Thyroid Function test

[Lottyplum]

A friend has recently had TSH and T4 blood test via GP . I have suggested she join this wonderful community but said I would give her blood test results for your input. She has had a lot of gut issues, brain fog, exhaustion. Her results are:

Serum free T4 level (XaERr) below range 9.7 pmol/L (10.5-24.5) Below low reference limit

Serum TSH level (XaELV) 3.46 (0.27-4.2)

Serum Ferritin level 9 ug/L (30.0-400.0) Consistent with iron deficiency

Serum Folate level 8.9 ug/L (3.9-9999.0)

Serum Vit B 12 level 498 ng/L (197.0-1000.0)

your valuable input would be most appreciated. Thanks in advance.

[SlowDragon Administrator]

Ferritin 9

Well she’s very anaemic

Is she vegetarian or vegan?

Approx age?

Pre or post menopause

Heavy periods?

Presumably she’s been prescribed iron supplements, or possibly even iron infusion

B12 and folate are not optimal

No vitamin D

Ft4 below range

Suggest she request GP retest thyroid including both TPO and TG thyroid antibodies for autoimmune thyroid disease

ALWAYS test thyroid early morning, ideally before 9am, only drinking water between waking and test

Also needs coeliac blood test

[Lottyplum in reply to SlowDragon]

Thank you SlowDragon. I am sending her your response and will get back as soon as she does. She is trying to get a GP phone appointment but that will take a couple of weeks she says. I have sent her a host of information I have copied from responses here, together with links for her to read to prepare for the GP appt. I am going to suggest again that she contacts Thyroid UK herself and gets plugged into this community. Big thank you again.

[Lottyplum in reply to SlowDragon]

This is the info from my friend:

Is she vegetarian or vegan? No

Approx age? 54

Pre or post menopause peri - last bleed day 1 19/7/2023

Heavy periods? Yes always up until last one.

Presumably she’s been prescribed iron supplements, or possibly even iron infusion

Nothing yet prescribed as not had follow up since FIT and Thyroid function results came in.

[SlowDragon Administrator in reply to Lottyplum]

Heavy periods invariably result in anaemia

Being anaemic tends to cause heavy periods (design error there)

Work on improving B12 and folate too and get vitamin D tested

Then retest thyroid including thyroid antibodies in 6-8 weeks

[SlowDragon Administrator]

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...

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, 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...