Can you check my results please?

[KBird01]

Hi everyone,

I'm 55 years old and on HRT patches for 12 months. I've had longstanding issues with finding my vitamin D levels difficult to raise (currently 63) and also supplement with vit B12. At the end of Nov had a rapid increase in the following symptoms, which seemed to match with many on the thyroid symptoms checklist:

🟠Extreme fatigue - falling asleep at my desk and just generally feeling very slow

🟠Lack of concentration/forgetfulness

🟠Cold/white extremities - including the end of my nose going numb

🟠Burning hands and feet and tongue

🟠Clumsy and dropping things

🟠Dry skin

🟠Pain aching on the back of my neck/shoulders and tops of arms

🟠Lower back ache and stiffness

🟠Feeling of pressure on the front of my neck when I lay down or sometimes when swallowing

🟠Choking on my saliva once or twice a day

🟠Increase in my tinnitus

🟠Poor sleep quality

🟠Low mood - not depressed, just flat

I sent off for a medichecks thyroid test, as I was worried the GP would just attribute this to the menopause and not investigate further. I have my results back, which the Medichecks doc says is OK. I wondered if you kind folks could cast your eye over them too...

CRP HS = 1.85mg/L (0 - 5 )

TSH = 2.18 mU/L (0.27 - 4.2) - (1.3 @April 21)

Free T3 = 3.81pmol/L (3.1 - 6.8) - (4.4 @April 21)

Free Thyroxine = 14.3pmol/L (12 - 22) - (17.3 @April 21)

Thyroglobulin Antibodies = 11IU/mL (< 115) - (12 @April 21)

Thyroid Peroxidase Antibodies = 20IU/mL (< 34) - (27.2 @April 21)

I realise lots of the symptoms could indicate other issues, so hopefully I can work o a process of elimination... TIA. 😊

[GlowCoach Administrator]

Both your FT4 and FT3 are low in range and your TSH above 2. Aim for a TSH below 1. You need a 25mcg dose increase, nothing to do with menopause!

[KBird01 in reply to GlowCoach]

Thanks for your reply. I don't currently have a thyroid diagnosis - this is more to exclude any potential issues.

[GlowCoach Administrator in reply to KBird01]

Ah that makes things a bit clearer. Well your antibodies are negative so no autoimmune thyroid condition on this test. They do vary though so could be retested some months later and get a different result.

Both your FT4 and FT3 and low but your TSH only just above 2. No doctor will treat you based on those results but your thyroid could be struggling. Better to get bloods done at 9am, yours were slightly early. TSH varies throughout the day and is highest at 9am.

You need to get iron and ferritin tested.

[KBird01 in reply to GlowCoach]

Sorry, I didn't post these. My ferritin is 48.2ug/L (13 - 150). As per my reply to Slow Dragon below, I've been told I should have these around the 70 mark, but have struggled for several years to raise this consistently. Thanks again for your support. 😊

[SeasideSusie Remembering]

KBird01

I have my results back, which the Medichecks doc says is OK

First of all, they're not worth having, they slow up receipt of your results and they take the same line as any NHS GP.

Are you diagnosed underactive and on Levo? If so

Going through your results:

CRP HS = 1.85mg/L (0 - 5 )

As an inflammation marker, the lower the better with this test. Yours is at the lower end of the range.

TSH = 2.18 mU/L (0.27 - 4.2) - (1.3 @April 21)

Has increased since last time. Hypo patients generally feel best when TSH is 1 or below. This result suggests undermedication.

Free T3 = 3.81pmol/L (3.1 - 6.8) - (4.4 @April 21)

Has reduced since last time, is only 19.19% through range which is very low. Suggests undermedication.

Free Thyroxine = 14.3pmol/L (12 - 22) - (17.3 @April 21)

Again reduced since last now, now only 23% through range. Suggests undermedication.

Were both tests done under the exact same circumstances:

* No later than 9am

* Nothing but water before the test

* Last dose of Levo before the test

* No biotin, B Complex or other supplement containing biotin for 3-7 days before the test.

If you are not diagnosed and not any any thyroid hormone replacement then your results suggest that you are on your way to hypothyroidism but your results, at the moment, aren't bad enough to give you a diagnosis and prescription. Your GP will want to see your TSH at least over range and may want to wait until it reaches 10, or your FT4 below range.

