results & feeling bad : Might some kind soul... - Thyroid UK

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results & feeling bad

Quinc profile image
18 Replies

Might some kind soul take a quick peep at these test results please and tell me anything looks adrift?

mall seems to be within normal .. but I am feeling dreadful- exhausted, cold, faint and generally out of it … been going on for a few weeks now. Taking B complex and 25 Levo twice a day …

Thanks

Serum ALT level: 19 U/L (normal range: 0-45)

Serum bilirubin level: 15 umol/L (normal range: 0 - 21)

Serum alkaline phosphatase: 49 U/L (normal range: 30 - 130)

Serum albumin: 37 g/L (normal range: 35-50)

Serum folate: 11.8 ug/L (normal range: 2.7 -

12 May 2023

Serum ferritin: 166 ug/L (normal range: 20 - 300)

12 May 2023

Serum TSH level: 2.73 mU/L (normal range:

Serum total 25-OH vit D level: 111.8 mol/L (normal range: 50 - 150)

12 May 2023

Serum vitamin B12: 263 ng/L (normal range:

160 - 800)

12 May 2023

HbA1c levl - IFCC standardised: 31 mmol/mol (normal range: 20 - 41)

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Quinc profile image
Quinc
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18 Replies
SeasideSusie profile image
SeasideSusieRemembering

Quinc

Did you do your test as we advise:

* No later than9am

* No food/drink other than water before the test

* Last dose of Levo 24 hours before test

* Leave off B Complex/biotin supplement for 3-7 days before test

Ferritin looks OK providing no inflammation, was an inflammation marker, eg CRP, tested at the same time? Ferritin rises with inflammation, your previous posts suggest you have Hashi's and Hashi's can cause inflammation.

Serum TSH level: 2.73 mU/L (normal range:

You haven't put the range but we know that 2.73 for TSH is too high. Most people on Levo only tend to feel best when TSH is around 1 or lower, with FT4 and FT3 in the upper part of their reference ranges. Your TSH level suggests undermedication. 50mcg Levo daily is a small dose, just really a starter dose. How long have you been on this dose and any reason why you haven't progressed to a higher dose?

How much do you weigh?

No FT4 result. You cannot tell thyroid status from TSH alone, it's a pituitary hormone not a thyroid hormone, FT4 and FT3 are the thyroid hormones. With your TSH high I expect your FT4 will be low which means your FT3 will probably be low too.

If you can't get FT4 and FT3 tested with your GP you may wish to consider doing private tests as many of here do. Monitor My Health, Medichecks and Blue Horizon are the most popular private labs, details and discount codes here:

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

Serum folate: 11.8 ug/L (normal range: 2.7 -

Again, not a complete range. Folate is recommended to be at least half way through range. Add the lower/upper limits of range together and divide by two, is your folate level higher than that?

Vit D is OK, it's recommended to be between 100-150nmol/L.

Serum vitamin B12: 263 ng/L (normal range: 160 - 800)

This is low and you'll need more than a B Complex to raise this level. Some people with a B12 level in the 300s have been found to need B12 injections. This poor B12 level wont be helping at all.

According to an extract from the book, "Could it be B12?" by Sally M. Pacholok:

"We believe that the 'normal' serum B12 threshold needs to be raised from 200 pg/ml to at least 450 pg/ml because deficiencies begin to appear in the cerebrospinal fluid below 550".

"For brain and nervous system health and prevention of disease in older adults, serum B12 levels should be maintained near or above 1000 pg/ml."

Do you have any signs of B12 deficiency – check here:

b12deficiency.info/signs-an...

b12d.org/submit/document?id=46

If you do then list them to discuss with your GP and ask for testing for B12 deficiency and Pernicious Anaemia. Do not take any B12 supplements or folic acid/folate/B Complex supplements before further testing of B12 as this will mask signs of B12 deficiency and skew results and if you have B12 deficiency and it is not detected and treated then this could affect your nervous system. B12 deficiency should be treated before starting folic acid because folic acid can sometimes improve your symptoms so much that is masks B12 deficiency.

If you do not have any symptoms of B12 deficiency then consider taking a B12 sublingual methylcobalamin supplement until your level reaches 550ng/L (same as pg/ml) together with B Complex. Once you've reached this level drop the B12 and continue with the B Complex only. Remember to leave B Complex off for 3-7 days before any blood test as it causes false results.

Liver and HbA1C tests are all within normal range and don't suggest any problems. However, if you've had liver test before then compare results, if significantly different maybe discuss with GP, one would expect them to stay reasonably stable.

SlowDragon profile image
SlowDragonAdministrator in reply to SeasideSusie

Quinc is vegetarian so going to need separate B12 as well as vitamin B complex

Quinc profile image
Quinc in reply to SeasideSusie

thanks so much for taking the time for such a considered response SeasideSusie, I hugely appreciate your help.

I took the blood test after 11am (no dates for ages at my clinic). I weigh about 80k. I take Levo 25 twice a day as 50 was giving me flutters and making me over conscious of heart beat. I take Wockhardt around 7am and around 11pm. Do you think I should raise morning to 50 first?

