Help with blood test results : Hi I have had a... - Thyroid UK

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Help with blood test results

lizziep profile image
13 Replies

Hi

I have had a medichecks blood test done after doctor wanting to lower my levothyroxine dose and hope you can help with the results.

Ferritin 20.2. Range 30-650

Folate serum 8.9 Range 8.83-60.8

Vit B12 active 143 Range 37.5- 188

Vit D 107 Range 50-250

TSH 0.198 Range 0.27-4.5

Free T3 4.4 Range 3.1-6.8

Free thyroxin 19. Range 12-22

Thyroglobulin 18.3 Range 0-115

Thyroid peroxidase antibodies 12.7

Range 0-34

Thanks in advance

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lizziep
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SlowDragon profile image
SlowDragonAdministrator

So looking at previous post

healthunlocked.com/thyroidu...

You are gluten intolerant and on strictly gluten free diet

Assuming you tested as recommended…..early morning, only water to drink between waking and test and last dose levothyroxine 24 hours before test

FT4: 19 pmol/l (Range 12 - 22)

Ft4 is 70.00% through range

FT3: 4.4 pmol/l (Range 3.1 - 6.8)

Ft3 very low at just 35.14% though range

So very poor conversion of Ft4 (levothyroxine) to Ft3 (active hormone)

For good conversion we need OPTIMAL vitamin levels

So first step is to improve deficient ferritin and folate

Email these results to your GP

Request full iron panel test for anaemia

Likely to need iron supplements

What vitamin supplements are you currently taking

Folate is virtually deficient

GP should initially prescribe folic acid

Once you finish folic acid prescription you can then take a daily vitamin B complex…..probably indefinitely

Retest thyroid levels in 8 weeks

You should see Ft3 increasing …..possibly TSH rising a little

SlowDragon profile image
SlowDragonAdministrator

Low folate

Once you finish prescription folic acid from GP

Start supplementing a good quality daily vitamin B complex, one with folate in (not folic acid)

This can help keep all B vitamins in balance

Difference between folate and folic acid

healthline.com/nutrition/fo...

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)

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

How other member saw how effective improving low B vitamins has been

healthunlocked.com/thyroidu...

lizziep profile image
lizziep in reply toSlowDragon

Thank you SlowDragon. I will act on your advice and read your links 😊

SlowDragon profile image
SlowDragonAdministrator

Deficient ferritin will tend to lower TSH

Low Ft3 results in low vitamin levels

Low vitamin levels results in poor conversion……it’s a vicious circle

Any obvious reason for such dire ferritin

Are you vegetarian or vegan

Or heavy periods

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

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...

Iron patches

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. ‘

lizziep profile image
lizziep in reply toSlowDragon

my diet isn’t great I suppose I don’t eat red meat at all. I will increase leafy greens

I am post menopausal so that’s not a problem.

SlowDragon profile image
SlowDragonAdministrator in reply tolizziep

come back with new post once you get full iron panel test results via GP …..or via Medichecks

Test early morning, fasting, don’t eat iron rich dinner night before test (eg liver and bacon)

lizziep profile image
lizziep in reply toSlowDragon

Well I went for a blood test at GP they wouldn't do full bloods just ferritin as they said all other results were normal!

Result of Ferritin via GP = 12ug/L ( 10.0 - 420)

Classed Normal No further action needed.

SlowDragon profile image
SlowDragonAdministrator in reply tolizziep

Ferritin is extremely deficient

You need FULL iron panel test for anaemia

if GP won’t you will need to test yourself via Medichecks

Test early morning, don’t eat iron rich dinner night before test and only drink water between waking and test

medichecks.com/products/iro...

lizziep profile image
lizziep in reply toSlowDragon

Full bloods done 20 June GP surgery say all ok.

Results June 2023
SlowDragon profile image
SlowDragonAdministrator in reply tolizziep

You need iron, TIBC, transferrin and ferritin tested

Iron is a mineral that is essential for life. It is a component of haemoglobin, a protein in our red blood cells that is responsible for transporting oxygen around our body. If we don't have enough iron, our haemoglobin levels fall and we can't get sufficient oxygen to our cells. This can cause symptoms which include fatigue, dizziness, and shortness of breath. Serum iron is a very transient reading and can be influenced by the amount of iron-rich food in your diet in the days before your blood test. For this reason, iron is rarely looked at on its own, and is interpreted alongside other markers in an iron status test.

TIBC

Total iron-binding capacity (TIBC) is a measure of the ability of your body to efficiently carry iron through the blood.

Transferrin saturation

Transferrin is made in the liver and is the major protein in the blood which binds to iron and transports it round the body. This test measures how much this protein is 'saturated' by iron.

Ferritin

Ferritin is a protein which stores iron in your cells and tissues. Usually, the body incorporates iron into haemoglobin to be transported around the body, but when it has a surplus, it stores the remaining iron in ferritin for later use. Measuring ferritin levels gives us a good indication of the amount of iron stored in your body.

lizziep profile image
lizziep in reply toSlowDragon

GP Folate results back

Folate 9.5ug /L.

Says :- Range <3.0 shows deficiency. 3.0-4.5 shows folate deficiency but not diagnostic

Therefore Normal no action required.

Really wondering why medichecks shows deficiency but 2 weeks later GP tests show ok I will have iron panel test done as you suggest but it’s spending a lot of money for tests that my GP won’t act on. Do these discrepancies happen a lot I wonder ? and should I just except their results and just try to sort it myself ? So frustrating!

Thank goodness we have people like you who are generous with advice.

SlowDragon profile image
SlowDragonAdministrator in reply tolizziep

Iron and ferritin are complicated

Ferritin is very deficient

But before starting supplements you need to check if iron is also deficient

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Examples of 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...

lizziep profile image
lizziep in reply toSlowDragon

Thank you

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