Blood tests ahead of endo appt: NHS referral... - Thyroid UK

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Blood tests ahead of endo appt

dizzyarmadillo profile image
18 Replies

NHS referral still pending ("on the waiting list") so am paying to see one of the consultants privately in the mean time.

Latest blood test results from Wednesday last week (all done before 9am, fasting, etc etc).

My TSH has increased from last medichecks blood test in February, while T4 has dropped slightly.

Currently supplementing B vitamins and Vitamin D/K2. Ferritin is also increased slightly after eating pate more regularly.

I'm slightly anxious about my upcoming endo appt in May - I'm so used to being told there's nothing wrong with me (despite writing out my list of symptoms for the endo and feeling mildly overwhelmed...) that I'm still half convinced it's an unnecessary issue 🙈🙈

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dizzyarmadillo
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dizzyarmadillo profile image
dizzyarmadillo

Here's my February test results for comparison....

Test results
SlowDragon profile image
SlowDragonAdministrator

How much vitamin D are you currently taking

You need to improve vitamin D to at least over 80nmol

GP should prescribe 1600iu everyday for 6 months

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 with Hashimoto’s, 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 yearly via NHS private testing service when supplementing 

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, with thyroid issues we frequently need higher dose than average

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...

dizzyarmadillo profile image
dizzyarmadillo in reply to SlowDragon

I use the Vitamin D mouth spray by Better You with K2, 7000iu per day.

SlowDragon profile image
SlowDragonAdministrator in reply to dizzyarmadillo

which one…..if it’s the Red one with K2 …..one spray = 1000iu

How long have you been taking 7000iu per day

Are you taking any magnesium?

dizzyarmadillo profile image
dizzyarmadillo in reply to SlowDragon

Yes it's the red spray - seven sprays so 7000iu. I've been taking it since end of February.

No, I need to look into magnesium

SlowDragon profile image
SlowDragonAdministrator in reply to dizzyarmadillo

I found it took around 4 months to improve low vitamin D on 6000iu vitamin D

Retest again in another 2 months

Once you get level up it’s trial and error what dose you need as maintenance dose

SeasideSusie profile image
SeasideSusieRemembering

dizzyarmadillo

CRP is still raised which suggests there is inflammation somewhere (CRP being an inflammation marker but it's non-specific so can't tell you what's causing the inflammation).

Ferritin is very poor, even more so because ferritin rises with inflammation and as your CRP indicates inflammation then this isn't a true ferritin level, your normal ferritin level will be lower. I would ask your GP to do a full iron panel to include

serum iron

saturation percentage

total iron binding capacity

ferritin

You may have iron deficiency, the serum iron and saturation levels would show if that's the case, or you might just have low ferritin but normal iron levels.

Folate is lower than before. What B Complex are you taking? How much methylfolate does it contain (hopefully you have one which contains methyfolate rather than folic acid).

Did you remember to leave your B Complex off for 3 days before this test, this is because it contains biotin which gives false results with any blood test.

Active B12 is good, are you taking a separate B12 supplement? if so you no longer need it, the amount of methylcobalamin B12 in your B Complex should be enough to now maintain a good level.

Vit D: 47nmol/L

This is very low. You were asked on 10th February in this post

healthunlocked.com/thyroidu...

what you were taking for your low Vit D but you never responded.

You might want to check out a recent post that I wrote about Vit D and supplementing:

healthunlocked.com/thyroidu...

and you can check out the link to how to work out the dose you need to increase your current level to the recommended level.

Your current level of 47nmol/L = 18.8ng/ml

On the Vit D Council's website

web.archive.org/web/2019070...

you would scroll down to the 2nd table

My level is between 10-20 ng/ml

The Vit D Council, the Vit D Society and Grassroots Health all recommend a level of 100-150nmol/L (40-60ng/ml), with a recent blog post on Grassroots Health mentioning a study which recommends over 125nmol/L (50ng/ml).

You will see that they suggest 4,900iu D3 daily, nearest amount to buy would be 5,000iu.

I see you are taking K2, are you also taking magnesium as this is another important cofactor when taking D3 as it helps the body convert D3 into it's usable form.

There are many types of magnesium so we have to check to see which one is most suitable for our own 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...

Magnesium should be taken 4 hours away from thyroid meds and as it tends to be calming it's best taken in the evening. Vit D should also be taken 4 hours away from thyroid meds. Vit K2-MK7 should be taken 2 hours away from thyroid meds. Don't take D3 and K2 at the same time unless both are oil based supplements, they both are fat soluble vitamins which require their own fat to be absorbed otherwise they will compete for the fat.

Your Hashi's is probably responsible for your poor nutrient levels and your TSH is obviously still too high and should be nearer 1 so this suggests an increase in Levo is needed.

dizzyarmadillo profile image
dizzyarmadillo in reply to SeasideSusie

Thanks,

I am aware of the CRP marker - I occasionally get small amounts of swelling of my thyroid (it comes and goes), but also still rotate through gastric extremes, so there's several possibilities for that 🙈

My doctor didn't seem to worry that my ferritin was so low (my NHS test last year was on the base of the range), so I've had no luck with them about iron tests. I'll have to try and sort out an iron panel myself.

I've been taking Thorne b complex, though had to stop it for two weeks before the blood test (because it has b12 in it and I wasn't allowed b12 for two weeks beforehand apparently). I was also taking a separate b12 liquid, but have since stopped that as my levels are now healthy.

I use the Vitamin D mouth spray by Better You with K2, 7000iu per day. I'll need to look into adding magnesium as well, thanks.

Thank you, I'm hoping my new endo will be willing to increase my meds (currently 25mg levo daily) as my GP and the initial hospital I was referred to both declared that it was fine and I didn't need an increase 🤷🏻‍♀️

SeasideSusie profile image
SeasideSusieRemembering in reply to dizzyarmadillo

I'll have to try and sort out an iron panel myself.

