My Blood Test Yesterday - mentions Abnormal, Communicate Patient!

[Ellie-Louise]

Feels scary, what do you think can be wrong?

(Abnormal. Communicate Patient).

TSH - 0.03 mu/L [0.35 - 4.94] below low ref limit.

FT4 - 20.1 pmol/L [9.0 - 19.0 ] above high ref limit.

FT3 - 4.89 pmol/L [ 2.6 - 5.7]

Vit D - 161.0 nmol/L [50.0 - 350.0] please note.

(Satisfactory. No further action).

Ferritin - 195 ug/L [15.0 - 200.0]

Folate - 9.4 ug/L [3.0 - 20.0]

Vit B12 - 675 ng/L [180.0 - 640.0] above high ref limit.

I also had a full blood count that seems to flag something wrong with my liver. That noted that I need to speak to doctor!

I am getting worried now.

Any help you can offer may put my mind at rest, I had these tests yesterday at 08:00 and have just checked them out on System Online test results.

Thank you.

[Hidden]

It looks like GP is responding to flag on low TSH and slightly raised FT4. I do hope that they consider all the possibilities for these results and don’t just decrease your Levothyroxine.

Do you take T3 too?

Ferritin - 195 ug/L [15.0 - 200.0

Ferritin result is very high but because it’s ‘in range’ it hasn’t been picked up by the computer flagging system. Nor will it be picked up by GP in all probability. This is what really annoys me about ‘ranges’. Bring back the days when GPs interpreted results themselves, using symptomology and context to reach conclusions.

Ferritin can indicate high levels of inflammation or, occasionally, liver disease.

[Ellie-Louise in reply to Hidden]

No only 100 Levo.

Last September when I had the last blood test one of the doctors rang and told me I was on too high a dose and to drop it to 75 from the 100 I was on. Because he wouldn’t listen to me I dropped it and over the next months up to Christmas’22 I felt absolutely lousy, couldn’t stay awake etc. Then the night before Christmas Eve one of my cats died, she had developed kidney failure over that last week which led to numerous vet/hospital visits.

Consequently I decided that I had had enough and raised my Levo back up to 100mcg again. It put me back to feeling normal once more. So I told another doctor what I had done and he was ok with it but told me to get another test after 8 weeks. I tried to, but there was such a wait (weeks) at the surgery that it went out of my mind after that.

It was only after a really bad hemourage (sp) in my eye that made me call the ophthalmologist who in turn told me to see the doctor for a blood test, and that doctor also arranged my latest thyroid blood test.

[Hidden in reply to Ellie-Louise]

With a high FT4 and a fairly low FT3 perhaps your doctor should be considering that you’re not converting well from T4 to FT3.

Inflammation is a big factor in poor conversion.

[Ellie-Louise in reply to Hidden]

I know my knee must be inflamed, I smashed the side of it into some hard furniture when I swivelled my chair back to my pc a couple of years ago. I had an X-ray that showed nothing bone wise, but it has been painful every day since. I am just putting up with it. Plus my digestive system isn’t top notch either which is a worry.

[SlowDragon Ambassador]

was test done as recommended

Recommended that all thyroid blood tests early morning, 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)

Looking at your helpful profile…..are you still taking 100mcg levothyroxine daily

Which brand of levothyroxine

What vitamin supplements are you taking

[Ellie-Louise in reply to SlowDragon]

Yes, Accord Levo, Solar B12 and Thorne Basic B. I do take D3 and it’s helpers but only when I think about it which isn’t very often.

I’m wondering if I’m taking too much B12? My husband has just been looking up info on B12 and recommended dosage.

[SlowDragon Ambassador in reply to Ellie-Louise]

You don’t need separate B12 and vitamin B complex

As your serum B12 is over 500 (or Active B12 level has reached 70), you can stop the B12 and just carry on with the B Complex.

If Vegetarian or vegan likely to need ongoing separate B12 2-3 per week

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...

[Ellie-Louise in reply to SlowDragon]

I actually stopped my B complex for just over the 7 days, but continued the B12.

[SlowDragon Ambassador in reply to Ellie-Louise]

And that’s reflected in the low Folate result

[greygoose]

Nothing to worry about as far as thyroid goes. A suppressed TSH is often unavoidable, and isn't a problem in itself. The high FT4 is best avoided if possible, but you are a poor converter, so you appear to need it that high. T4 is basically a storage hormone that doesn't do much until it is converted into T3. Your FT3 is well within range, so you're not over-medicated.

Don't know about liver results because you haven't posted them.

[Ellie-Louise in reply to greygoose]

Would you know about those results if I posted them for you?

[greygoose in reply to Ellie-Louise]

Not much, no, but if they're only slightly out of range, you GP is going to say it's nothing to worry about, anyway. That's what was said to me.

But, I'm not the only one reading posts. Bet there are plenty of people on here that know about liver testing. It's not uncommon to have liver problems when you're hypo.

