Blood results - advice on interpreting these and next steps

[Slowrunner1208]

I was diagnosed with hypothyroidism at the beginning of Feb and started on 50mg of Levothyroxine. The dose was increased to 100mg in March as my TSH levels were still outside the reference range, at the same time I was diagnosed with Hashimoto's.

As I have felt no better I have had further investigations and got these test results back this week:

- TSH level 0.45 mu/L [0.3 - 4.5]

- B12 level 345pmol/L [145 - 569]

- Folate 6.3 ug/L [3.9 - 26.8]

- Cortisol 196 nmol/L [133 - 537]

I have also tested negative for Lupus, Coeliac, Cushings and Rheumatoid Arthritis

Earlier tests in Feb, March and April showed:

- Vitamin D 52nmol/L

- Ferritin level 94 ug/L

- Serum free T4 6.6 pmol/L [10 - 22]

This is all still very new and I'm trying to get to grips with results and what it all means.

I think my TSH level is now good and so I'm struggling to understand why I feel no better at all, my symptoms are in my bio, briefly though I'm exhausted pretty much all of the time, my body hurts and is cold, my hair is thinning, I have put on a huge amount of weight and my brain simply isn't working as well as it did. I have to plan my time now as I feel like I have a certain amount of battery and need to be careful how I use this.

The latest bloods were taken in the afternoon as I wasn't expecting them to be asked for there and then and I am waiting for a call from the GP to discuss them (I've accessed the results on the NHS App).

Is there anything in the results that i should speak to the GP about?

Am I being impatient and should I just wait to feel better?

Are there any vitamins that i should be taking (I do take Vit D)?

Would private testing show anything more and is it worth me doing this?

Any other suggestions?

Thanks so much for any advice or input, i really appreciate it!

[Jaydee1507 Administrator]

Although your TSH doesn't look bad it really isnt giving a full picture of whether you are converting or not and where your free hormone numbers FT4 & Ft3 are. It may also have been higher had you tested at around 9am. We cannot see if you are converting T4 to T3 adequately at all. Many people in this group buy private teststo show the results that they need. See link for companies offering private blood tests & discount codes, some offer a blood draw service at an extra cost. thyroiduk.org/help-and-supp...

There is also a new company offering walk in & mail order blood tests in Crawley, Hove and Reigate areas. Check to see if there is a blood test companies near you. onedaytests.com/products/ul...

Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw, last T3 dose 8-12 hours before blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process)? Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsly elevated result and your GP/Endo might change your dose incorrectly as a result.

Your low vitamin levels will mean that your thyroid hormone isnt working as well as it should, so working on getting those optimal & then keeping them optimal will help.

Begin vitamin supplements one at a time for a few weeks to assess if its helping before adding the next.

➢Was your Vit D result before you started supplementing as otherwise you arent taking enough. Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Use this calculator to work out how much to take to get your level to 100-150. wildatlantichealth.com/vita...

➢Ferritin looks OK but can be falsley rasised if you have inflammation in the body.

➢Folate - aim for a level of 20. Recommend taking an active/methyl (should say on label) B complex which contains 400mcgs folate (also B12). This B complex has all the right vitamins at a not unreasonable cost for 90 days supply. amazon.co.uk/Liposomal-Soft...

➢B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

gb.pipingrock.com/methylcob...

cytoplan.co.uk/vitamin-b12-...

So get full bloods done privately and begin on vitamin supplements one at a time.

[Slowrunner1208 in reply to Jaydee1507]

thanks so much for the advice, I’ve been taking Vit D for years but will look at the dose again. I’ll also book a private test to check conversion. 😊