Medichecks do one - Iron Blood Test £49 - don't forget 10% discount code:

thyroiduk.org/help-and-supp...

I've been taking Thorne b complex, though had to stop it for two weeks before the blood test (because it has b12 in it and I wasn't allowed b12 for two weeks beforehand apparently)

No point in stopping B12 2 weeks beforehand, to get a measure of what you're holding on to you need to be off B12 supplements for 4 months. To know what your B12 supplement is achieving you continue but don't take before the test on the day. If it's just B12 in a B Complex then of course you'd leave the B Complex off for 3-7 days before testing.

I use the Vitamin D mouth spray by Better You with K2, 7000iu per day.

You've haven't had much of a rise in your level considering you're taking such a high dose. I raised my severely deficient level of 15 to 202nmol/L in 2.5 months taking Doctor's Best D3 softgels. I'd consider changing to a different supplement to see if it gives greater results. Don't consider tablets as they're the least absorbable of all D3 supplements, look for an oil based softgel or maybe a capsule. I was checking out some combined D3/K2 for my son yesterday and these two were close contenders

Nature Provides:

amazon.co.uk/Strength-Subli...

You adjust the number of drops to what dose of D3 you require

Time Health:

amazon.co.uk/Vitamin-Plant-...

Both contain the all trans form of K2 which is the better form, it is the converted bioavailable form rather like methylfolate is the bioavailable form of folic acid.

dizzyarmadillo profile image
dizzyarmadillo in reply to SeasideSusie

I tried the nature provides one before moving onto the spray - it was absolutely foul and made me very very sick 🤢

I'll have to have a look into other alternatives

SeasideSusie profile image
SeasideSusieRemembering in reply to dizzyarmadillo

If you're happy to take separate D3 and K2-MK7 then I use

Doctor's Best D3 which are much cheaper at Dolphin Fitness

dolphinfitness.co.uk/en/doc...

Vegavero K2-MK7 - it's 200mcg capsules so I take alternate days

amazon.co.uk/VEGAVERO%C2%AE...

SlowDragon profile image
SlowDragonAdministrator

TSH is high …..yet Ft4 and Ft3 not bad

How much levothyroxine are you currently taking

Ferritin. Keep going…..aiming for ferritin at least over 70

Are you on gluten free or dairy free diet

dizzyarmadillo profile image
dizzyarmadillo in reply to SlowDragon

I'm currently on 25mg daily - GP and initial endo I was referred too both declared I didn't need an increase and I was perfectly fine 🤷🏻‍♀️

I'm currently dairy free.

SlowDragon profile image
SlowDragonAdministrator in reply to dizzyarmadillo

Which brand of levothyroxine are you currently taking

Suggest you give GP copy of these test results and request/insist on 25mcg dose increase in levothyroxine to 50mcg daily

You might initially only increase 25mcg and 50mcg alternate days for first 6 weeks

Comprehensive list of references for needing LOW TSH on levothyroxine 

healthunlocked.com/thyroidu....

TSH should be under 2 as an absolute maximum when on levothyroxine 

gponline.com/endocrinology-...

NHS England Liothyronine guidelines July 2019

 

sps.nhs.uk/wp-content/uploa...

Page 9 

Test for Deficiency of any of the following: Vitamin B12, Folate,  Vitamin D, Iron

See page 13 

1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

dizzyarmadillo profile image
dizzyarmadillo in reply to SlowDragon

Teva is the brand I use at the moment - I was not getting on with the other brands due to the lactose and I find Teva doesn't have any negative effects for me.

I did insist with the February results, which is why I'm now being referred as my doctor told me he wasn't going to increase my dosage for any reason essentially.

SlowDragon profile image
SlowDragonAdministrator in reply to dizzyarmadillo

Well levothyroxine doesn’t “top up” failing thyroid….it replaces it

So almost everyone, ideally eventually ends up on full replacement dose of around 1.6mcg levothyroxine per kilo of your weight per day

standard starter dose is 50mcg levothyroxine

McPammy profile image
McPammy

Your Thyrogobulin antibodies are raised along with the other thyroid antibodies. Has any Dr explained why this could be. Your T4 and T3 look good levels but your TSH is too high calling for more thyroid hormones to be produced. You mentioned in a reply that you get issues with your neck at times? Have you considered going to see an Ear, Nose and Throat Dr at your local hospital so they can do some biopsies or scans. I’m saying this as my sister was in a similar position to yourself. However, she wasn’t on any thyroid medication as her Dr kept saying she had no issue. She clearly had symptoms. She developed a small lump in her throat and decided to switch Drs from an Endocrinologist to an ENT Dr and also switched hospitals as she was getting very upset by now. The ENT Dr ordered a biopsy of the small lump and found thyroid cancer. She was quickly diagnosed and within 2 weeks had her thyroid removed. She gets her thyrogobulin checked regularly now along with the normal TSH, T4 and T3 checks. I don’t wish to alarm you but I do think you should rule this avenue out at least. Myself I have Hashimoto’s and a very poor converter T4 to T3. I take combined medication levo and liothyronine.

dizzyarmadillo profile image
dizzyarmadillo in reply to McPammy

Thanks for that,

No, my GP only ever tests TSH and isn't interested in anything else - the antibody tests are ones I've done privately. I don't think my GP would know what they mean, as he didn't even seem to know where my thyroid was to feel it 🙄

The GP thought about sending me for an ultrasound, but didn't want to "slow down my referral" to the endocrinologist. I'll have to have a think about ENT as well. The swelling I have comes and go, it isn't consistent so I've always just assumed it was to do with autoimmune reactions. Something to think about 🙈

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