Test results

[Charliekilosierra]

Hi so following on from appointment and full blood test the thyroid part came back as follows:TSH 1.16 Miu/L

serum free T4 12.5 pmol/L

Basically said I'm fine apart from low vitamin D which is 29 nmol/L

So all that stuff I listed is from that?! I don't believe that at all. Feel lost now

[greygoose]

Can you add the range to the FT4, please? It looks low, compared to most ranges, but impossible to tell for sure without knowing the range.

But, if it is low, then your FT3 will also be low, and it's low T3 that causes symptoms, not TSH, and rarely low T4. And they haven't tested the FT3, for frankly we're none the wiser.

[Charliekilosierra in reply to greygoose]

Range is 9-19

[greygoose in reply to Charliekilosierra]

OK, so it is pretty low - only 35% through the range. It should be more like 75% - or wherever you feel well. Not surprised you don't feel well!

[Charliekilosierra in reply to greygoose]

What can I do then ?

[greygoose in reply to Charliekilosierra]

What else did you get tested? FT3? Antibodies?

There's really nothing much you can do by yourself. You need to get a diagnosis of hypothyroidism. But, those two results on their own don't give us enough information to even try for a diagnosis. Most docters only look at the TSH because that's all they're trained to do. And your TSH result would not give you a diagnosis. So, you need more information to see what's going on and try and build a case.

I see your nutrients are very low, so you do need to boost those somewhat, and that might raise your TSH a bit. But, you also need to get tested early morning, when the TSH is highest. At 2 pm it was around it's lowest. And it's a high TSH that is going to get you a diagnosis.

[Charliekilosierra in reply to greygoose]

Ok thanks I've a plan. I'll boost up my b12 and vitamin D and in a few months I'll get a test again this time early in the morning and go from there. Thankyou

[greygoose in reply to Charliekilosierra]

That sounds like a very good plan. But, you can't just take B12 and vit D on their own:

- All the B vits work together, so you need to keep them balanced. So, as well as the B12 (1000 mcg sublingual methylcobalaming) you need to take a B complex. Also, your folate is low, so you need to boost that with about 400 mcg methylfolate. The best B complex for that is Thorne Basic B. Whatever you do, don't get one with vit C because B12 and vit C should not be taken together.

- Taking vit D will increase your absorption of calcium from food, so you also need to take vit K2-MK7 to make sure that extra calcium goes into the bones and teeth, and doesn't build up in the soft tissues and arteries.

- Vit D and magnesium work together so you need to also take magnesium or you will deplete your magnesium levels, and that is not a good thing to do.

It would also be a good idea to get ferritin and CRP (inflammation marker) tested together. If the rest is low, ferritin could also be.

[Charliekilosierra in reply to greygoose]

I'm so confused 😭

[Charliekilosierra in reply to greygoose]

CRP is 0.7 range is 0-5

[greygoose in reply to Charliekilosierra]

OK, that's good. Nothing to worry about there.

[PurpleNails Administrator]

Was anything else tested? B12, folate, ferritin?

[Charliekilosierra in reply to PurpleNails]

B12 ok yes Folate 3.6 range is 3-20.5

[SlowDragon Administrator in reply to Charliekilosierra]

please add actual results with ranges next to them

Eg

TSH 1.6 (0.5-4.2)

Ft4 12.5 (9-19)

Ft3 result?

Thyroid antibodies tests?

Vitamin D is insufficient/borderline deficient

Folate extremely low

B12 result?

Ferritin result?

Was test done early morning?

[Charliekilosierra in reply to SlowDragon]

Hi no folate test done. Test was done at 3pmNo antibody tests as I'm aware also no ft3 test.

B12 is 289 range 187-883

[SlowDragon Administrator in reply to Charliekilosierra]

you said

Folate 3.6 range is 3-20.5

B12 is 289 range 187-883

So both are far too low

what’s your diet like

Are you vegetarian or vegan

Do you have any Low B12 symptoms 

If you do and NOT vegetarian or vegan request testing for Pernicious Anaemia via GP before starting any B12 supplements

b12deficiency.info/signs-an...

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

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a B12 supplement as well as a B Complex 

Then once your serum B12 is over 500 (or Active B12 level has reached 70), you may be able to reduce then stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 few times a week 

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...

low folate

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 also help improve B12 levels too

Difference between folate and folic acid 

healthline.com/nutrition/fo...

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-£25. iherb.com often have in stock. Or try ebay

[Charliekilosierra in reply to SlowDragon]

Yeh my diet is not the best. I don't eat much veg and no fruit I don't like it. I skip meals such as breakfast. Have done for years unfortunately. I really do need to sort my eating out it's finally caught up with me I think. My wife's friend does the b12 injections. I'm not a vegan or veggie I like my meat.

[SlowDragon Administrator in reply to Charliekilosierra]

So as well as vitamin supplements, look at improving your diet

We are what we eat …..

[SlowDragon Administrator in reply to Charliekilosierra]

TSH would be significantly higher at 9am …..but unlikely over 3

Getting all four vitamins at optimal levels is first step

[SlowDragon Administrator]

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 year when supplementing

NHS private testing service

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

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...

[Charliekilosierra in reply to SlowDragon]

Thanks just ordered that spray one

[SlowDragon Administrator]

Work on improving low vitamin D, low folate and low B12

Retest FULL Thyroid including Ft3 and BOTH thyroid antibodies and vitamin levels in 2-3 months

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

Also 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...

only do test around 9am on Monday or Tuesday morning

Come back with new post once you get results