Help with latest bloods please!

[Smartypants1]

hi everyone

I’m on 50mcg of Levothyroxine for Hashimotos and my original test results are in my profile. I’ve just had some bloods done with the GP and they’ve said no further action is required. I’m conscious that there is a difference between being within range and optimal, so I thought I’d come on here and check with the experts! I’d also be interested to get your take on my vitamin levels. They only took my TSH and free T4 so I know it’s not the full picture so I’ve also ordered a private test.

Free T4 - 17 (10-20)

TSH - 2.9 (0.2 - 4.0)

B12 473 (211-911)

Ferritin 32 (10-322)

Folate 11.2 (5.4-24)

thank you!

[SlowDragon Administrator]

Looking at your profile

You have Hashimoto’s

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 taking

Have you had coeliac blood test done yet or are you already on strictly gluten free diet

Ferritin very low

Are you vegetarian or vegan

No vitamin D test result

[Smartypants1 in reply to SlowDragon]

Thanks for your speedy reply Slowdragon.

No, it wasn’t taken first thing and I did take my Levo in the morning! I’ve ordered a private test because I want my T3 results too.

I haven’t had a coeliac test done but I’ve been strictly gluten free for four weeks now.

Yes, I’m vegetarian

They didn’t test my bit D but I’ll get that added onto my private test.

Thanks

[SlowDragon Administrator in reply to Smartypants1]

No, it wasn’t taken first thing and I did take my Levo in the morning! I’ve ordered a private test because I want my T3 results too.

So TSH would have been higher if tested earlier, ideally before 9am

Ft4 false high result as last dose levothyroxine should be 24 hours before test

[Smartypants1 in reply to Smartypants1]

Also, I’m taking Cytoplan coQ10 multi

[SlowDragon Administrator in reply to Smartypants1]

This one?

cytoplan.co.uk/coq10-antiox...

[Smartypants1 in reply to SlowDragon]

no. I tried to copy the link but I don’t think it’s pasting properly

cytoplan.co.uk/coq10-multi?...

[SlowDragon Administrator in reply to Smartypants1]

That contains iodine

Suggest you stop

Multivitamins never recommended

[SlowDragon Administrator in reply to Smartypants1]

Also stop any supplements that contain biotin 5-7 days before ALL blood tests as biotin can falsely affect test results

Levothyroxine contains all the iodine you need…..unless possibly long term vegan…..even then supplementing iodine can exacerbate thyroid issues

Don’t supplement iron unless tested first and in need. Iron is toxic in excess

Roughly How old are you?

Pre or post menopause

[Smartypants1 in reply to SlowDragon]

I’m 48 and perimenopausal

[SlowDragon Administrator in reply to Smartypants1]

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.

Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.

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

Stop iron supplements 5-7 days before test

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

Eating iron rich foods

List of iron rich foods

dailyiron.net

Links about iron and ferritin

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 - not suitable for vegetarians

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...

Iron deficiency without anaemia

healthunlocked.com/thyroidu...

Ferritin over 100 to alleviate symptoms

healthunlocked.com/thyroidu...

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...

Inflammation affecting ferritin

healthunlocked.com/thyroidu...

Updated reference ranges for top of ferritin range depending upon age

healthunlocked.com/thyroidu...

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.

[SlowDragon Administrator]

As vegetarian you should be taking B12 daily

Do you do that

academic.oup.com/nutritionr...

The present review of the literature regarding B12 status among vegetarians shows that the rates of B12 depletion and deficiency are high. It is, therefore, recommended that health professionals alert vegetarians about the risk of developing subnormal B12 status. Vegetarians should also take preventive measures to ensure adequate intake of this vitamin, including the regular intake of B12 supplements to prevent deficiency. Considering the low absorption rate of B12 from supplements, a dose of at least 250 μg should be ingested for the best results.3

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

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

Highly effective 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

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) and continue separate B12 until over 500

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

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