[Ellie-Louise]

I photographed the page but it doesn’t seem to want to go. Does a picture take long to load? It doesn’t look as if anything is uploading.

[SlowDragon Ambassador in reply to Ellie-Louise]

Add photo in a reply

Click on the rectangle with mountain in to add image

[Ellie-Louise in reply to SlowDragon]

That’s what I did, twice and then once again on a different browser but although it shows up it isn’t loading the picture. I waited a while but nothing happens, then a message pops up with ‘error’ and tells me to refresh the page. I have no problem posting pictures on my knitting forum. Same method btw.

[SlowDragon Ambassador in reply to Ellie-Louise]

Can you write out the actual results and ranges

[Ellie-Louise in reply to SlowDragon]

Serum gamma-glutamyl transferase level 66 iu/L [0.0 - 38.0]. Above high ref limit.

Liver Function Tests:

Serum total protein level 70 g/L 60.0 - 80.0]

Serum albumin level 40 g/L [35.0 - 50.0]

Serum total bilirubin level 6 umol/L [2.0 - 21.0]

Serum alkaline phosphatase level 118 u/L [20.0 - 150.0]

Serum globulin level 30 g/L [20.0 - 35.0]

Serum alanine aminotransferase level 20 u/L [5.0 - 40.0]

Serum urea level 3.5 mmol/L [2.5 - 7.8]

Actually while I was typing all this out, the surgery rang me. The doctor is going to ring me about this result on the 19th. October. It was also mentioned that the doc will probably want to reduce my Levo!

I refused to consider doing that and told them I was staying on the 100. I did explain why and it was accepted for the time being on condition that when I get my call it will be discussed. Details of the phone call just now is going to be passed along to the doctor anyway.

[Ellie-Louise in reply to SlowDragon]

A few days ago I received the letter confirming what the call from the surgery about the doctor wanting to call me on the 19th.October, in it she says there is nothing to worry about.

This morning I received another letter telling me that in one of the tests it shows my blood sugar is high and that I’m pre-diabetic! Along with that was information about what to eat and what not to eat, exercise etc.

Well, from reading through that lot I already am eating the right things, the only thing I don’t do is loads of exercise. My arthritic big toe puts paid to long walks that we used to do. I can walk round the supermarket occasionally or a short walk but I do suffer after getting back and taking my shoes off. (Still waiting to hear back for the treatment promised by consultant last December, so have given up on that).

[SlowDragon Ambassador in reply to Ellie-Louise]

You might get better conversion rate of Ft4 to Ft3 if you’re Ft4 was slightly lower

Perhaps agree to small dose reduction to 87.5mcg 4 days week and 100mcg 3 days week

Retest in 6-8 weeks

Suggest you reduce and slowly stop separate B12

Just take daily vitamin B complex. But stop this week before test, taking just folate supplement instead

[Ellie-Louise in reply to SlowDragon]

Thank you, I have stopped the B12 already, it was when you mentioned it. So I have passed the bottle on to my husband who needed to order more for himself anyway.

I looked up blood sugar today and pomegranate juice is recommended to reduce it. I have ordered some in the shopping. 🙂

[Ellie-Louise in reply to Ellie-Louise]

I don’t care for pomegranate juice, it’s like drinking thick dark blood. Uggh!

[Ellie-Louise in reply to SlowDragon]

Hi, can I just ask you about the dose you suggested please?

I worked it out just now and 87.5 x 4 = 350 plus the 100 x 3 which all comes to 650 per the week, which is only 50 less than I am taking now.

So would it make any difference if I took 100 x 6 days and only 50 on the 7th day?

It would be much easier than trying to chop a 50 into quarters. Do you see what I mean?

Thanks so much SlowDragon.

Edit: maybe it won’t matter too much because I do on rare occasions forget to take my Levo anyway.

[SlowDragon Ambassador in reply to Ellie-Louise]

So would it make any difference if I took 100 x 6 days and only 50 on the 7th day?

It would probably be fine

Some people find it better to stick to roughly same dose every day

Edit: maybe it won’t matter too much because I do on rare occasions forget to take my Levo anyway.

That’s really not a good idea….can mess with TSH

Get weekly pill dispenser so you can see immediately if forgot to take

[Ellie-Louise in reply to SlowDragon]

I had a lovely chat with the doctor yesterday, she appears to be on the same page as we are regarding thyroid. She is also aware of thyroidUK. I’d never seen this one before even though she is down as my doctor in the practice.

We discussed my T4 issue and what to do, she never once mentioned my low TSH which surprised me. In the end I told her that I would try the new dose to bring my T4 down a bit and she agreed, wrote it on my files and told me to get another test in 6-8 weeks. I said I’d do it in 8 weeks and she said ok.

She was really nice. I felt so relieved. 😁

[SlowDragon Ambassador in reply to Ellie-Louise]

Brilliant 👏👏👏👏

[Ellie-Louise]

Thank you, I appreciate that. I hope you had a good day.