Medichecks blood test results

[needlewoman22]

MY GP reduced my thyroxine meds to 75mcgs a day 2 months ago, saying my TSH was too high. I decided to get a Medichecks test done so I had more thorough info on where I am vis à vis generally.

I also take Edoxaban 60mg and 2.5 bisoprolol fumerate as I had an episode of AF in 2017, I have an Eylea injection each month for a BRVO, Letrozole anti-hormone tab to help prevent very early breast cancer recurrence,(since 2021) as well as 20mg Lisinopril, Simvastatin and potassium sparing diruretic each day. I have a B12 shot every 12 weeks and am about 6 weeks in from the last one.

These are the results which I got yesterday from Medichecks. I have a phone appt with a GP in May (!) to discuss, but would like some guidance from the lay experts here please!

19 Apr 2023 TSH 7.69mIU/L 0.27 - 4.2 

19 Apr 2023 FREE T3 3.7pmol/L 3.1 - 6.8 

19 Apr 2023 FREE THYROXINE 13.1pmol/L 12 - 22 

19 Apr 2023 THYROGLOBULIN ANTIBODIES 23.3kIU/L 0 - 115  

19 Apr 2023 THYROID PEROXIDASE ANTIBODIES 52.1kIU/L 0 - 34 

19 Apr 2023 CRP HS 1.02 mg/L < 3 

19 Apr 2023 FERRITIN 27ug/L 30 - 650 

19 Apr 2023 FOLATE – SERUM 36.1nmol/L 8.83 - 60.8 

19 Apr 2023 VITAMIN B12 – ACTIVE 143pmol/L 37.5 - 188

19 Apr 2023 VITAMIN D 179nmol/L 50 - 250 

[SeasideSusie Remembering]

needlewoman22

MY GP reduced my thyroxine meds to 75mcgs a day 2 months ago, saying my TSH was too high.

19 Apr 2023 TSH 7.69mIU/L 0.27 - 4.2 19

Apr 2023 FREE T3 3.7pmol/L 3.1 - 6.8 19

Apr 2023 FREE THYROXINE 13.1pmol/L 12 - 22 19

This doesn't make sense. If your TSH is high that means you are undermedicated and you need an increase in your dose of Levo.

What were the results of your GP tests? If you don't have them either get a print out or you may have online access to them.

If this doctor really has reduced your Levo due to high TSH then run away from him very fast, see another doctor and get the increase that you need. Most Hypo patients on Levo only tend to feel best when TSH is 1 or below with FT4 and FT3 in the upper part of their reference ranges, so you can see you are a long way from that as your results here show.

19 Apr 2023 FERRITIN 27ug/L 30 - 650

This is dire. According to NICE it suggests iron deficiency:

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

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

Show this result and the link to you r GP, ask for a full iron panel to include

Serum iron

Saturation percentage

Total Iron Binding Capacity

Ferritin

This will show if you have iron deficiency.

Also ask for a full blood count as this will show if you have anaemia. You can have iron deficiency with or without anaemia.

Don't consider taking an iron supplement unless you do an iron panel, if you already have a decent level of serum iron and a good saturation percentage then taking iron tablets can push your iron level even higher, too much iron is as bad as too little.

Your other vitamins are fine, presumably you are supplementing?

If taking a B Complex or Biotin, did you leave this off for 3-7 days before testing to avoid false results?

[needlewoman22 in reply to SeasideSusie]

yes, I supplement, B12 shot every 12 weeks, but I was about 6 weeks since last shot when I did this test. Thanks for your input! These results are taken from my patient record.

I did have anaemia a few years ago but

Haemoglobin estimation135 g/L115 - 165 Normal on 8th Feb this year.

Serum iron level17.1 umol/L4.4 - 27.9 Normal15 Dec 2021

8 Feb 2023 Serum free T4 level19.20 pmol/L9.01 - 19.05 Abnormal

3 May 2022 Serum free T4 level15.60 pmol/L9.01 - 19.05 Normal

19 Oct 2021 Serum free T4 level13.70 pmol/L9.01 - 19.05 Normal

8 Feb 2023 Serum TSH level0.07 mIU/L0.35 - 4.94 Abnormal

1 Jun 2022 Serum TSH level1.02 mIU/L0.35 - 4.94 Normal

3 May 2022 Serum TSH level0.08 mIU/L0.35 - 4.94 Abnormal

19 Oct 2021Serum TSH level3.19 mIU/L0.35 - 4.94 Normal

[SlowDragon Administrator in reply to needlewoman22]

So February results

Serum TSH level0.07 mIU/L0.35 - 4.94 Abnormal

Serum free T4 level19.20 pmol/L9.01 - 19.05 Abnormal

Was this test done early morning and last dose levothyroxine 24 hours before test

Never agree to dose reduction based just on TSH and Ft4

Always get TSH, Ft4 and Ft3 tested together and all four vitamins

Low ferritin will tend to lower TSH

Work on improving low ferritin levels and increase dose levothyroxine back up

Retest again in another 8 weeks

[needlewoman22 in reply to SlowDragon]

Yes, it was done 8 ish on Monday morning, fasting, no thyroxine for 48 hours before, and I followed the Medichecks instructions closely.

