Bloods results help please

[bajmon]

I went to see my private endo 3 weeks ago and he asked for loads of bloods. I'll post them below but I'm confused as my previous tests on 07/10 showed TSH 2.89 (range 0.35-5.5 um/L) and free T4 14.3 pmol/L (range 10.5-21) - those were done by GPThe last bloods were done on 9/11 at di only a month later in different labs and showing huge change to both with no Levo dose change and using the same brand Wockhardt which I used for the last year and I'm on 75 mcg. Initially when my Endo saw the TSH 2.89 from October, he said we'll add extra to make one day a week a 100mcg dose. I took one higher dose I think before the last bloods but this wouldn't make such huge difference in assuming since you have to wait 6 weeks.

All bloods always taken on empty stomach with last Levo and vitamins taken 24h or more and always before 8-9am

I want to know why such change please. I asked Endo about that but he didn't reply to that email.

Results from 09/11 tests

TSH 0.713 (range 0.27-4.2 mlU/L)

T4 18.35 (range 12-22 pmol/L)

T3 4.4 (range 3.1-6.8 pmol/L)

Ferritin 56.18 (range 13-159 ug/L)

Vit B12 380.9 (range 197-771 pg/ml)

Total vit D 64 (range <25-250> nmol/L)

Sodium 140 (range 133-146 nmol/L)

Potassium 4.0 (range 3.5-5.3 nmol/L)

Urea 6.8 (range 2.5-7.8 nmol/L)

Creatine ∆93 (range 45-84 umol/L)

eGFR result/1.73m2. 66

There's plenty others but I think these are more important.

Please compare with those above.

Just to remind, I don't have hashimotos but hypothyroidism post Subacute Thyroiditis.

Thyroid is small and damaged due to the illness in 2020/2021

So to recap, my questions are;

1) Are these results ok? My Endo is happy but I'm not feeling great; occasional palpitations, slight anxiety and low mood, problems sleeping, waking up achy and sluggish, itchy skin especially scalp (all day), all body itchiness when going to sleep and tight, uncomfortable skin on face.

2) why such difference in bloods (TSH/T4) with no dose change?

3) are um/L the same as mlU/L ?

Thank you for all replies in advance!

I'm trying my best to take supplements but I've been only taking them daily again for the last month with on an off breaks 🙈

I'm taking Wellwoman and Solgar Vit D 4000 iu plus occasional vit C and magnesium

[SlowDragon Administrator]

multivitamins never recommended on here - only for the worried well, not high enough dose supplements to improve low vitamin levels

Retest vitamin D again in 3-4 months

B12 is too low

Unfortunately no folate result ?

Do you have any Low B12 symptoms 

b12deficiency.info/signs-an...

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

If you do request GP test for Pernicious Anaemia before starting on B12 supplement

And test folate levels too

Look at improving B12 to at least over 500

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...

[SlowDragon Administrator]

meanwhile working on improving iron/ferritin by increasing iron rich foods in your diet like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked 

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin 

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin 

healthunlocked.com/thyroidu...

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing. It’s possible to have low ferritin but high iron 

Medichecks iron panel test 

medichecks.com/products/iro...

Iron and thyroid link

healthunlocked.com/thyroidu...

Excellent article on iron and thyroid 

cambridge.org/core/journals...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms 

healthunlocked.com/thyroidu...

Low Iron implicated in hypothyroidism 

healthunlocked.com/thyroidu...

[Hidden in reply to SlowDragon]

Hi slow dragon- really interesting what you say about iron and ferritin . My most recent blood work shows my ferritin is 46.1 which is actually too low right? Thanks for links to various research papers.

[SlowDragon Administrator in reply to Hidden]

You need full iron panel test for anaemia including ferritin as next step

Meanwhile increasing iron rich foods in diet

[Hidden in reply to SlowDragon]

thanks

[bajmon in reply to SlowDragon]

Thank you. You have me a lot of reading which I'll get through at some point. Any idea why would my results would be so different writing a month?

[SlowDragon Administrator in reply to bajmon]

Have you had BOTH TPO and TG antibodies tested in past

Ultrasound suggests you have Ord’s thyroiditis - autoimmune thyroid disease where thyroid shrinks and shrivels up

20% of Hashimoto's patients never have raised antibodies 

healthunlocked.com/thyroidu...

