented. Back for another chat I think.

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