Thyroglobulin Antibodies = 11IU/mL (< 115) - (12 @April 21)

Thyroid Peroxidase Antibodies = 20IU/mL (< 34) - (27.2 @April 21)

As these are below range they are classed as negative for autoimmune thyroid disease.

As CRP was included, I expect this was a full thyroid/vitamin panel. How were your vitamin levels?

[KBird01 in reply to SeasideSusie]

Thank you for your reply. I don't have a thyroid diagnosis, but as everything gets attributed to my menopause at the moment, I thought I'd do a bit of research myself to inform discussions with my GP. I know a lot of these symptoms do overlap with menopause and vitamin issues and am happy to look at this, but want the whole picture if I can.

I took both tests between 7-8am with nothing but water before or after and came off all supplements for 2 weeks before.

My vitamin levels were:

Folate = 26.27ug/L (> 3.89) - this is always at a high level even though I don't supplement

B12 Active = >150pmol/L (37.5 - 150) - I have had issues with this in the past, but these were improved somewhat with supplementing. I have no diagnosis of pernicious anaemia, but I am a vegetarian. I didn't supplement at all for over 2 weeks prior to the test.

Vit D = 63nmol/L (50 - 200) - Despite high doses of supplements (&K2) and sun in the summer, I have struggled to get above this level for years.

Thanks again for your info. 😊

[SeasideSusie Remembering in reply to KBird01]

KBird01

Vit D = 63nmol/L (50 - 200) - Despite high doses of supplements (&K2) and sun in the summer, I have struggled to get above this level for years.

Do you also take magnesium, it's another important cofactor of D3. Magnesium helps the body convert D3 into it's usable form. As there are many different forms of magnesium we need to choose the one most suited to our needs:

naturalnews.com/046401_magn...

explore.globalhealing.com/t...

and ignore the fact that this is a supplement company, the information is relevant:

swansonvitamins.com/blog/ar...

Another thought, what form of D3 are you taking - tablet, capsule, oil based softgel, sublingual liquid? D3 is fat soluble so needs fat to be absorbed, as does K2. If you're not taking a combined D3/K2 and taking separate supplements, do you take them at the same time? K2 will compete with D3 for the fat to be absorbed so either both need to contain their own fat or they need to be taken at different times of the day.

[KBird01 in reply to SeasideSusie]

Sorry, I thought I'd already replied to this! I tell you, my cognition skills are rock bottom right now! 🤦‍♀️

Thanks for the links, I'll check these out. Also for the Vit D info. I do take a combination of tablet & sublingual D3/K2 at 2-3000iu of D a day. I take these with fatty food, but wasn't aware they were best taken separately, so I'll give that a go.

Thanks again. 😊

[SlowDragon Administrator]

no iron and ferritin results?

Request full iron panel test for anaemia including ferritin

[KBird01 in reply to SlowDragon]

Hi. Sorry, I forgot to post my ferritin results. These were:

48.2 ug/L - (13 - 150) - as with my Vit D levels, I've struggled to get these up with previous results being:

March 2019 - 47.6

Jan 2020 - 56.9

April 2021 - 68

I was told that I should have ferritin levels around the 70 mark. I'm a vegetarian, but eat a lot of eggs and dairy and also have a good diet with lots of fresh veg, although I know the iron in these is less easily accessed than the other version.

I struggle to take iron supplements as they upset my tummy - even the expensive solgar ones. ( I do wish life were a little simpler! 😉)

[SlowDragon Administrator in reply to KBird01]

Very difficult/impossible to maintain good iron/ferritin by foods alone on vegetarian or vegan diet

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 

preventmiscarriage.com/iron...

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.

healthunlocked.com/thyroidu...

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...

Shellfish and Mussels are excellent source of iron 

healthline.com/nutrition/he...

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...

Ferritin range on Medichecks 

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

[KBird01 in reply to SlowDragon]

Thank you again, I'll check these out. I don't eat chicken or fish, but will see what else I can do to up my intake. 😊

[SlowDragon Administrator in reply to KBird01]

There’s loads of different types of iron supplements

But if self supplementing you MUST do full iron panel every 3-4 months …..not just ferritin

Iron is extremely toxic in excess