test results

[AustinHealeySprite]

Hia everyone

Could someone please comment on the following results

Thanks for any help

[SlowDragon Ambassador]

Other results here

healthunlocked.com/thyroidu...

what vitamin supplements are you taking

B12 is too low

Ferritin last year at 100 was on low side …..dropped further this year

How do you feel

What medications are you on

Levothyroxine?

No TSH, Ft4 or Ft3 or thyroid antibodies test results

[AustinHealeySprite in reply to SlowDragon]

Hia SlowDragon thanks for reply

answers to questions

Not taking any supplements but I’ve bought some recently to start

Medications until recently 200mcg Levo now 175 but Doc /lab wants to drop to 125 😡

I feel quite good on 200

Last Wednesday tests

TSH 0.03 0.55-4.78

T3 5.5 3.5-6.5

T4 20.2 11.5-22.7

These results are after reducing Levo by 25mcg

My TSH was 0.01 but as I said feeling quite good on 200 mcg

Recently paid to see an Endo who was happy with me to catty on with surpressed TSH but doc /lab wants to drop it another 50mcg

Endo even wrote to doc to say it was ok but !!!

Hope this all makes sense

[SlowDragon Ambassador in reply to AustinHealeySprite]

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

is this how you did this test

Which brand levothyroxine are you taking

Do you always get same brand levothyroxine

FT4: 20.2 pmol/l (Range 11.5 - 22.7)

Ft4 is now 77.68% through range

FT3: 5.5 pmol/l (Range 3.5 - 6.5)

Ft3 66.67% through range

helpful calculator for working out percentage through range

thyroid.dopiaza.org

Stay on this dose

Retest again in another 6-8 weeks

If Ft4 and Ft3 are dropping….increase dose a little

GP is not an endocrinologist

Endocrinologist trumps GP and you have a letter on file as well

Just refuse to reduce further

If GP says " I have to reduce your dose because the guidelines say i can't let you have a below range TSH" .....

The first paragraph in the NICE (NHS) Thyroid Disease, Assessment and Management guidelines says :

nice.org.uk/guidance/ng145

"Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian. "

T4 therapy

ncbi.nlm.nih.gov/labs/pmc/a...

In a study evaluating tissue function tests before total thyroidectomy and at 1 year postoperatively when using LT4, it was found that peripheral tissue function tests indicated mild hyperthyroidism at TSH <0.03 mU/L and mild hypothyroidism at TSH 0.3 to 5.0 mU/L; the tissues were closest to euthyroidism at TSH 0.03 to 0.3 mU/L [48]. A normal serum TSH level consequently does not necessarily indicate a euthyroid state at the tissue level.

[AustinHealeySprite in reply to SlowDragon]

Thank you very much

Yes I take my meds correctly and have the same brand of Levo

Thanks again

[SlowDragon Ambassador]

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 and add a separate vitamin B Complex after a week

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

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...

Low folate

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

This can help keep all B vitamins in balance and will help improve B12 levels too

Difference between folate and folic acid

healthline.com/nutrition/fo...

Many Hashimoto’s patients have MTHFR gene variation and can have trouble processing folic acid.

thyroidpharmacist.com/artic...

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....

Igennus B complex popular option too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose

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

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

[TiggerMe Ambassador]

I'll pop them here with the other results ( if you need to add more just pop them in as a reply to yourself to keep them on the same thread 🤗)

test results

[AustinHealeySprite in reply to TiggerMe]

Thanks

[SlowDragon Ambassador]

Work on improving low vitamin levels and then retest thyroid and vitamin levels in 2-3 months

Use Medichecks or BH if GP unhelpful

You might be better getting small dose T3 prescribed alongside levothyroxine

List of thyroid specialists and endocrinologists who will prescribe T3

healthunlocked.com/thyroidu...