Latest Blood Test Results

[nimble]

Good morning all. I have an endo appt this Thursday and am trying to prepare myself as I am worried my dosage of Levo might be reduced. I am concerned that T3 conversion needs improvement as I still don't feel 'good' but because my TSH is at the bottom of the range my endo may ignore my concern.

I can't work out at the moment if the not feeling 'good' is the T3 conversion or the Hyperparathyroid issues which are driving me mad. What should I do? Should I be on T3 medication? They have also tested me for Coeliac disease which has come out 'negative.'

The hyperparathyroid complicates things as I have unexplained pains in joints which come and go without notice and suffer immensely with polyuria (am not diabetic). They've prescribed Oxybutynin for this but I have not taken the meds as I already suffer with dry mouth, due to hyperparathyroid I guess. Its only through contact and communication with the healthunlocked community I am beginning to understand the complexities of my health conditions which were previously fobbed off by the GP as menopausal. But, unfortunately I still struggle with my confidence in challenging the clinicians. Any help/guidance is greatly appreciated.

I have been working hard to optimize my vitamins/iron etc over the last few months too.

I stopped all vitamins etc 5 days before the blood test was taken.

Last dose of Mercury Pharma Levo (125mcg) was taken 24 hours before the blood test.

Time of blood test was 8.50am)

I have put in brackets any previous results which were taken on Feb 2nd 2023.

T3 3.8 pmol/L Range:3.1 - 6.8 pmol/L ( 4 )

TSH 0.267 Range:0.27 - 4.2 mIU/L ( 0.444 )

T4 18.74 pmol/L Range:12 - 22 pmol/L ( 19.8 )

Vitamin B12 or cobalamin 826 ng/L or pg/mL Range:197 - 771 ng/L or pg/mL ( 236 ).

I had a B12 injection in February (after some serious begging to a newbie GP) and have been supplementing every day since with B12 drops but stopped taking 5 days prior to blood test.

Bone Profile Results

Calcium [Moles/volume] corrected for albumin in Serum or Plasma 2.72 mmol/L Range:2.2 - 2.6 mmol/L ( 2.63)

Calcium [Moles/volume] in Serum or Plasma 2.71 mmol/L Range:2.15 - 2.55 mmol/L ( 2.51 )

Renal Profile

Estimated GFR " 78 . " Range " >90 . "

PTH (Parathyrin.intact) [Moles/volume] 5.7 pmol/L Range:1.6 - 6.9 pmol/L ( 6.1 )

February 2023 ONLY -

Folic Acid 6.1 ug/L Range:> 2.7 ug/L

Ferritin in Serum or Plasma 102 ng/mL or ug/L Range:13 - 150 ng/mL or ug/L

Vitamin D (25-hydroxycholecalciferol) Range:51 - 163 nmol/L

Apr Results pending.

Feb result was 75 nmol/L

Nov 2022 was 51 nmol/L

May 2022 was 73.7 nmol/L

[SlowDragon Administrator]

parathyroid

Looking at previous post with spreadsheet

healthunlocked.com/thyroidu...

You need vitamin D, parathyroid and calcium levels tested together

Don’t seem to have been done since May 2021

Have you put previous results in calcium pro app

calciumpro.com/

App made by Norman centre who run website

parathyroid.com/

[SlowDragon Administrator]

What vitamin supplements are you currently taking apart from B12

Have you had thyroid antibodies tested for autoimmune thyroid disease, also called Hashimoto’s, usually diagnosed by high TPO or high TG antibodies and/or ultrasound scan of thyroid

[nimble in reply to SlowDragon]

Hi SlowDragon

I was diagnosed with Hashimotos (a couple of years ago).

I have been taking B-Complex drops two weeks after I started the B12 drops (both sets of drops by Liposomal).

The B12 drops were started after the B12 injection in Feb 2023

I also use the Vit D spray Better You 1000iu daily

And K2 separately at a different time to the Vit D spray.

1 capsule Mag Malate around bedtime.

I leave plenty of gaps between taking supplements

The Vit D results have just come in now:

25-Hydroxyvitamin D3 April 2023 69 nmol/L

in Feb 2023 74 nmol/L

in Nov 2022 was 51 nmol/L

in May 2022 was 73.7 nmol/L

The vitamin D, parathyroid and calcium levels were tested together last week at the same time (8.50am) as the blood draw was taken for the Thyroid TSH, T4 & T3

PTH (Parathyrin.intact) [Moles/volume] 5.7 pmol/L Range:1.6 - 6.9 pmol/L ( 6.1 )

in Feb 2023 6.1 pmol/L

Calcium [Moles/volume] corrected for albumin in Serum or Plasma 2.72 mmol/L Range:2.2 - 2.6 mmol/L ( 2.63)

Calcium [Moles/volume] in Serum or Plasma 2.71 mmol/L Range:2.15 - 2.55 mmol/L ( 2.51 )

[nimble in reply to nimble]

Sorry SlowDragon I meant to remove the numbers in the brackets after the results.

