First time posting, confused about results - Thyroid UK

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First time posting, confused about results

Hybridfuj profile image
10 Replies

First of all, I'm so grateful for everyone who answers posts and explains things on this forum. I've benefitted immensely just by reading others posts.

I would like some help understanding my latest results before I go to my appointment. I'll give my back story for clarity and hopefully with your help I can be a bit more informed.

I first got diagnosed as borderline hypo in 2020, took 50mg and 2 months later got pregnant. During pregnancy and post partum my thyroid levels were fine and I wasn't taking thyroxine. It seemed to have self corrected and I didn't know much about it.

Fast forward 2022, I again was newly pregnant and my thyroid was very hypo (tsh was 13) so I got put on 150,which then sent my hyperthyroid, so reduced to alternate 150/100 and then settled on 100 until after giving birth.

I had a period of about a month where I wasn't taking my medicine regularly so at my appointment doc said stop it altogether for 6 weeks and retest to get a proper idea.

Tested after that, in September, and of course was hypo again, also atpo was around 300 so was diagnosed as autoimmune hypothyroidism aka hashis.

Was given 75mg thyroxine but after a month didn't feel it was enough so increased to 100. In hindsight shouldn't have changed the dose before testing.

that was about 2 weeks ago, which brings us up to my latest tests.

I did a fasting test about 24hrs after last thyroxine dose.

The results are as follows :

Tsh 0.5 (range 1-5)

Ft3 3.53 (range 4-6)

Ft4 15.49 (range 9-20)

Vit d: 25

B12: 251 (range 156-672)

Magnesium: 0.78 mmol (range 1-1)

Ferritin: 35 (range 10-291)

Iron 11.62 (range 9-30)

Hgb 12.6 (12-15)

Rdw 14.3 (12-14)

I did a load of other tests but they all appear within range, I also did the rheumatoid factor test and it was 10.

I know my vit d is low which explains why I didn't feel the thyroxine was working, since the symptoms overlap.

But not sure what my latest thyroid results mean.

Any help would be greatly appreciated.

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Hybridfuj profile image
Hybridfuj
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10 Replies
SlowDragon profile image
SlowDragonAdministrator

welcome to the forum

Please add ranges on results, especially Ft4 and Ft3

How long before test had you increased to 100mcg

Only test 6-8 weeks after any increase

Which brand of levothyroxine are you taking

Vitamin levels are all very poor as expected when hypothyroid

No folate result?

Vitamin D is deficient.

Ferritin virtually deficient

B12 extremely low.

Are you vegetarian or vegan?

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 a week later add a separate vitamin B Complex 

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 until over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

Hybridfuj profile image
Hybridfuj in reply to SlowDragon

Thankyou so much, I'll dive into all of these links.I've updated to add ranges. Unfortunately can't see my atpo results so will need to wait for apptmt.

I also added the hgb and rdw results as I'm not sure on this but combining these results with the ferritin and iron, it looks like I might be a bit anaemic?

No folate result available, maybe they didn't test me for it.

I'm not a vegetarian, I eat red meat about once or twice a week but admittedly I have a very poor diet made up mainly from whatever my toddler leaves on the plate!

Hybridfuj profile image
Hybridfuj in reply to SlowDragon

Also I only tested 2 weeks after increasing dose, I now know that was too soon.

SlowDragon profile image
SlowDragonAdministrator in reply to Hybridfuj

Also I only tested 2 weeks after increasing dose, I now know that was too soon.

Yes ….so ignore low TSH ..that will creep back higher

Work on improving low vitamin levels while waiting for next increase in levothyroxine

SlowDragon profile image
SlowDragonAdministrator

Only add one supplement at a time then wait 7-10 days to assess before adding another

Low vitamin D

GP should prescribe LOADING dose of 300,000iu over 6-8 weeks

NHS Guidelines on dose vitamin D required

ouh.nhs.uk/osteoporosis/use...

or you could self supplement 6000iu per day for 8 weeks

Then retest

vitamindtest.org.uk

You will need ongoing daily maintenance dose vitamin D

GP will often only prescribe to bring vitamin D levels to 50nmol.

Some areas will prescribe to bring levels to 75nmol or even 80nmol

leedsformulary.nhs.uk/docs/...

GP should advise on self supplementing if over 50nmol, but under 75nmol (but they rarely do)

mm.wirral.nhs.uk/document_u...

But with Hashimoto’s, improving to around 80nmol or 100nmol by self supplementing may be better

pubmed.ncbi.nlm.nih.gov/218...

vitamindsociety.org/pdf/Vit...

Once you Improve level, very likely you will need on going maintenance dose to keep it there.

Test twice yearly via NHS private testing service when supplementing

Vitamin D mouth spray by Better You is very effective as it avoids poor gut function.

There’s a version made that also contains vitamin K2 Mk7.

One spray = 1000iu

amazon.co.uk/BetterYou-Dlux...

It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average

Vitamin D and thyroid disease

grassrootshealth.net/blog/t...

Vitamin D may prevent Autoimmune disease

newscientist.com/article/23...

Web links about taking important cofactors - magnesium and Vit K2-MK7

Magnesium best taken in the afternoon or evening, but must be four hours away from levothyroxine

betterbones.com/bone-nutrit...

medicalnewstoday.com/articl...

livescience.com/61866-magne...

sciencedaily.com/releases/2...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

humanbean profile image
humanbean

my thyroid was very hypo (tsh was 13)

...

at my appointment doc said stop it altogether for 6 weeks and retest to get a proper idea.

As someone who has had a TSH result of 13 in the past, telling you to stop taking Levo altogether was sadistic in my opinion. Don't agree to do that ever again.

