I am not on Thyroid meds but feel something is very off, I’m in perimenopause also. These results were 7 months ago. I’m losing hair, shaking inside, cold all the time, weight loss. I’m on HRT. I had iron deficient anaemia in 2020. Feel like I’m going mad!
Serum TSH 1.3 mu/L 0.27-4.20mu/L
Serum Free T4 17.5 pmol/L 12.00-22.00 pmol/L
Serum iron 13.5
Serum Ferritin 50ug/L 13.00-150 ug/L
Serum Transferrin 2.6g/L. 2.00-3.60/L
Any advice appreciated before I speak to GP
Thank you in advance.
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marillo
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Your thyroid biomarkers tested (TSH & FT4) appear good, but it is only part of the thyroid picture.
When these results are in range it’s very unlikely you have a thyroid issue & further tests are deemed unnecessary but to completely rule out thyroid issues you need FT3 & Thyroid antibodies (TPO & TG) tested.
Is there a particular symptom causing you to think of thyroid issue, or any family history?
The weight loss & would make iron deficiency anaemia recurrence possible.
Ferritin is in range but over 80 is nearer optimal.
Is there a range for serum iron?
Has haemoglobin been tested?
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Sample recommended to be taken at 09.00 fast overnight, avoid biotin 3 days before test.
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Thank you Purple nails, really helpful. My haemoblobin was 132 g/l, my serum iron was 13.5, both in April 2023, I noticed in my records my serum iron was 26.5, November 22, is it usual to differ so much? I couldn’t see a record of my Ferritin in November 22. The reason I am delving, I’m having such a terrible time with perimenopause/menopause and HRT, migraines in the mix, I take beta blockers 3 times a day for prevention. It’s mainly the feeling cold and inner trembling for the past 12 months, racing heart at certain times of the day, nobody seems to be able to give me an answer, it’s very frustrating and driving severe anxiety. I give a Thyriod nodule which I’ve had for years, checked about 18 months ago, they said it shouldn’t be causing a problem. Thank you for listening, Karen
Lab ranges vary but I think that haemoglobin is low. or it might be it’s just within range & so hasn’t been flagged as issue by dr.
Iron levels will change but by what degree is “normal” I’m not sure. Dr will be focusing for out of range results.
Do you take propranolol? Or another beta blockers?
I was given high dose propranolol when diagnosed hyperthyroid with fast heart rate. Is was then stopped abruptly (which should not be done) & I had terrible migraines. I resumed it & reduced it to a lower dose slowly but remain on it for migraines prevention.
Propranolol specifically can lower magnesium levels & this can worsen migraine & headaches, I’m my case low levels caused twitching around my eyes, It can also can affect FT3 levels & parathyroid.
This a a good article about the best forms of magnesium.
I do well with powdered citrate as I take it in a drink before sleep.
You might find glycinate a good form which I took initially, however the brand I had were 3 large pills a day & I find the powdered more convenient.
Magnesium is a mineral which can usually be taken safely at over the counter doses, without testing first, blood tests tend not to be reliable as body is good a regulating blood levels, but there no test for magnesium in other cells. Excess will be safely excreted.
Always worth obtaining previous ultrasound? or any scan reports. Sometimes includes details about thyroid health which aren’t fully explained.
Ultrasounds can’t determine the function throughout thyroid, drs rely on thyroid function results to decide if there is a function problem. Scans look for potential physical issues.
I have hyper nodule which was cleared after scan but months later found to be hyper functioning, the blood tests weren’t processed.
Non functioning nodules are more common & the thyroid can compensate for the non functioning area & rarely an issues.
Thank you, I take propranolol, 40mg 3 times a day. I did wonder if there is some kind of conflict going on? I take Estradiol patch and Utrogestan progesterone. I understand the thyroid can be affected, not sure how etc.. I take Magnesium Glycinate also. The Hrt has helped massively with migraine, I am questioning whether I need the propranolol 3 times a day now, been on it for 17 years, I’m 54. It’s difficult getting a GP to look at all this. I think I’ll ask for iron studies and Thyroid again, B12 etc. maybe then get some private testing, Thanks so much.
