Wildly different results 1 month apart!?

[wavedancers]

Hello all,

I had my bloods re-done at Medichecks, and I am so baffled. I also convinced my GP to provide me with the ranges for the tests I had done in June so I could compare them. Has anyone else had such differing results? I almost feel as though one of these was not from me!

I stopped my B12 two weeks before and all my other supplements and Levo (75mcg) 48 hrs before. I did the test at 9am while fasting... in other words, I followed all the advice on this forum to make sure I got a really clean test done. And, here are the results:

Serum free T4 - JUNE 28: 17.3 pmol/L (10-24) | JULY 26: 23.5 pmol/L (12-22)

Serum free triiodothyronine - JUNE 28: 2.4 pmol/L (3.1-6.8) | JULY 26: 3.7 pmol/L (3.1-6.8)

Serum TSH - JUNE 28: 3.36 mU/L (0.30 - 4.20) | JULY 26: 1.13 mIU/L (0.27-4.2)

Serum vitamin B12 - JUNE 28: 1774 ng/L | JULY 26: 6539.45 ng/L (155 pmol/L 37.5-188)

Serum folate - JUNE 28: 12.8 ug/L | JULY 26: Test not completed due to blood failure

JULY 26: Thyroid peroxidase (TPO) >600 klU/L (range 0-34)

JULY 26: Thyroglobulin antibodies 89.1 klU/L (range 0-115)

JULY 26: Ferritin 104 ug/L (30-650)

JULY 26: Vitamin D 112 nmol/L (50-250)

I have every symptom on the Mayo Clinic, NIH and NHS list, but these don't make sense to me. I am resistant to telling my GP about the T3 result for fear she may pull back on the referral to an NHS endo that she's already put in (although I haven't heard from them yet.) I am considering a ZOOM appt with an endo in Liverpool as he's far away from me.

Thanks all! India

[Lalatoot]

You have hashis . Your antibodies are high in July. That points to your immune system having attacked your thyroid. An immune attack results in a spike in thyroid hormone levels which would explain the rise .

[GlowCoach Administrator]

The usual recommended timing is 24 hours not 48 for stopping Levo before a blood test. You only need to stop a supplement that contains biotin such as a B complex. B12 would be fine to take right up until the day before.

Different labs do have slightly different tolerances and ranges which can make results look quite different. Also slightly different timings can make a difference.

Either way your FT3 is too low, although you do have room to increase Levo still. With a low FT3 I found for myself my results varied.

[Lalatoot in reply to GlowCoach]

The July ft4, 48 hours after levo dose, was over range so I don't think theis person should consider an increase in levo .

[GlowCoach Administrator in reply to Lalatoot]

That's true but would need retest on NHS with the correct 24hr gap to know for sure.

[Tanitha in reply to GlowCoach]

I noticed recently Medichecks states no b12 for 2 weeks prior to test. This is from their website "Do not take vitamin B12 for two weeks prior to this test. If your B12 is prescribed ask your doctor whether to stop."

[GlowCoach Administrator in reply to Tanitha]

It's odd advice as it would take 3 months + to get it out of your system if supplementing.

Iwonder if SeasideSusie knows what this is about?

[SeasideSusie Remembering in reply to Tanitha]

Tanitha

Medichecks can't make up their minds, or they're not giving enough information.

I have queried with them in the past how long a B12 supplement should be left off and this was their answer:

Vitamin B12 supplements.

The answer to this depends upon what they are wanting to assess.

To work out whether B12 supplements are meeting the body's requirements we recommend not taking supplements for one week prior to having their blood drawn.

If a customer wants to assess whether they have an underlying B12 deficiency then it can take months (and potentially up to two years) for levels to fall to their natural levels after stopping supplementation. In this instance we would not recommend.

I can also confirm this information will be displayed on our test instructions in the near future.

I have also seen from another source the same information given but if you are supplementing and want to see what your supplement is achieving you continue taking it up to and including the day before the test (no need to leave off for a week). If you want to see what you are holding on to (ie to give a baseline) then you stop supplementing for 4 months.

[Hidden in reply to SeasideSusie]

I have B12 shots every twelve weeks as I do not have 'intrinsic factor' which is needed to enable B12 to be absorbed in the body. I read that supplementing with a tablet was not effective if intrinsic factor is not present, so I'm wondering if some people are being given the supplement without knowing if their body can utilise it!