I am veggie and am taking Viridian B 12complex (B12 ug) …

🙏🏽

SeasideSusie profile image
SeasideSusieRemembering in reply to Quinc

If you have those sort of reactions to Levo then take increases low and slow, 12.5mcg rather than 25mcg, even 6.25mcg if necessary, some people do need to increase very slowly.

What about symptoms of B12 deficiency, do you have any?

Quinc profile image
Quinc in reply to SeasideSusie

reckon I do … (never knew B12 deficiency covered such a range of problems!!) … I am seriously fatigued (including first thing in the morning), cold, irritable and slightly dizzy. I also seem to be having inflammation problems and IBS flare ups ….

SeasideSusie profile image
SeasideSusieRemembering in reply to Quinc

So maybe ask GP to test for B12 deficiency and to see if the cause is Pernicious Anaemia. It just may be because you are veggie and the cause is purely not getting enough from diet, in which case supplementing or even B12 injections for a while to get level up to a decent number then OTC sublingual B12.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Quinc

The Viridian B complex is low dose of inactive vitamins. The B Complexes we recommend are any one of these which are higher dose and active/methyl vitamins.

amazon.co.uk/Liposomal-Soft...

amazon.co.uk/Yipmai-Liposom...

hempoutlet.co.uk/vitablosso...

Quinc profile image
Quinc in reply to Jaydee1507

thanks … will try Luposomal

Quinc profile image
Quinc in reply to Jaydee1507

thanks …. “Inactive ingredients” … can you please expand on what that means? That these current vitamins are useless?

SlowDragon profile image
SlowDragonAdministrator

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

TSH is too high for someone on levothyroxine

No Ft4 or Ft3 results

You need 25mcg dose increase in levothyroxine

Which brand of levothyroxine are you currently taking

You split the dose levothyroxine as 2 x 25mcg

What time do you normally take 25mcg in morning and 2nd dose

Did you stop vitamin B complex 5-7 days before test

B12 is far too low, especially considering you are taking vitamin B complex

Which brand is it

Most likely B12 is because you’re not on high enough dose levothyroxine

Or ……Are you vegetarian or vegan

Low B12 symptoms 

b12deficiency.info/signs-an...

methyl-life.com/blogs/defic...

With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement

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 

Very effective B12 drops 

natureprovides.com/products...

Or

B12 sublingual lozenges 

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate 

healthunlocked.com/thyroidu...

B vitamins best taken after breakfast

Thorne Basic B recommended vitamin B complex that contains folate, but they are large capsules. (You can tip powder out if can’t swallow capsule) 

Thorne currently difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay 

Other options 

healthunlocked.com/thyroidu....

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

endo.confex.com/endo/2016en...

endocrinenews.endocrine.org...

In week before blood test, when you stop vitamin B complex, you might want to consider taking a separate folate supplement (eg Jarrow methyl folate 400mcg) and continue separate B12 until over 500

Quinc profile image
Quinc in reply to SlowDragon

thanks SlowDragon … I will act on tackling B12 first …

SlowDragon profile image
SlowDragonAdministrator

Looking at previous post a year ago

healthunlocked.com/thyroidu...

Vegetarian so you will need separate B12 everyday for at least 2-3 months…..then experiment with perhaps reducing to taking 4-5 days week ……

This is as well as taking daily vitamin B complex continuously

Levothyroxine doesn’t top up failing thyroid it replaces

It’s important to increase slowly upwards until on high enough dose …..usually that’s Approx 1.6mcg per kilo of your weight per day

so weight 80kg x 1.6mcg = 128mcg

You might not need full replacement, but likely you will need further increase up over 75mcg in 3-4 months

Get levothyroxine prescription increased to 75mcg

Stick to same brand levothyroxine as on now

Perhaps initially add 12.5mcg (half 25mcg tablet) per day for first 6 weeks

Then either retest ….or increase up to 75mcg everyday…..and retest in 2-3 months time

Meanwhile working on improving low B12 level

Quinc profile image
Quinc in reply to SlowDragon

brilliant … thanks for that advice. Hugely appreciated

SlowDragon profile image
SlowDragonAdministrator in reply to Quinc

Which brand of levothyroxine are you taking

Quinc profile image
Quinc in reply to SlowDragon

Wockhardt … 25 morn 25 night

SlowDragon profile image
SlowDragonAdministrator in reply to Quinc

Perhaps add half 25mcg tablet to morning dose initially

Request prescription is increased to 3 x 25mcg per day so you can stay on Wockhardt

CapnM profile image
CapnM

I am 50 and take 25 mcg a day, what I thought was thyroid and/or levo side effects turned out to be sleep apnea which can be exacerbated by Hashimotos. I was waking up feeling absolutely dreadful, very fatigued and iritable and again later in day. Always felt like having not slept on an overnight flight to Asia so to speak. I had an inkling it might be sleep related but it seemed to be triggered by changes to levo dose so stuck with that thyroid path but each dose change the symptoms would be triggered/ get worse. Ultimately got a sleep test and was blown away by the results and immediate relief from treatment. Bit leftfield but worth considering. If any thoughts it might be sleep apnea try forcing your self to sleep on your left side for a night or two (something to do with gravity), any immediate relief suggests it might be, obviously partners can help spot it too.

Quinc profile image
Quinc in reply to CapnM

interesting - thanks

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