New blood results - advice on whether to speak to GP?

[BeeHappi23]

Good afternoon everyone,

I posted back in November (healthunlocked.com/thyroidu... and received some really helpful advice, so I thought I’d post again for your opinions with some new blood results.

Blood test taken at 08:50 on an empty stomach. I am not currently on any medication for my thyroid.

Please see my November 2023 and January 2024 blood test results below.

Am I correct in thinking that this shows a slightly worse thyroid profile? If so, should I now speak to my GP with these results, or is it worth repeating them again in another 2-3 months?

I understand that the nhs has a wide range for “normal” thyroid function, and that my TSH is technically acceptable… basically I’m not too sure how to proceed with these and whether my GP will take my concerns seriously.

Thank you very much! ☺️

TSH - (0.27 - 4.2 mU/L)

November- 2.51 mu/L

January - 2.58 mu/L

FT4 - (12 - 22 pmol/L)

November - 11 pmol/L

January - 10.9 pmol/L

FT3 - (3.1 - 6.8 pmol/L)

November - 4.6 pmol/L

January - 3.8 pmol/L

TPO - only tested in January - 9 IU/ml (negative)

Ferritin - (no range given, but stated “Normal”)

November - 66 ug/L

January - 66 ug/L

Transferrin Saturation - (no range given, but stated “Low”)

November - 13%

January - 14%

Active B12 - (no range given, but states “Normal”)

November - 70 pmol/L

January - 90 pmol/L

Folate - (no range given, but stated “Normal”)

November - 4.4 ug/L

January - 2.4 ug/L

Vitamin D - (no range given, but stated “Normal”)

November - 44 nmol/L

January - 37 nmol/L

[SlowDragon Administrator]

As your Ft4 is BELOW RANGE GP should refer you to endocrinologist for central hypothyroidism

See ….Starting levothyroxine - flow chart

gps.northcentrallondonccg.n...

Meanwhile get BOTH thyroid antibodies tested privately via Medichecks or Blue Horizon

NHS currently refusing to test Thyroglobulin antibodies unless TPO are high

Significant minority of Hashimoto’s patients only have high Thyroglobulin antibodies

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

If both antibodies are negative get ultrasound scan of thyroid

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue too.

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

[SlowDragon Administrator]

November - 44 nmol/L

January - 37 nmol/L

Neither result is normal….both are insufficient

GP should have prescribed 1600iu daily for 6 months in November

Did this happen?

What dose vitamin D have you been taking

NHS Guidelines on dose vitamin D required

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

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 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

vitamindtest.org.uk

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

Suggest you start taking 3 sprays per day (3000iu daily)

Retest in 2-3 months

You may need higher dose

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...

Only start one supplement at a time

Wait at least 10-14 days before adding magnesium in evening

[SlowDragon Administrator]

Folate

Looks extremely low

You need to know the range

2 weeks after starting magnesium supplements look at adding daily vitamin B complex for 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

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

Post discussing different B complex

healthunlocked.com/thyroidu...

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...

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

[BeeHappi23 in reply to SlowDragon]

Hi SlowDragon,

Thank you very very much for your comprehensive replies.

To answer a couple of questions, no my GP has not replaced my vitamin D, I currently take a supplement with 5ug (200IU) daily - I’ll look into what you have advised.

I’ll also look to get both TPO and thyroglobulin antibodies tested.

And will look into the addition of magnesium and the vitamin b complexes. Unfortunately there was no range provided for my folate results.

This is really helpful, thank you for taking the time to reply ☺️ - I’ll work my way through the links you have suggested and get in touch with my GP.

Thank you again!