Tsh (miu/l) 0.5

Ft3 (pmol/l) 3.53

Ft4 15.49

Vit d: 25

B12: 251 (pmol)

Magnesium: 0.78 mmol

Ferritin: 35 ng/ml

Iron 11.62 umo/l

Working on the basis of the most common ranges for the above, all of them except TSH are too low for good health. But to be sure, you really need the ranges supplied by whoever did the tests, since ranges can't be "borrowed" from other test labs.

Once you've supplied the ranges we can give more useful and tailored help.

Hybridfuj profile image
Hybridfuj in reply to humanbean

Thanks, I've edited it to add ranges now, should be there.To be fair to the doc, my tsh wasn't 13 when he said that. The 13 was about a year ago. At the time I stopped, all results were in range but due to me being inconsistent with my meds in the month prior, he wanted a more accurate reading.

In all honesty every aspect of my health deteriorated in these six weeks, and that's starting from a baseline of in range results.

humanbean profile image
humanbean in reply to Hybridfuj

Regarding "in range" - this is used to save money at patient's expense.

Suppose three patients A, B and C have a ferritin (iron stores) test. In each case in this example the range is the same (10 - 150). Results are :

A = 10

B = 80 (mid-range)

C = 150

All of these results are in range so some doctors might say these results are all "fine". But in reality patient A will feel worst and patient B will probably feel best. So being "in range" is not the only factor to be taken into account. Where in range matters too.

To make matters worse, if a result is close to the bottom of the range but under it e.g. 7 in this example, some doctors think this is "close enough".

So beware of "in range". It definitely doesn't mean "optimal", although many doctors do appear to think that "in range " is the same as "optimal".

humanbean profile image
humanbean

Vit d: 25

B12: 251 (range 156-672)

Magnesium: 0.78 mmol (range 1-1)

Ferritin: 35 (range 10-291)

Iron 11.62 (range 9-30)

Hgb 12.6 (12-15)

Rdw 14.3 (12-14)

Vitamin D - Optimal for vitamin D is usually quoted as being 100 - 150 nmol/L in the UK. Note that the units of measurement matter. Some vitamin D tests are given in ng/mL and optimal is a different number (40 - 60 ng/mL). I would suggest that you need to supplement 5000 iU - 6000 iU per day of vitamin D3 (NOT D2). The best supplements are capsules containing only olive oil and vitamin D3, but I do okay with cheaper ones than that.

Vitamin B12 - The reference ranges used in the UK are remarkably low. It is not dangerous to have higher than top of the range B12 levels, although this is the only nutrient I know of that this is true for. Some links on the subject :

perniciousanemia.org/b12/le...

perniciousanemia.org/b12/le...

There are four different kinds of B12 supplements generally available and their pros and cons are given here. Personally I always stick to methylcobalamin and occasional use of adenosylcobalamin with a dose of 500mcg - 1000mcg per dose :

perniciousanemia.org/b12/fo...

Magnesium - I wrote about magnesium for another member in this reply :

healthunlocked.com/thyroidu...

Hgb 12.6 (12-15)

Rdw 14.3 (12-14)

Your haemoglobin (Hgb) is within range but low in range. If your Hgb drops below range you will be officially anaemic, but you can feel awful before you reach rock bottom, and you aren't far off it now. Note the NHS usually uses ranges where the lower level of the range is 11.5. I think they have reduced it that low to save money, but then I'm a cynic.

RDW - In cases of anaemia, caused either by low iron/ferritin or low B12/folate RDW tends to rise. It means that your red blood cells have a greater variation in size than would be the case for people who aren't anaemic.

labtestsonline.org.uk/tests...

The Clinical Knowledge Summaries for Anaemia produced by NICE can be found here :

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

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

Ferritin: 35 (range 10-291) 8.9% through the reference range

Iron 11.62 (range 9-30) 12.48% through the reference range

Optimal levels usually used for iron and iron-related parameters on this forum are given in this link :

rt3-adrenals.org/Iron_test_...

As you can see :

Serum iron

• 55 to 70% of the range

• higher end for men

To reach optimal your serum iron would have to rise to 20.55 - 23.7 with the same range. I don't know if you are male or female. To raise your iron you would need to take iron supplements.

Optimal for ferritin is not given very precisely in the rt3-adrenals link, so this is an alternative :

thyroidpharmacist.com/artic...

Normal ferritin levels for women are between 20 and 200 ng/mL. According to some experts, ferritin levels of at least 40 ng/ml are required to stop hair loss, while levels of at least 70 ng/ml are needed for hair regrowth. The optimal ferritin level for thyroid function is between 90-110 ng/ml.

.

Some popular iron supplements on the forum are described in these links :

* healthunlocked.com/thyroidu...

* healthunlocked.com/thyroidu...

There are other iron supplements available but they can be quite slow in raising levels :

healthunlocked.com/thyroidu...

That last link is quite old and I'd go with the two links with stars before trying iron salts.

Note that once people start taking iron supplements they need to do fairly frequent iron panels to check on what is happening to their levels. A couple of possible outcomes of taking iron supplements are :

1) Iron shoots up and ferritin stays low.

2) Ferritin shoots up and iron stays low.

Also note that depending on genetics some people actually absorb iron better if their folate levels are good. Good B12 might help too.

Hybridfuj profile image
Hybridfuj in reply to humanbean

This was very clear and helpful, thankyou.So basically b12 is deficient, need to get over 500;

vit d is horribly deficient (my test was nmol)

And i am probably slightly anaemic or borderline anaemic, will need to get ferritin up to 80 or 90.

This on top of the autoimmune hypothyroidism-No wonder I feel so awful!

I've also suspected sjogren's syndrome and am waiting on the autoimmune test results, but knowing I'm deficient in all of this, it could be that if I get the levels in order, other symptoms disappear.

I've now got a great base of information to work from, thank you so much.

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