[Tanitha in reply to SeasideSusie]

Thank you for that information. I had put off supplementing and seen my levels consistently fall. After supplementing for three months and feeling no better i had decided to test again but after reading that shall give it a couple of weeks. It will be interesting to see the results. Presuming the time factor also applies to serum tests, anyone taking an occasional multi vitamin, as people do, could unwittingly be significantly skewing their results. I had assumed it needed to build up but perhaps not.

[SlowDragon Administrator]

test should be done early morning, before 9am and last dose levothyroxine 24 hours before test

What brand of levothyroxine are you taking and what dose

How long have you been on this dose levothyroxine

What vitamin supplements are you currently taking

As you have Hashimoto’s GP should have done coeliac blood test…..has this been done

Or are you already on strictly gluten free diet

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

[wavedancers in reply to SlowDragon]

Thanks for the replies. The test was done just about 1/2 hour after I woke, but 48 hours after the last dose of levo. I realize now that was too long. I'm on 75mcg Teva (NHS regular supply) and have been on it for 6 years.

I usually take B12, D +K2, a multi, calcium, magnesium, zinc, selenium and flaxseed oil, DHA, EPA because I'm vegan. Coeliac test hasn't been done, but I gave up gluten years ago.

I also have Rheumatoid Arthritis — so a autoimmune nightmare. Still have had quite a bit of weight gain in the last few years , the hair loss is getting to the scary point, and the fatigue and lack of libido is awful... as well as the constant pain.

[SlowDragon Administrator in reply to wavedancers]

so as a vegan it’s EXTREMELY IMPORTANT to get full iron panel test including ferritin

Likely to need to supplement iron

stop any supplements that contain iron 5-7 days before testing

Test early morning and fasting

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 high ferritin due to inflammation of autoimmune disease…..but low iron

Medichecks iron panel test

medichecks.com/products/iro...

[wavedancers in reply to SlowDragon]

Good morning SlowDragon ~ my Ferritin was 104 ug/L (30-650) and the CRP was 0.35 mg/L (<3). I do take biologic injections for the RA to keep my inflammation down, so that may be responsible. Would the "full" iron panel give any more info?

[SlowDragon Administrator in reply to wavedancers]

Yes

Iron and ferritin are complex

Ferritin is an “acute phase reactant” …..it rises with inflammation

You might have low iron and high ferritin

[csj113]

Hi, yes I’ve had a similar experience - as an example FT4 was 19 from my local NHS lab and FT4 was 23 (above range) from Medichecks 2 weeks later. Can’t remember the other numbers but a similar difference.

Both bloods done at same time of day under same fasted conditions. I don’t have the answer but as I feel fine in my current dose of Levo I have ignored the Medichecks one and my GP feels the same!

I’ve had Hashi for 30 plus years and my antibodies don’t really change these days.

[Choosychops]

My endocrinologist will not use any blood test results from Inuvi labs, which Medichecks use. Fortunately I was able to get it done through my doctors surgery on the NHS. It may be worth trying another provider.

[RedApple in reply to Choosychops]

Interesting. I know some GPs/Endos are still sceptical of any private tests and will only go by results of NHS tests. But I'm curious to know why your endo specifically rejects blood test results from Inuvi labs. Did he give a reason?

[Choosychops in reply to RedApple]

Yes, he has had some wildly differing results from them. He will accept from other private providers just not if they use Inuvi labs.

[wavedancers]

Might be worthwhile to try another... I will consider it.

[Beau55]

it looks like you could benefit from potentially reducing your Levo slightly and adding in some T3.

I wouldn’t pay too much attention to fluctuations while your TSH isn’t supressed. I often had very different thyroid results when testing often.

How do you feel?

[wavedancers]

Just off a call with a new private endo, and he's going to trial me on NDT to see if things improve, as well as asking my GP to order another set of bloods to see if the lab (Inuvi) might be the reason for the differing results. Will report back after I transition off the Levo. Fingers crossed!

[TiggerMe Ambassador in reply to wavedancers]

Did the new Endo discuss the T4/T3 combined option which if it works for you could be taken up by the NHS (as both your results show you are a bad converter) whereas NDT is a whole lot trickier and the most expensive route to self fund? It can be easier to find your optimal dose on combined treatment as you can adjust them individually which you can't on NDT other than by adding a bit of T3/4 to it?