I wonder if the propranolol is lowering your blood pressure or heart rate too much which is making you feel cold? I would speak to a GP about possibly lowering the dose a tiny bit. But I have no medical reason for saying this, it’s just my thought after reading your post. I am lucky though, my current GP is good and does listen - even though she doesn’t always have the answers, but at least she admits it and is nice.
your ferritin would make me feel awful, achey and my thyroid conversion would be poor. Highly recommend Three Arrows Heme Irop Repair. Order from US and wait weeks for it to come but it does what other iron supplements don’t do 🌱
Hi, just an update. I asked my GP to look at my iron, he also did my Thyroid, Vitamin D, B12 and Folate, I have some results. The blood was taken at 9.30am, that’s the earliest I could get, I had fasted since 7 the previous evening, the GP did not tell me to do this, I listened to your advice re Thyroid results. Is it possible for anyone to comment on the results? My serum Ferretin looks low but not out of range yet? Thank you in advance.
Eating iron rich foods, red meat daily and liver or liver pate once a week, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40 30 to 180
Females 40 ≤ age < 50 30 to 207
Females 50 ≤ age < 60 30 to 264
Females Age ≥ 60 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Thanks SlowDragon for all your information, very helpful. I’m not vegetarian or Vegan, I don’t eat a lot of red meat though, I’m trying to eat more.I’ve made an appt with the GP to discuss the results and my propranolol. All the tests have been marked as normal no action, but clearly my symptoms are telling me otherwise. You suggested a new post for more comments, I’ll do this also. If my Ferretin gets lower does this mean I will have iron deficient anemia? Are the Thyroid levels a bit useless because of my Propranolol.
Propranolol increases reverse T3 (rT3). Possibly by increasing the conversion of T4 to rT3, and by reducing it’s metabolism and clearance from the body.
What is interesting is that T4 will often rise, and TSH does not appear to be influenced by Propranolol. So consider you are put on a beta blocker. After a period of time you start to have low thyroid symptoms; tired, fatigue, weight gain, edema, dry skin, etc. You see your primary who runs a TSH with fT4 reflex panel.
Since the beta blocker does not influence TSH it may look normal. If it is high and fT4 is run, it to will be normal or possibly high because beta blockers raise T4 levels.
You will be told you don’t have a thyroid problem because these two labs are normal. If however a comprehensive thyroid panel was run to include T3 and rT3, we would be able to see that the beta blocker is inducing a cellular hypothyroid state.
This is a case of Drug Induced Hypothyroidism. The beta blocker induces the hypothyroid state as well as hide the impact because limited thyroid panels are often performed.
Ween off propranolol VERY SLOWLY over 6-12 months…..and wait at least 3-6 months for thyroid levels to recover
I was stuck on 40mg propranolol 20 years and already diagnosed as hypothyroid due to autoimmune thyroid disease …..caused no end of issues….more on my profile
Thank you SlowDragon, really helpful, I will discuss with the GP. I’ve managed to get a face to face appt, hopefully I can get somewhere with all this. Thanks again.
Thank you, I only started with migraine after my first child was born, I was referred to an endocrinologist because of changes to my Thyroid levels I think, they discovered 2 nodules, apparently harmless. No medication ever given, 27 years ago now. I’ve just had cealiac test, it was negative. Thanks again.
I only started with migraine after my first child was born, I was referred to an endocrinologist because of changes to my Thyroid levels I think, they discovered 2 nodules, apparently harmless. No medication ever given, 27 years ago now.
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and a week or so 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
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
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
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Back to feeling awful : < - do these blood tests mean anything?
Red line and dark discoloration on neck
Vitamin shots?
Help interpretation of results
Flu shots