So should read as follows:

The vitamin D, parathyroid and calcium levels were tested together last week at the same time (8.50am) as the blood draw was taken for the Thyroid TSH, T4 & T3

PTH (Parathyrin.intact) [Moles/volume] 5.7 pmol/L Range:1.6 - 6.9 pmol/L

in Feb 2023 6.1 pmol/L

Calcium [Moles/volume] corrected for albumin in Serum or Plasma 2.72 mmol/L Range:2.2 - 2.6 mmol/L

Calcium [Moles/volume] in Serum or Plasma 2.71 mmol/L Range:2.15 - 2.55 mmol/L

[SlowDragon Administrator in reply to nimble]

calcium pro app analysis of your results suggests hyperparathyroid is highly likely

Is there a plan in place to investigate/remove offending parathyroid gland

[nimble]

SlowDragon, as far as I know nothing has been progressed. I had a Dexa scan more than 3 years ago and was told I had osteopenia which they said was a normal finding in a female of my age. Since then there has been nothing further done. I am meeting with the endo on Thursday and I hope that something can be done as well as the concerns I have about my T3 conversion.

Do you think the low conversion to T3 is related to hyperparathyroidism ?

[SlowDragon Administrator in reply to nimble]

no they are almost certainly entirely separate

You should have scan of parathyroid glands to find the glands (or glands) that need removing

parathyroid.com/treatment-s...

[nimble in reply to SlowDragon]

Thank you SlowDragon

I have no idea how the discussion will go on Thursday but I hope my endo will put a plan in place. I will keep you updated.

Regarding T3 - I have read a lot of the posts from other members and their experiences in trying to narrow down the margins in reaching that 'sweet spot.' I'm really confused about whether this is something I should be trialling or not, whether through the NHS or privately. Although I'd rather not go down the private route due to the expense involved.

[SlowDragon Administrator in reply to nimble]

Is this private endo or NHS

You need to get them to discuss trial of T3 alongside levothyroxine and parathyroid…..as 2 separate issues

[nimble in reply to SlowDragon]

SlowDragon , the appointment is with an NHS endo. The same one I have had for the last 3 years but have only seen twice. This appointment was scheduled was for last October.

[SlowDragon Administrator in reply to nimble]

Most endocrinologists are diabetes specialists

are they on the list of recommended thyroid specialist endocrinologists who will prescribe T3 if clinically appropriate 

Email Thyroid U.K. for list if not got it

[e-mail]

[nimble in reply to SlowDragon]

Thank you SlowDragon - I have just emailed them and await their reply. Can't thank you all enough.

[SlowDragon Administrator in reply to nimble]

Over 61,800 prescriptions for T3 in England in last year

Typically that’s 6 prescriptions per person per year

searchable by ICB area

openprescribing.net/analyse...

Cost of T3 dropped considerably so more patients are now getting T3 prescription reinstated or trial for first time

Typically eventually most people on T3 take 2 or 3 x 5mcg dose per day

Cheapest by far is to get 20mcg tablets and cut into 1/4’s

Current NHS costs listed here

healthunlocked.com/thyroidu...

[pennyannie]

Hello Nimble ;

Once on thyroid hormone replacement T4 monotherapy, we generally feel at our best when our T4 is in the top quadrant of its range as this should in theory convert to a good level of T3 at around a 1/4 ratio - T3/T4 :

The accepted conversion ratio when on T4 monotherapy is said to be 1 / 3.50 - 4.50 with most people feeling at their best when they come in this range at 4 or under.

So to find how well you are currently converting we can divide your T4 by your T3 and I'm getting your conversion coming in at 4.93 showing your thyroid struggling and your conversion wide of the centre and outside the ratio reference range.

No thyroid hormone replacement works until the core strength vitamins and minerals of ferritin, folate, B12 and vitamin d are up and maintained at optimal - i now aim for a ferritin of 100 ; folate around 20: active B12 75 ++ ( serum B12 500 ++ ) and vitamin D at around 100:

I do not know enough to say if this is due to hyperparathyroid issues but would think the addition of a little T3 to rebalance these 2 vital hormones might help resole some hypothyroid symptoms you maybe suffering.

[nimble in reply to pennyannie]

Thank you pennyannie, the ratio analysis is really useful. And I totally understand the point about optimizing the core strength vitamins and minerals. It's been a struggle to get the Vit D up and unfortunately ferritin was not tested this time around. Definitely a lot of very valid points from your good self and SlowDragon. Fingers and everything else that can be crossed, for a smooth, calm appointment later this week.

[pennyannie in reply to nimble]

Well I'd uncross your toes when walking in otherwise you'll likely be referred to a physiotherapist !!