Help with additional test results please - Thyroid UK

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Help with additional test results please

m0dgal1 profile image
10 Replies

Further to previous posts I now have results of additional blood tests which were suggested.

To recap, my thyroid function tests results were as follows:

TSH 0.52 mu/L (normal range 0.27 -4.2 )

FT3 3.6 pmol/L (normal range 3.1 - 6.8)

FT4 20.5 pmol/L (normal range 12 - 22)

Additional test results are as follows:

TPO Negative 11 IU/ml

Folate greater than 20.0 ng/mL

Total iron 9.3 umol/L

Transferrin 37.1 umol/L

Transferrin Saturation 13%

Ferritin 28 ug/L

Vitamin B12 greater than 300 pmol/L

All the above tests were via MMH

Vitamin D 94.9 nmol/L (D3 89.5 nmol/L)

As mentioned previously I was diagnosed with under active thyroid aged 15 for which I take Levothyroxine 100 mcg daily; I have Type 1 diabetes for which I inject Novomix 30 insulin twice daily and pernicious anaemia for which I have Hydroxocobalamin injections every 12 weeks (I’d had my latest Hydroxocobalamin injection days before the blood test for Active B12.

I take the following supplements daily: methyl folate, D3 and K2, Betaine HCL and Glucosamine.

Many thanks for your help

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SlowDragon profile image
SlowDragonAdministrator

previous post

healthunlocked.com/thyroidu...

Total iron 9.3 umol/L

Transferrin 37.1 umol/L

Transferrin Saturation 13%

Ferritin 28 ug/L

Can you add ranges on these

Ferritin is deficient

Are you vegetarian or vegan

Pre or post menopause

cks.nice.org.uk/topics/anae...

Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency.

retest 3-4 times a year if self supplementing iron.

It’s possible to have low ferritin but high iron

Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption

List of iron rich foods

dailyiron.net

Links about iron and ferritin

An article that explains why Low ferritin and low thyroid levels are often linked

preventmiscarriage.com/iron...

irondisorders.org/too-littl...

davidg170.sg-host.com/wp-co...

Great in-depth article on low ferritin

oatext.com/iron-deficiency-...

drhedberg.com/ferritin-hypo...

This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.

healthunlocked.com/thyroidu...

Posts discussing Three Arrows as very effective supplement

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron patches

healthunlocked.com/thyroidu...

Thyroid disease is as much about optimising vitamins as thyroid hormones

healthunlocked.com/thyroidu...

restartmed.com/hypothyroidi...

Post discussing just how long it can take to raise low ferritin

healthunlocked.com/thyroidu...

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

Good iron but low ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Chicken livers if iron is good, but ferritin low

healthunlocked.com/thyroidu...

Shellfish and Mussels are excellent source of iron

healthline.com/nutrition/he...

Heme iron v non heme

hsph.harvard.edu/nutritions...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

Great research article discussing similar…..ferritin over 100 often necessary

ncbi.nlm.nih.gov/pmc/articl...

Low Iron implicated in hypothyroidism

healthunlocked.com/thyroidu...

Ferritin range on Medichecks

healthunlocked.com/thyroidu...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

We have received further information the lab about ferritin reference ranges. They confirm that they are sex dependent up to the age of 60, then beyond the age of 60 the reference range is the same for both sexes: 

Males 16-60: 30-400 ug/L

Female's: 16-60: 30-150

Both >60: 30-650 

The lower limit of 30 ug/L is in accordance with the updated NICE guidance and the upper limits are in accordance with guidance from the Association of Clinical Biochemists. ‘

SlowDragon profile image
SlowDragonAdministrator

Rather than taking just folate we recommend taking good quality daily vitamin B complex

one with folate in (not folic acid)

This can help keep all B vitamins in balance and may help maintain B12 levels between injections

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, 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...

Are you on gluten free or dairy free diet?

m0dgal1 profile image
m0dgal1 in reply to SlowDragon

Although I restrict the amount of gluten in my diet, my diet is not totally gluten free. I am not on a dairy free diet. Is going gluten and dairy free recommended in my situation?

Many thanks

m0dgal1 profile image
m0dgal1 in reply to SlowDragon

Sorry I missed answering a couple of your questions. I am neither vegetarian nor vegan. My red meat consumption is pretty low though I have started incorporating lambs liver into my diet. I am post menopausal.

Thank you for the posts and all the information which will be very helpful as I seek to improve matters for myself. I must admit I feel a bit overwhelmed at the moment.

I consulted one of the GPS at my practice to request a referral to an endocrinologist re poor T4 to T3 conversion. I was told I am likely to have a years wait for an appointment.

SlowDragon profile image
SlowDragonAdministrator in reply to m0dgal1

Yes NHS referral waiting at least a year and if TSH and Ft4 are within range referral can often be refused

Vast majority of endocrinologists are diabetes specialists and useless for thyroid

Worth going private if you can

Some on this recommended list are NHS and private

List of thyroid specialists and endocrinologists who will prescribe T3

healthunlocked.com/thyroidu...

But get ferritin improved first

Roughly where in U.K. are you

m0dgal1 profile image
m0dgal1 in reply to SlowDragon

Yes I am wondering about going private. I live in Leeds so would want to see an endocrinologist in West Yorkshire or North Yorkshire area.

My GP did mention that an NHS referral might be refused as my results are in the normal range.

As you suggest I will get my ferritin levels improved first.

Thank you so much for your help. It is greatly appreciated.

Jaydee1507 profile image
Jaydee1507Administrator

If you only had a B12 injection a few days before this test then you may well need more frequent injections than every 3 months. 300 is very low for serum B12. You can post on the pernicious anaemia group here on HealthUnlocked for further advice.

Your FT3 is too low as you know already and will be causing your high cholesterol.

rt3-adrenals link to optimal iron results: rt3-adrenals.org/Iron_test_...

I was trying to work out your iron results but you haven't given ranges for each test if you could add those please? They do look on the low side.

m0dgal1 profile image
m0dgal1 in reply to Jaydee1507

I was given cut off values for tests as follows:

“Ferritin: below 15 ug/L suggests iron deficiency

Transferrin Saturation below 16% suggests iron deficiency

Folate: 3 ug/L or below suggests folate deficiency

Active vitamin B12 below 38 pmol/L suggests vitamin B12 deficiency

iron and transferrin are used to calculate transferrin saturation”

Many thanks for your help

Jaydee1507 profile image
Jaydee1507Administrator in reply to m0dgal1

UK NICE guidelines actually say that a ferritin of less than 30 is deficient so your GP needs to update themselves. I'm not sure why lab values still quote higher levels.

cks.nice.org.uk/topics/anae...

I would show these results to your GP and insist on them treating you for iron deficiency.

Also get B12 injections more frequently.

m0dgal1 profile image
m0dgal1 in reply to Jaydee1507

Many thanks for the additional information and advice. Increasing the frequency of B12 injections is already something I’d decided to action. I will seek treatment for iron deficiency.

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