firstly, thank you those who replied to my last post and validated my feelings following another dismissive GP appointment.
i took the advice given and used the NHS lab tests through Monitor my Health, and got the overview message that my results are unusual and I need to see my GP who pretty much sent me out of the surgery because ‘there is nothing wrong’ 🙄
Antibody test was normal ruling that out. Other results are below.
If anyone has had similar results ( normal but low end TSH, out of range low FT4) and a diagnostic outcome I would really appreciate your opinion because I went armed with info before but failed to be taken seriously.
Thank you in advance
TSH- 1.77 (0.27-4.2)
FT4 -11.8 (12-22)
FT3 -4.3 (3.1-6.8)
B12 381 (197-771)
Ferritin 12 (13-150)
Folate 5.2 (3-20)
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Montson
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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
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
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.
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. ‘
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
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
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
wow thank you for so much detail in your response, I will work through each bit. I have a lifetime history of anaemia despite taking supplements and have a good diet, I thinks it’s more an absorption issue.
I just wish one person at my surgery would take a holistic view of everything for me, I feel so poorly so much of the time.
hi, my TSH was 0.35 (0.35 was the lowest part of the range) and my FT4 was low but in range and FT3 low but still in range. I went to an endo and had all kinds of tests including MRI and said that my ranges were fine, low but low is my ‘normal’. Sorry I know that’s not what you wanted to hear, hopefully someone comes along with a more positive outcome. Following with interest!
Your test results look simular to what mine did several years before I was finally diagnosed when my TSH went over range . I did not feel well. I'm afraid no doctor in the uk will treat you with ranges like that, despite your ft4 being on the low end of range. They may be prepared to do periodic retesting. I saw a private doctor too. He said my low ft4 was suspicious but it was a wait & see game.
Your best bet is to make sure you have optimised all your vits minerals. Vit D, B12, folate, iron. Adding selium in may help. Consider a trial of GF.
improving terrible vitamin levels with either just help thyroid work better, or if thyroid is causing the issues……improving vitamin levels, especially ferritin will help TSH rise so you can get levothyroxine prescribed
this was my suspected diagnosis. However, all other tests didn’t point to this. I am watch and wait, repeat testing and optimise everything else! Good luck. Hope you feel better soon
Ah.... Can't comment on that am not a medical professional.Your ferritin is very low. They should treat you for that & your B12 is lowish... Best over 500 but GP won't treat unless it's under range or you have neurological symptoms.
Your Ferritin is below range and needs investigating - you must be feeling dreadful :
Your folate and B12 are much too low, though in range, to be helping support you and I can't see a vitamin D :
I now know I need to aim for a ferritin at around 100 : folate 20 : active B12 75++ ( serum B12 500 ++ ) and vitamin D at around 100:
From what i read and have experienced doctors are not obliged to treat you if you fall into the ranges but understand that some ranges NHS are too wide to even be considered sensible.
At the very least the NHS should offer you an iron panel and if nothing else is going on and iron infusion.
Your T4 is under range and again, this needs more thought as your TSH is not responding in the normal way - which would be to rise high and over range.
T4 is a storage hormone and needs to be able to convert well into T3 the active hormone that runs all bodily functions and currently struggling to find enough T4 to keep you well.
We generally need a T4 in the upper quadrant of it's range at around , say, 20 to be able to convert to a decent level of T3 and up in the range at around 5's.
Currently your T4 is in under range and your T3 in overdrive as there's no T4 in the tank, and like a car, you are trying to function on an almost empty fuel tank.
Your body s trying hard to compensate but with a T3 at just around 30% through the range this is not high enough to perform all the bodily functions you need to do to stay well.
You need T4 - Levothyroxine but in order for this to work well you do need your core strength vitamins and minerals - ferritin, folate, B12 and vitamin D , f - up and maintained at optimal levels.
So, it's a bit of a chicken and egg - but please, first off, see if there is a different doctor within this surgery.
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