Blood test readings sent : Hi everyone, Can... - Thyroid UK

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Blood test readings sent

Tracy99 profile image
13 Replies

Hi everyone, Can someone work out exactly what my thyroid and iron test means?

Asked today for first copy of my blood test and received without any qualms,

Regards

Bill

Values and Investigations (Latest Value)

17-Jul-2023 HbA1c levl - IFCC standardised - (Ralston5490) -

Normal - No Action

35 mmol/mol 20.00 - 41.00mmol/mol

17-Jul-2023 ! Serum ferritin - (IP5490) - Acceptable No Action 225 ug/L 15.00 - 200.00ug/L

Ferritin high, but transferrin saturation normal.

Haemochromatosis unlikely (assuming not known/treated).

17-Jul-2023 Serum C reactive protein level - (IP5490) - Normal

- No Action

7 mg/L 0.00 - 7.00mg/L

17-Jul-2023 Serum iron tests - (IP5490) - Normal - No Action

Serum iron level 16 umol/L 11.00 - 30.00umol/L

Serum transferrin 2 g/L 2.00 - 3.60g/L

Transferrin saturation index 32 % 15.00 - 45.00%

17-Jul-2023 Thyroid function test - (Ralston5490) - Normal -

No Action

TFT results in euthyroid range.

Serum free T4 level 11.9 pmol/L 7.00 - 17.00pmol/L

Serum TSH level 2.62 mu/L

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Tracy99
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13 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Your TSH is well above 1 where most people feel well.

Your FT4 is only at 49% of its range and should be in the upper quarter, so you need to insist on a dose increase from your GP.

I'll let others comment on your iron results. Do you have any other vitamin results?

What supplements are you taking?

Tracy99 profile image
Tracy99 in reply toJaydee1507

Thank you jaydee, is the FT4 referred to my thyroid? Nothing about vitamins, but I take vitamin D3 & B12, also cod liver oil capsules

Jaydee1507 profile image
Jaydee1507Administrator in reply toTracy99

FT4 is serum free T4.

How much D3 do you take and have you added vitamin K2 to help it go to the bones?

Which B12 do you take and how much is in it?

Its usually recommended to take a good methyl/active B complex to help keep all the B's in balance. This B complex has all the right vitamins at a not unreasonable cost for 90 days supply(also contains folate). Once B12 is good (over 500) you can stop the stand alone B12 and just continue with the B complex. amazon.co.uk/Liposomal-Soft...

Tracy99 profile image
Tracy99 in reply toJaydee1507

I take d3 400iu and b12 1000 ug, I just ordered of amazon trying to boost up me energy, been fine last 3 days and today just feel exhausted again 😴

SlowDragon profile image
SlowDragonAdministrator

Your thyroid result shows you need 25mcg dose increase in levothyroxine

Retest again in 6-8 weeks time

Were vitamin D, folate, B12 levels tested too?

CRP is at high end of normal (inflammation marker)

Inflammation often results in higher ferritin level

But ferritin of 200 is not high for a bloke anyway

SeasideSusie may pop along and comment on iron panel test results

Tracy99 profile image
Tracy99 in reply toSlowDragon

Hi slowdragon,Thanks for your reply, how do I ask my GP in increase my dose? Re: levo by 25 mcg

SlowDragon profile image
SlowDragonAdministrator in reply toTracy99

List any Symptoms of hypothyroidism you still have

thyroiduk.org/wp-content/up...

How much do you weigh

NICE guidelines on full replacement dose

nice.org.uk/guidance/ng145/...

1.3.6

Consider starting levothyroxine at a dosage of 1.6 micrograms per kilogram of body weight per day (rounded to the nearest 25 micrograms) for adults under 65 with primary hypothyroidism and no history of cardiovascular disease.

Also here

cks.nice.org.uk/topics/hypo...

pathlabs.rlbuht.nhs.uk/tft_...

Guiding Treatment with Thyroxine:

In the majority of patients 50-100 μg thyroxine can be used as the starting dose. Alterations in dose are achieved by using 25-50 μg increments and adequacy of the new dose can be confirmed by repeat measurement of TSH after 2-3 months.

The majority of patients will be clinically euthyroid with a ‘normal’ TSH and having thyroxine replacement in the range 75-150 μg/day (1.6ug/Kg on average).

The recommended approach is to titrate thyroxine therapy against the TSH concentration whilst assessing clinical well-being. The target is a serum TSH within the reference range.

……The primary target of thyroxine replacement therapy is to make the patient feel well and to achieve a serum TSH that is within the reference range. The corresponding FT4 will be within or slightly above its reference range.