[SlowDragon Administrator in reply to needlewoman22]

Last dose levothyroxine 24 hours before test…..not 48 hours

Work on improving low ferritin

Get GP to do full iron panel test or test privately

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 

Medichecks iron panel test 

test early morning fasting and don’t eat iron rich dinner night before 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

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. ‘

[greygoose]

I presume you are taking a statin because your cholesterol is high - which is not in the least bit surprising given the level of your FT3!

Please read my explanation in this thread:

healthunlocked.com/thyroidu...

[needlewoman22 in reply to greygoose]

yes, but not sure I really NEED 40mgs a day!

08 Feb 2023.Serum Cholesterol 4.0 mmol/L

08 Feb 2023 HDL cholesterol level1.1 mmol/L

08 Feb 2023 Se non HDL cholesterol level2.9 mmol/L

Cholesterol/HDL Ratio3.6

[greygoose in reply to needlewoman22]

You don't need a statin at all. You need an increased level of T4.

Did you read that link?

[Jaydee1507 Administrator]

Clearly your dose has been reduced by far too much. You may not even have bene on enough in the first place!

What dose were you on in February and how did you feel then?

I cant really add much to what has already been said as you have had excellent advice already.

We do need to take charge of our thyroid treatment though. Try not to be rail roaded into things that you're not happy with such as reducing your dose. Should that happen ask for a retest in 6 weeks which will give you a breather to gather some evidence for having the results that you do. We need to be our own health advocates with this condition.

[needlewoman22 in reply to Jaydee1507]

I was on 100mcg, and had been for ages. Felt ok on that. Following on from my last post further down after I had a retest at the surgery-3rd May, re iron studies,

Serum iron level16.7 umol/L4.4 - 27.9 Normal03 May 2023

Serum transferrin2.99 g/L2.0 - 3.2 Normal03 May 2023

Transferrin saturation index22 %0 - 55 Normal03 May 2023

Serum ferritin45 ng/mL20 - 204 Normal3 May 2023

I am also on Letrozole anti oestrogen tablet after the early breast cancer in 2021, and Letrozole can increase weight, BP, cholesterol, but the GP seems to ignore all these side effects! I am Working toward seeing someone at Oxford oncology to discuss everything in detail.

[Jaydee1507 Administrator in reply to needlewoman22]

Push GP for a full 25mcgs increase.

humanbean is very good with iron panel results. Thank you!

[humanbean in reply to needlewoman22]

Serum iron level 16.7 umol/L (4.4 - 27.9) 52% through the range

Serum transferrin 2.99 g/L (2.0 - 3.2) 82% through the range

Transferrin saturation index 22 % (0 - 55)

Serum ferritin 45 ng/mL (20 - 204) 14% through the range

.

I'm using this link as a guide to optimal iron levels :

rt3-adrenals.org/Iron_test_...

Please note that it is common for people to have contradictory iron results.

.

Serum iron

• 55 to 70% of the range

• lower end for women

Your iron is 52% through the range, so is almost optimal.

.

Transferrin

• Low in range indicates lack of capacity for additional iron

• High in range indicates body's need for supplemental iron

Your result of 82% through the range is high in range, suggesting you need more iron.

.

Saturation

• optimal is 35 to 45%

• lower end for women#

Your result of 22% is much lower than optimal, suggesting you need more iron.

.

Ferritin

• Low level virtually always indicates need for iron supplementation

There are various opinions on what constitutes an optimal level of ferritin. Ferritin is a measure of your iron stores. Yours is low in range suggesting you need more iron. I would suggest aiming for mid-range, which is 112 with your range. But if you were to raise your ferritin with supplements and you felt well before you reached mid-range then I would suggest you reduce your dose and keep it where you feel well.

.

Beware.... Your serum iron is much, much closer to optimal than your ferritin. If you started taking supplements there is a possibility that your serum iron would rise, possibly quite dramatically, and leave your ferritin barely changed. This is not a good outcome. Having lots of free iron in the blood can encourage the growth of any infections, increase inflammation, and possibly even encourage the growth of cancer cells.

Anyone with low iron and ferritin who supplements iron should do so, at the start, for 4 - 6 weeks and then retest, to find out what is happening to their iron and ferritin, and whether one shoots up and the other doesn't move. If this happens then supplements should be stopped.

This problem with iron and ferritin, and whether or not one of them will shoot up with supplements, can be caused by having certain genetic variants that affect methylation :

stopthethyroidmadness.com/h...

One way to deal with it is to optimise Vitamin B12 (with methylcobalamin, avoiding cyanocobalamin) and Folate (with methylfolate, avoiding folic acid). Methylcobalamin and methylfolate are both easily sourced on websites selling supplements e.g. Amazon, Ebay, and many others.

[humanbean in reply to humanbean]

Iron supplements in the UK can be bought in pharmacies or online without prescription. I listed several in this reply to another member :

healthunlocked.com/thyroidu...

[humanbean in reply to humanbean]

You should read this reply I made to another member on the subject of methylation :

healthunlocked.com/thyroidu...

[needlewoman22 in reply to humanbean]

Thank you so much! There is such a lot of info to absorb, and while I'm interested in helping myself I do find all the comparisons daunting! I take on board all you say. 👍