bloods please help interpret

[Sleepy101]

hi! I have been Tsh supressed until recently, I am pregnant. My blood results are:

Thyroid Stimulating Hormone (TSH) 1.18 0.27 - 4.20 mIU/Final 

Free Thyroxine (Free T4) 13.7 12.0-22.0 pmol/LFinal Free Tri-iodothyronine

(Free T3) 5.0 3.1- 6.8 pmol/LPreliminary

[jimh111]

Normally these results would be fine. However, I believe you had thyroid cancer? Are you on levothyroxine? If so perhaps they could increase your dose a touch to get your fT4 towards midway (assuming you are in the first half of pregnancy. This is because T4 is the prime hormone for the foetus during the early stages of pregnancy.

If you are not on any thyroid hormone it should be OK because the pituitary and thyroid can respond to any increase in demand.

Please note I am a patient NOT a doctor.

[Sleepy101 in reply to jimh111]

hi yes had thyroid cancer and I’m on levothyroxine. Thank you 😊

[SlowDragon Administrator]

Congratulations on your pregnancy

How long since pregnancy was confirmed

GP should have increased levothyroxine, have they done so

Was test done early morning and last dose levothyroxine 24 hours before test

Ft4 is low. Suggests you need increase in dose of levothyroxine and bloods retested 6-8 weeks after

Also important to regularly retest vitamin D, folate, ferritin and B12

Did you get these tested a year ago

healthunlocked.com/thyroidu...

What vitamin supplements are you currently taking

Request GP retest vitamin levels now

[Sleepy101 in reply to SlowDragon]

I was on 125 6 weeks ago but I was Tsh suppressed. Taking 100 and I’m 16 weeks now.

Test was at 12 and i took levothyroxine at 5am

Can I ask why T4 is low when it’s in range please?

I take vitamin D

I will ask GP to test vitamins.

vitamins tested march 2021 been taking vitamin D since and recent tests have been normal but not tested in a while

Vitamin results

[SlowDragon Administrator in reply to Sleepy101]

TSH is highest early morning, around 9

So TSH would have been higher if tested as recommended

If you took levothyroxine at 5am and test at noon …that’s only 7 hours before

Had you taken last dose levothyroxine Ft4 would be lower…..how much difficult to say

FT4: 13.7 pmol/l (Range 12 - 22)

currently Ft4 only 17.00% through range

Most people when adequately treated will have Ft4 at least 50-60% through range

I was on 125 6 weeks ago but I was Tsh suppressed

Most important results are ALWAYS Ft4 and Ft3 …..not TSH

What were Ft4 and Ft3 results

TSH is initially always low after dose levothyroxine is increased …….it’s why it’s important not to consider TSH until at least 2 months after a dose increase

[SlowDragon Administrator in reply to Sleepy101]

folate is on low side

Are you not taking any vitamin B complex

What is ferritin result

Vitamin D is insufficient

[SlowDragon Administrator]

Low vitamin D

GP should have prescribe 1600iu everyday for 6 months

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing 

vitamindtest.org.uk

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7. 

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

Another member recommended this one recently

Vitamin D with k2

amazon.co.uk/Strength-Subli...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease 

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease 

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

[SlowDragon Administrator]

Discuss with GP your low folate

Yes it was in range but could be higher

Hopefully is higher now

supplementing a good quality daily vitamin B complex, one with folate in (not folic acid) 

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid 

chriskresser.com/folate-vs-...

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) 

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