Full Blood Count Test Results : Hiya, I’ve had a... - Thyroid UK

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Full Blood Count Test Results

NiaJayne profile image
8 Replies

Hiya,

I’ve had a lot of help on this forum in regards to making some sense of my thyroid blood test results and I was wondering if anyone is able to advise with these results too.

They are out of date as they are from December 2022 but they are the tests I was given when my hypothyroid symptoms started getting bad after my partial thyroidectomy in July 2022.

I know the results might have changed by now but I’m still feeling just as unwell as I did then.

I’m not sure if this is a silly question, but do these results link to my thyroid in anyway? I know ferritin is related but I’m unsure of anything else as I’ve had absolutely nothing explained to me by any doctors involved!

Also, do I need to get these tests done again?

Thanks again for your help x

Nia

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SlowDragon profile image
SlowDragonAdministrator

Ferritin was virtually deficient

No B12, folate or vitamin D test results

Suggest you get FULL thyroid and vitamin testing done

Ideally via GP but in reality you’re going to need to test privately

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 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...

If you can get GP to test vitamins then cheapest option for just TSH, FT4 and FT3

£32 (via NHS private service ) and 10% off if go on thyroid uk for code

thyroiduk.org/getting-a-dia...

monitormyhealth.org.uk/

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65 

(Doesn’t include thyroid antibodies) 

monitormyhealth.org.uk/full...

10% off code here 

thyroiduk.org/getting-a-dia...

Only do private testing early Monday or Tuesday morning. 

Link about thyroid blood tests

thyroiduk.org/getting-a-dia...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism 

thyroiduk.org/wp-content/up...

SlowDragon profile image
SlowDragonAdministrator

Ferritin

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

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 

Test early morning and only water between waking and test

Medichecks iron panel test 

medichecks.com/products/iro...

Look at increasing iron rich foods in diet 

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

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...

Effective supplement 

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...

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...

Great research article discussing similar…..ferritin over 100 often necessary 

ncbi.nlm.nih.gov/pmc/articl...

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. ‘

SlowDragon profile image
SlowDragonAdministrator

As per previous posts

healthunlocked.com/thyroidu...

You need to get FULL thyroid and vitamin testing

Ft4 was below range

Hair loss strongly linked to low iron/ferritin

Come back with new post once you get results

Approximately how old are you

Standard STARTER dose levothyroxine is 50mcg

Avoid Teva brand initially, unless you know you’re lactose intolerant. Teva upsets many people

Even if we frequently don’t start on full replacement dose, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or near full replacement dose

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here 

cks.nice.org.uk/topics/hypo...

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine: 

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months. 

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range. 

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

NiaJayne profile image
NiaJayne in reply toSlowDragon

Thank you! I’m in the process of putting all of this information together so that I can request a second opinion from a different GP so I thought I would ask in case these results also needed addressing. I’m 30 😊

SlowDragon profile image
SlowDragonAdministrator in reply toNiaJayne

Any obvious reason for low ferritin

eg

Are you vegetarian or vegan

Or heavy periods

So at your age you could start on at least 50mcg levothyroxine

pennyannie profile image
pennyannie

Hey there again :

I replied to your second post and see we are no further forward :

You really do need to arrange a full thyroid panel to include a TSH, T3, T4, inflammation, antibodies and ferritin- which has probably fallen further through the range by now, folate, B12 and vitamin D.

You have lost part of your thyroid and your TSH and T4 are shouting out for help and support and your need to start taking some form of thyroid hormone replacement - and in the first instance it will be T4 - Levothyroxine.

Your ferritin reading is all but deficient and your T4 reading below the range :

When metabolism is slowed so much the core strength vitamins and ferritin, folate, B12 and vitamin D tend to nose dive through the ranges and you really do need to get these up and maintained at optimal for any thyroid hormone replacement to work well.

I understand with the weight gain you thought to restrict your food intake but this can and likely will impact you in a negative way - the body needs good fats and protein rich healthy foods to metabolise and build back and repair the body.

Please go and talk with a doctor - these results re not acceptable and you must be feeling quite unwell, let alone the psychological impact of the hair loss, which is likely due to low ferritin level.

NiaJayne profile image
NiaJayne in reply topennyannie

Thank you! Yes I’m feeling pretty awful and have for a while now and honestly it’s just nice to know that when I post here, I won’t be fobbed off.

I’m in the process of putting all of this information together so that I can request a second opinion from a different GP so I thought I would ask in case these results also needed addressing. I’ve tried explaining this to my doctor but all he says is oh it’s normal, you’ll be fine when some time has passed.

Thanks so much for your advice and support and I’ll make sure to post again when I get a second opinion. 😊

pennyannie profile image
pennyannie in reply toNiaJayne

You shouldn't need a second opinion for such obvious deficiencies.

Is there another doctor within your existing surgery ?

If you are wanting a referral to an endocrinologist I believe you can choose one of your own choice.

Thyroid UK - thyroiduk.org - the charity who support this forum - hold a patient to patient recommended list of thyroid specialists and endocrinologists so maybe after the weekend email admin @ thyroiduk.org for this and hopefully if looking for a face to face appointment there is someone on there within a doable distance.

Alternatively you could start a new post on here, asking for recommendations within your area - and you will hopefully receive replies - but these be by Private Message as we are not allowed to openly discuss any person by name.

The Private Message ( PM ) just means your replies will light up the Chat icon above - looks like a paper plane - and you just press when lit and taken to a different screen.

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