Blood tests & upcoming endo appt advice

[JUUJOO]

I had to cancel and rebook my endo blood test last minute as they messed me around with my endo appointment- so my latest blood test wasn't done pre 9am with 24hours from last dose. I had no choice but to go with the blood test offered at 11am unless I moved my endo appointment. I had taken my thyroxine 13hours previous aswell. How will this effect my results?

As normal the endo didnt test FT3 or any vitamins

16th June23:

TSH 0.23 (0.27-4.2) FT4 22.3 (10.8-25.5)

My endo appt later this week - I am hoping he will offer me a trial of T3. Last time I spoke to him was in March after I had a dose increase in December from 100/125 to 125 daily. I felt terrible, I felt like death . I couldnt cope with the side effects,so reduced slightly to 125x5 days and 100x 2days and rode it out, but I still have zero energy and all the other hypo symptoms I had originally. He did mention trialling another drug if I didnt do well. .. Are these blood tests suggesting I might be worthy of a trial still?

My last bloods were in March with medichecks:

TSH 1.32 (0.27-4.2) FT4 17.9 ( 12-22) FT3 4.02 (3.1-6.8)

VIt D 97 (5--200) Folate 10.96 (3.89-19.45) B12 101 (37.5-150)

Ferritin 32.9 (13-150)

When I have my appt later this week I am hoping he will offer me T3. Any advice if he does offer me T3, or what do I do if he doesn't offer anything? Life is pretty miserable. Should I be asking for a second opinion elsewhere? I cant imagine that this is how I have to feel forever.. Many thanks.

[pennyannie]

Hello Juujoo :

Has anything been discussed regarding your low ferritin level ?

Everywhere I researched suggested ferritin needed to be at least over 70 for any thyroid hormone replacement to work well.

Since the endo isn't even running a blood test forT3 I can't see how he can justify prescribing a trial of same.

[JUUJOO in reply to pennyannie]

Thankyou - the endo has dismissed my low ferritin multiple times. My gp prescribed me tablets which Ive been taking 8 months or so now..yet still it remains low.

[pennyannie in reply to JUUJOO]

Ferritin does take time to build but after 8 months what progress has been made ?

Was an iron panel run when presumably your ferritin level was much lower and before the prescription given ?

When my ferritin level was at 22 I had to undergo both an endoscopy and colonoscopy before I was prescribed a supplement.

Maybe your dose needs increasing ?

I found the NHS iron too harsh on my stomach and was refused an alternative so purchased my own - any brand of an iron bisglycinate will be kinder on your stomach.

[JUUJOO in reply to pennyannie]

When I was diagnosed with Graves before I had Rai, my ferritin was 70. Then 6 months after Rai and taking thyroxine I went down to 19. I take 210 of ferrous fumerate a day. Gp wants to get my levels to 90 but unfortunately endo not interested at all. I have an appt with the gp to discuss iron next month..

[pennyannie in reply to JUUJOO]

Yes - RAI is known to trash vitamins and minerals and we need optimal vitamins and minerals for the thyroid hormone medication to work well :

I wonder if you have an absorption issue since your ferritin was 19 and now 8 months later just 33 ?

At the time I was taking 3 x 210 tablets a day and ate liver twice a week and it still took me around 9 months to tip over 70 :

[pennyannie in reply to JUUJOO]

Just looked back and see I've written most of this to you before !!

Having Graves Disease and having had RAI thyroid ablation myself I know I feel better with full spectrum thyroid hormone replacement but I had to do this for myself as I was refused both T3 and NDT by the NHS back in 2018.

Guessing if I look back further I've probably written more fully to you ages ago !!

[pennyannie in reply to pennyannie]

Yup - just read your very first question from 9 months ago and see we all probably left you in information overload !!

[JUUJOO in reply to pennyannie]

Yes thankyou, there is only so much my brain can handle at once! Its an ongoing learning journey.

[pennyannie in reply to JUUJOO]

Yes, I know - I too was very unwell and just want you better -

Sorry, I'm just upset for you - and cross your medical team are not more proactive.

[pennyannie in reply to pennyannie]

Do you know how to find everything you have ever written on this forum and all of your replies ?

Simply press on the icon top right on this screen which says " More ' and go to your Profile page :

If you wish to read another persons Profile simply press on the face icon alongside any comment they have written and go to their Profile page :

I didn't find this out for around a year of reading on here and was trying to remember everything - there is so much information - and i do understand it' all a bit daunting !!

[JUUJOO in reply to pennyannie]

Thank you, you're a star!

[pennyannie in reply to JUUJOO]

Bit dim on occasion !!!

[SlowDragon Administrator]

obviously just testing TSH and Ft4 is completely useless

If this is private appointment rebook for a date after getting FULL thyroid and vitamin results privately FIRST

if you search Ferritin you will see hundreds of posts discussing low ferritin and poor conversion

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 

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

An article that explains why Low ferritin and low thyroid levels are often linked 

preventmiscarriage.com/iron...

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...

Posts discussing Three Arrows as VERY EFFECTIVE supplement 

healthunlocked.com/thyroidu...

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...

Good iron but low ferritin 

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. ‘

[JUUJOO in reply to SlowDragon]

Thankyou, ill take a read of the links...

[66olives]

I cannot offer advice, my knowledge isn't hood enough. But I do wish you lots of luck.