new blood test,

[Haze1975]

New blood test, any help of understanding this I’d would be great full.

Serum lipid levels

Serum cholesterol level 6.5 mmol/L

Serum HDL cholesterol level 1.1 mmol/L

Cholesterol/HDL Ratio 5.9

Serum LDL cholesterol level 3.8 mmol/L

Serum triglyceride levels 3.5 mmol/L

Guide to Lipid Interpretation: ~

Primary Prevention:

Refer to risk tables

Secondary Prevention:

Target Cholesterol < 4.0 mmol/L

or 25% reduction (whichever is greater)

Target LDL-Cholesterol < 2.0 mmol/L

or 30% reduction (whichever is greater)

HDL Cholesterol should be > 1.0 mmol/L

Target non HDL Cholesterol <2.5mmol/L (JBS3 2014)

or 40% reduction from baseline (NICE CG181/July 2014)

Fasting Triglyceride should be less than 1.7 mmol/L

Serum non high density lipoprotein cholesterol level 5.4 mmol/L

LIVER FUNCTION TESTS

Serum alanine aminotransferase level 13 U/L [10.0 - 35.0]

Serum bilirubin level 5 umol/L [0.0 - 21.0]

THYROID STIMULATING HORM.

Serum TSH level 4.48 mIU/L [0.35 - 4.94]

Serum free T4 level 14.10 pmol/L [9.01 - 19.05]

Serum free triiodothyronine level 3.60 pmol/L [2.63 - 5.7]

Haemoglobin A1c level - IFCC standardised 43 mmol/mol [20.0 - 41.0]; (>47 mmol/mol) - Diabetes Mellitus if confirmed.

(42 - 47 mmol/mol) - High risk of developing DM,

GFR calculated abbreviated MDRD > 90

Urea and electrolytes

Serum sodium level 142 mmol/L [136.0 - 145.0]

Serum potassium level 4.7 mmol/L [3.5 - 5.1]

Serum urea level 5.5 mmol/L [2.5 - 6.7]

Serum creatinine level 56 umol/L [50.0 - 98.0]

BONE PROFILE

Serum total protein level 81 g/L [64.0 - 83.0]

Serum albumin level 39 g/L [35.0 - 50.0]

Serum calcium level 2.31 mmol/L [2.1 - 2.55]

Serum inorganic phosphate level 1.00 mmol/L [0.8 - 1.5]

Corrected Calcium 2.33 mmol/L [2.1 - 2.55]

Serum globulin level 42 g/L [20.0 - 39.0]; Above high reference limit

Serum alkaline phosphatase level 144 U/L [40.0 - 150.0]

FULL BLOOD COUNT

Haemoglobin concentration 133 g/L [115.0 - 165.0]

Total white blood count 8.9 10*9/L [3.7 - 11.0]

Platelet count - observation 493 10*9/L [150.0 - 450.0]; Above high reference limit

Neutrophil count 5.6 10*9/L [1.7 - 7.5]

Lymphocyte count 2.1 10*9/L [1.0 - 4.0]

Monocyte count - observation 0.8 10*9/L [0.2 - 1.0]

Eosinophil count - observation 0.3 10*9/L [0.04 - 0.5]

Basophil count 0.1 10*9/L [0.0 - 0.1]

Red blood cell count 4.35 10*12/L [4.0 - 5.5]

Haematocrit 0.410 L/L [0.36 - 0.44]

Mean cell volume 94.3 fl [80.0 - 100.0]

Mean cell haemoglobin level 30.6 pg [27.0 - 32.0]

Mean cell haemoglobin concentration 324 g/L [320.0 - 360.0]

Nucleated red blood cell count 0.0 10*9/L [0.0 - 0.1]

it’s been nearly 10 years, last endo appointment in December. Before releasing me back to my own doctor surgery.

[SlowDragon Administrator]

You’re currently very under medicated

Would imagine you feel pretty rough?

How much levothyroxine are you currently taking

Which brand

was test done 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)

What vitamin supplements are you currently taking

On levothyroxine TSH should always be below 2

Most people will feel better when TSH is around or below 1

More importantly Ft3 at least 60-70% through range

Usually on just levothyroxine, Ft4 will need to be higher at least 70-80% through range

Currently

FT4: 14.01 pmol/l (Range 9.01 - 19.05)

Ft4 only 49.80% through range

FT3: 3.6 pmol/l (Range 2.63 - 5.7)

Ft3 only 31.60% through range

Request 25mcg dose increase in levothyroxine

Retest again in 2-3 months

High cholesterol is directly linked to being on inadequate dose levothyroxine and cholesterol levels will improve as levothyroxine dose increases

nhs.uk/conditions/statins/c...

If you have an underactive thyroid (hypothyroidism), treatment may be delayed until this problem is treated. This is because having an underactive thyroid can lead to an increased cholesterol level, and treating hypothyroidism may cause your cholesterol level to decrease, without the need for statins. Statins are also more likely to cause muscle damage in people with an underactive thyroid.

When were vitamin D, folate, ferritin and B12 levels last tested

These need testing annually and maintain at Good levels

What vitamin supplements are you taking

Many (most?) thyroid patients need to supplement vitamin D, magnesium and vitamin B complex continuously

Some need separate B12 initially (or permanently if vegetarian or vegan)

And many need iron supplements

[SlowDragon Administrator]

TSH should be under 2 as an absolute maximum when on levothyroxine

gponline.com/endocrinology-...

Graph showing median TSH in healthy population is 1-1.5

web.archive.org/web/2004060...

Comprehensive list of references for needing LOW TSH on levothyroxine

healthunlocked.com/thyroidu....

onlinelibrary.wiley.com/doi...

If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).

Two years ago your vitamin levels were really terrible

healthunlocked.com/thyroidu....

a year ago you were recommended to get FULL thyroid and vitamin testing as TSH was too high and likely inadequate dose levothyroxine

healthunlocked.com/thyroidu....