The minimum period to achieve stable concentrations after a change in dose of thyroxine is two months and thyroid function tests should not normally be requested before this period has elapsed.

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

NHS England Liothyronine guidelines July 2019

sps.nhs.uk/wp-content/uploa...

Page 9

Test for Deficiency of any of the following: Vitamin B12, Folate, Vitamin D, Iron

See page 13

1. Where symptoms of hypothyroidism persist despite optimal dosage with levothyroxine. (TSH 0.4-1.5mU/L)

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Tracy99 profile image
Tracy99 in reply toSlowDragon

Hi, Am overweight really, am 17 half stone, although put a lot on since this hormone treatment, looking at the contents you attached, probably 70 %, fatigue for ma y years and even more since the hormone treatment, bad back, ridged finger nails for as long as I remember, I've had the hoarse voice pre levo meds, and acid reflux has practically gone due to being on the levo, although prescribed omoprozol 2 years ago after surgeon discovered a scar on my bowel when having camera down my throat, been of the. Foe 2 weeks as don't want to be taken them forever

Tracy99 profile image
Tracy99 in reply toTracy99

Sorry for mistype, not had amoprosol for 2 weeks, not sure if I should?

SeasideSusie profile image
SeasideSusieRemembering

Tracy99

Presumably you followed our advised protocol for thyroid testing, ie

* Test no later than 9am

* Nothing but water before test (some foods and drinks can affect TSH)

* Last dose of Levo 24 hours before test

* No biotin, B Complex or any supplement containing biotin for 3-7 days before test

HbA1c: 35 mmol/mol 20.00 - 41.00mmol/mol

Nice result.

Ferritin 225 ug/L 15.00 - 200.00ug/L

C reactive protein level: 7 mg/L 0.00 - 7.00mg/L

Your CRP is at the top of the range, this suggests inflammation somewhere (CRP is a non-specific inflammation marker). Ferritin rises with inflammation so we can say that your ferritin level is very likely falsely raised due to inflammation and your normal level would be lower than that.

Iron panel

Serum iron level: 16 umol/L 11.00 - 30.00umol/L

Serum transferrin: 2 g/L 2.00 - 3.60g/L

Transferrin saturation index: 32 % 15.00 - 45.00%

Optimal iron panel levels according to rt3-adrenals.org/Iron_test_... are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 26.32% so it's low

Saturation: optimal is 35 to 45%, higher end for men - yours is 32% so is a little on the low side for a male

Transferrin: Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is at the very bottom of the range so suggests no need to supplement

Ferritin: Low level virtually always indicates need for iron supplementation; High level with low serum iron/low saturation indicates inflammation or infection; High level with high serum iron and low TIBC indicates excess iron; Over range with saturation above 45% suggests hemochromatosis.

Your serum iron and saturation could be higher, transferrin suggests no supplementation needed, ferritin is difficult to say as we have a raised level due to some inflammation.

I would be very wary of self supplementing with iron tablets, if you decide that's what you want to do then please do an iron panel every couple of months to keep an eye on your serum iron and saturation. Medichecks does a Home Iron Test which includes the full iron panel plus CRP so that's a good one to monitor with. If supplementing with iron keep this away from thyroid meds by at least 4 hours and take with Vit C to aid absorption and help prevent constipation. Also keep iron away from any other medication and supplements by 2 hours.

Serum free T4 level 11.9 pmol/L 7.00 - 17.00pmol/L

Serum TSH level 2.62 mu/L

These results suggest undermedication. Ask GP for an increase of 25mcg in Levo dose and retest in 6-8 weeks. The aim of a treated hypo patient on Levo only, generally, is for TSH to be 1 or below with FT4 and FT3 in the upper part of their reference ranges, if that is where you feel well.

As you take D3 then you should test twice a year to check levels and to see if you need to seasonally adjust. Do you take D3's important cofactors - Vit K2-MK7 and magnesium?

As you take B12 you should be taking a B Complex as well to keep all B vitamins balanced. Do you have B12 deficiency or Pernicious Anaemia? If not then you should test B12 whilst supplementing to see where your level is, if it's near top of range for Total B12 or 100 plus for Active B12 then you don't need to supplement with B12.

Tracy99 profile image
Tracy99 in reply toSeasideSusie

Thanks sue, It's a lot to take in but I have prostate cancer, stage 2, had radio therapy in june this year,don't know if maybe the CRP reading may relate?

SeasideSusie profile image
SeasideSusieRemembering in reply toTracy99

I'm not medically trained but I believe cancer can raise CRP and ferritin levels.

Tracy99 profile image
Tracy99

Thanks sue,Hoping the CRP is via my prostate treatment?

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