Just a thought as it is a bit of a time consuming hoo-ha swapping from one form of treatment to another so sticking with levo and adding lio is an easier trial

[wavedancers in reply to TiggerMe]

Thanks Eeyore. He didn't suggest that. I will contact his secretary today with that inquiry!

[TiggerMe Ambassador in reply to wavedancers]

It just seems a better starting point for where you are at the moment to get hopefully a quicker improvement... certainly if you are hoping that the NHS will step up and pick up the tab at some point in the future with less of a battle

Good to put the question to them... at least you'll have a clearer picture 🤗

[wavedancers in reply to TiggerMe]

Hi EEyore,

My Endo called and said, "Of course! We want the best results possible. Just tell me what you want." I was shocked! So now I need to ask you... or whomever may be following this thread. I am currently on 75 Levo. He suggested to write a script for Roseway Labs for Thybon Henning 20mcg tabs that I can split. How should I start the dosing and what should I look out for?

[TiggerMe Ambassador in reply to wavedancers]

Brilliant 😅 the joy of going private!

Right let's go back to the beginning... a week is a long time in my brain 🙃

So your last fT4 result was taken 48 hours (ideally would have been 24 hours) after last dose and still above range at 23.5.... JULY 26: 23.5 pmol/L (12-22)

JULY 26: 3.7 pmol/L (3.1-6.8) were your June results after a 48 hour gap too?

So it's a bit of a tricky one to gauge.... normal advice is to drop T4 down by either 25mcg everyday or every other day when adding in T3 and that's when starting within range...

When you add T3 it does tend to bring your fT4 down a bit generally to start with...

Ideally another test done with a 24 hour gap from last dose would be the best starting point...

I don't know whether to suggest dropping the T4 to 50mcg per day or 50/75 alternating and split the Thybon into at least quarters giving you 5mcg ( I've never seen TH so I don't know if you can get them into eighth?)

Always best to start with the smallest amount to see how you react and add from there... much easier to feel your way and take things slowly, as though T3 is fast acting it takes the body several weeks, months or more to adjust completely

Might be worth putting up a new post to get more views?

[wavedancers in reply to TiggerMe]

I actually did have another test at 24hrs in July: TSH 1.13 (0.27 - 4.2), Free T3 3.7 (3.1 - 6.8), and in August: TSH 1.26 (0.27 - 4.2), Free T4 17.2 (12 - 22). T3 wasn't done in August because it was a Medichecks test for Female Hormones...

I'll copy my results and start another post, but wanted to check in with you because you stuck with me in this one!

[TiggerMe Ambassador in reply to wavedancers]

Nice one... sorry I have to recap as I don't want to give duff advice

Ah ha! That's great, so we know fT4 is 17.2 on 75mcg I would say don't alter your T4 dose and just start to add in the T3 🤗

Some people tend to be very sensitive to T3... others (like me) can move up and down by 5mcg or more no problem at all... it often has to do with vit/ min levels (yours are good) and cortisol which doesn't want to be too high or too low 🙃

So that high fT4 was a weird rogue result then after 48 hours 😕

What did your sex hormones show?

[wavedancers in reply to TiggerMe]

SHBG: 60.4 (27.1 - 128); FSH 77.5 (25.8 - 134.8); LH 41.3 (7.7 - 58.5); OESTRADIOL 65.4 < 505; TESTOSTERONE 1.91 (0.101 - 1.42); FREE ANDROGEN 3.2 (0.2 - 7.1); PROLACTIN 110 (102 - 496)

I must confess, I really don't know much about these other than I'm losing hair on my head and it's relocating to my chin! HA!

[TiggerMe Ambassador in reply to wavedancers]

High testosterone explains that, adding some oestrogen ( yours is low, I think between 100 -300 post meno is the aim for bone and heart health, though symptom free is the real aim, so wherever that is for you) to balance it out wouldn't be a bad idea.... progesterone too if you still have your bits 😉

[wavedancers in reply to wavedancers]

Also Eeyore, I just received my printed summary from the Endo with these instructions:

10mcg T3 to replace 25mcg Levothyroxine.

Start with 5mcg in the morning with Levothyroxine 50mcg for 3 days. Then increase to 5mcg twice a day with Levothyroxine 50 mcg daily. Further increase in T3 as needed.

So, why do you think he wants me to lower the Levo??? Hmmmm....