 

Paul Robson on atrophied thyroid - especially if no TPO antibodies 

 paulrobinsonthyroid.com/cou...

[helvella]

3) are um/L the same as mlU/L ?

I think there might be a typo there?

mIU/L is milli-International Units per litre.

But they often leave I (for International) out so it doesn't get confused with l (for litre) or anything else. So we often see

mu/L

(U is usually capitalised - but not always)

[bajmon in reply to helvella]

Many thanks. I just wanted to check if both results are in the same units. So no wrist though why such change in my results with no obvious reason like dose change.

[FAB-jellybean]

Hi  bajmon , you are 63.5% through the range in your fT4 and only 35% in your fT3, which would suggest you're not converting T4 to T3 very well and that could be causing your symptoms. Optimal conversion needs optimal vitamin and mineral levels so you should consider taking daily good separate supplements. You can use the calculator (link below) to check any differences in tests from different labs but unfortunately you don't have any fT3 results in the first test to see if the conversion has got worse/better or stayed the same. Maybe you have other test results that you could check to see what's been happening previously. You may find you benefit from a trial of T3, something to think about discussing with your endo.

As far as differences in the results, have you had any illness over the last month or two, or did you get any of the seasonal vaccines? That can make our thyroid hormones go wildly awry. Or have you changed anything in your diet/medications/supplements? Again, these could fluctuations. Just a thought.

thyroid.dopiaza.org/

[bajmon in reply to FAB-jellybean]

Thank you so much. I'm in the office now but I'll look at the calculations when I'm at home later. I didn't take any vaccines as they made me extremely Intel last year and got my tests so over the place. I was in a lot of stress in October. Perhaps that it. I also was in gluten-free diet from august until just after the October tests. I'm back on gluten diet again as I was treated negative for celiac and didn't see much difference.Last time I had T3 checked was in April and it was 4.8 pmol/L

[SlowDragon Administrator]

FT4: 18 pmol/l (Range 12 - 22) 60.00%

FT3: 4.4 pmol/l (Range 3.1 - 6.8) 35.14%

Shows poor conversion rate of Ft4 to ft3

Improving low vitamin levels may increase conversion rate

So might going back on gluten free diet and dairy free diet

[bajmon in reply to SlowDragon]

Hi, which vitamins would improve things most? I'm taking vitD, B12 complex (makes my stomach really upset), magnesium and sometimes wellwoman for everything else. I'm having liver patte free time a week too

[SlowDragon Administrator in reply to bajmon]

which vitamin B complex are you currently taking

You need separate B12 as well until B12 result is over 500

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...

How other member saw how effective improving low B vitamins has been 

healthunlocked.com/thyroidu...

[bajmon in reply to SlowDragon]

I'll try B12 drops, maybe they won't upset my stomach at the complex. I'm using everyone from solgarWhy Endos think those levels are fine?! Honestly it's frustrating and we can't know everyone if they won't tell us/help us.

It's the tinnitus a symptom of low B12 levels you think?

[SlowDragon Administrator in reply to bajmon]

Recommend you Drop the multivitamin.

[bajmon in reply to SlowDragon]

Hi, why dropping multivitamins?

[SlowDragon Administrator in reply to bajmon]

most contain iodine not recommended for anyone on levothyroxine

Cheap poorly absorbed ingredients and at best a waste of money

[bajmon in reply to SlowDragon]

Which vit brands would you recommend then?

[SlowDragon Administrator in reply to bajmon]

vitamin B complex

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20 

If you want to try a different brand in the meantime, one with virtually identical doses of the ingredients, and bioavailable too, then take a look at Vitablossom Liposomal B Complex. Amazon sometimes has it branded Vitablossom but it's also available there branded as Yipmai, it's the same supplement

amazon.co.uk/Yipmai-Liposom...

or available as Vitablossom brand here

hempoutlet.co.uk/vitablosso... &description=true

IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 7 days before ALL BLOOD TESTS , as biotin can falsely affect test results

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate methyl folate supplement eg Jarrow methyl folate 400mcg and continue separate B12

[SlowDragon Administrator]

vitamin D. Look to get vitamin D at least over 80nmol and between 100-125nmol maybe better