Test results

[Fox123]

I’d be very grateful if someone could have a look at my results and give their thoughts please? The doctor at the testing lab is concerned about the high T3 ( I’m on 3.5 grains of Armour) and also not happy about my B12 being towards the lower end of the range- he’s citing warnings of pernicious anaemia. The STTP book states that high T3 when on NDT usually means it’s pooling and to check cortisol levels. I’ve seen my GP, he’s not concerned about B12 levels at all (!!) and simply suggests I reduce my dose because of the high T3. I showed him the article about T3 pooling in the blood which he did read. However the nhs don’t do cortisol saliva testing ( as recommended in STTP) so I said I’d order a test from Blue Horizon and he said he’d look at the results and possibly refer me to an endo. I’m feeling pretty low at the moment, the weight gain is back and the lethargy. Just when I thought I had it sussed. ( I’ve been on NDT for 6 years now) Many thanks for reading.

[Fox123]

Apologies! For STTP read STTM! Brain fog too! 🙄

[greygoose]

There's no such thing as 'pooling'. That's the trouble with STTM, they don't bother to keep up with the 'latest' research So, be careful what you read. T3 has a half-life of about 24 hours. It doesn't have time to 'pool'. But, you could still have abnormal cortisol levels. Worth getting it checked.

How much NDT are you taking? Because your FT4 is quite high in-range, too. Could just be that your dose is too high. Or, do you have Hashi's? Those antibodies are negative, but that doesn't mean much. Antibodies fluctuate. Have you had them tested before?

[Fox123 in reply to greygoose]

Thank you for replying. I was on 3.5 grains prior to testing so I have come down to 3 for now. I was told I have Hashis but I’m not quite sure how that is determined. I last had this test done in 2020 ( it’s quite expensive!) I will include those results. They were prior to my two hip replacement surgeries.

Test results 2020

[greygoose in reply to Fox123]

It's usually high antibodies that determine Hashi's. But it can also be diagnosed by an ultrasound when the damage is bad enough to be seen. Have you had an ultrasound of your thyroid?

Half a grain is rather a lot to decrease by in one go. It's better to increase or decrease by 1/4 grain at a time.

[SlowDragon Administrator]

what time was test

How long before test was last dose NDT

You will need to improve B12 and folate yourself

What vitamin supplements are you currently taking

Low B12 symptoms 

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 separate B12 supplement and add a separate vitamin B Complex after a week 

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...

or

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 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 

Other options 

healthunlocked.com/thyroidu....

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 and continue separate B12

[Fox123 in reply to SlowDragon]

Thank you! Very helpful. I’ve started a sublingual B12 supplement and folate capsule. I’ve ordered a six point cortisol saliva test kit too. Is there a list anywhere of endos that really understand thyroid issues in NW UK? I’d like to be fore armed if my GP agrees to refer me.

[SlowDragon Administrator in reply to Fox123]

rather than just folate you might be better taking vitamin B complex

Save the folate on its own for week before blood test when need to stop B complex

Regenerus do cortisol and DHEA saliva cortisol test

[SlowDragon Administrator in reply to Fox123]

Email Thyroid U.K. for list of thyroid specialist endocrinologists and doctors

[e-mail]

most are private

Some are doing consultations on zoom so distance no object

Few are private and NHS ….. so can see privately initially and then transfer

NHS - long wait - often at least 6-9 months

[pennyannie]

Hello Fox :

I think you may need to consider going back down to 3 or 3 + 1/4 grains NDT if you want to keep you doctor ' on side .'

On NDT you TSH will likely be low suppressed and your T4 lower than when on T4 monotherapy but your T3 proportionally much higher than when on T4 monotherapy.

My results generally come in with a T3 at around 90/110% through with my T4 at around 25/30% through - dependant on last dose to blood draw and if I had fasted before the blood test.

Your reverse T3 is now in range - but as you say your B12 needs some building up and once this is done and your ferritin, folate and vitamin D are also up and maintained at optimal you may find your conversion from T4 to T3 improved further, from a slightly lower Armour dose.

There is little inflammation - have you now had your hip surgery ?

Are you already supplementing any vitamins and minerals and did you leave these off for around 7 days before this blood draw?

[Fox123 in reply to pennyannie]

Thank you for your reply. I agree, I probably do need to lower my dose for a while, I’ve gone down to 3 grains for now. I’ve started taking a sublingual B12 supplement along with a folate tablet too. I am a bit sporadic with vit D in that I take it when I remember! I’ll have to be more strict. Yes, I’ve had both hips replaced now ( hurray!) so I think this is why my ferritin has come down. Much appreciated and thanks again. 🙏

[Brightness14]

I had been on NDT for years last amount was for 5 years on 2.25 grains per day in two doses. Just 1/4 grain can tip you over from just in to over. Perhaps just reduce by 1/4 grain.

[Fox123 in reply to Brightness14]

Thank you. You’re right, I will definitely just drop a quarter grain. 😉

[tattybogle]

a list of previous posts with good replies which explain why 'pooling' is a rather misleading term and isn't an accurate description of what is going on :

healthunlocked.com/thyroidu... explaining-reverse-t3

healthunlocked.com/thyroidu... pooling-and-cortisol

healthunlocked.com/thyroidu... t3-pooling

healthunlocked.com/thyroidu... a-little-pooling