Advice on my blood test results, please.

[Tired2022]

Hello,

I was diagnosed in August and really benefitted from advice from people here. I am lacking confidence in the GP as I feel they don't do anything proactively, although they have seemed happy to follow the guidance I am given here.

My blood test results are below. I have been prescribed Vitamin D 50,000 unit once per week for six weeks. I don't know if it's coincidence but I'm feeling much better one week in.

I was wondering if I should take folate and, if so, how do I know how much to take or do I ask the GP?

Should I also be worried that my ferratin is high?

I have found all your advice so helpful and would appreciate your thoughts on this. Thank you

Serum TSH level 0.47 mIU/L [0.27 - 4.2] (They didn't look at T4 as this in in the normal range...)

Serum ferritin level 245 ng/mL [13.0 - 150.0]; Above high reference limit

B12/Folate Haematinic assays

Serum vitamin B12 level 747 ng/L [197.0 - 771.0]

Serum folate level 3.1 ng/mL [3.0 - 20.0]

Total 250H Vitamin D 18.5 nmol/L; 25OH Vitamin D <25 nmol/L is consistent with deficiency.

Please note Alfacalcidiol is NOT detected by this assay

Urea and electrolytes See emrn.org.uk for interpretation

of MDRD estimated GFR.

Serum sodium level 139 mmol/L [133.0 - 146.0]

Serum potassium level 4.3 mmol/L [3.5 - 5.3]

Serum urea level 4.0 mmol/L [2.1 - 7.1]

Serum creatinine level 70 umol/L [44.0 - 80.0]

GFR calculated abbreviated MDRD 82.3 ml/min/1.73m2

Acute kidney injury warning stage 0 .

Iron & Iron Binding Please note a low serum iron in itself does not represent iron

deficiency unless the total Iron binding capacity is raised.

Serum iron level 16 umol/L [11.0 - 25.0]

Serum unsaturated iron binding capacity 36 umol/L [24.0 - 70.0]

Serum TIBC 52 umol/l [44.0 - 71.0]

Liver function tests

Serum total bilirubin level 7 umol/L [0.0 - 21.0]; !

Serum alanine aminotransferase level 48 IU/L [< 33.0]; Above high reference limit

Serum albumin level 49 g/L [35.0 - 50.0]

Alkaline phosphatase level 105 U/L [30.0 - 130.0]

Serum total protein level 75 g/L [60.0 - 80.0]

I also have full blood count and antibodies, but I didn't think these would be needed.

Thanks again for reading.

[SlowDragon Administrator]

You need to retest vitamin D at the end of prescribed vitamin D supplement if GP doesn’t do so

You will need to supplement yourself going forward.

Trial and error what maintenance dose you will need

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 with Hashimoto’s, 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]

What were thyroid antibodies results?

You need TSH, Ft4 and ft3 tested at next test in 6-8 weeks time

Test early morning and last dose levothyroxine 24 hours before test

Presumably you are still only on 75mcg levothyroxine

Which brand of levothyroxine?

Approx how much do you weigh in kilo

Likely to need further increase in levothyroxine over coming months, unless extremely petite