Medichecks bloods with some very low/high bloods. Appt with GP 4th March to discuss.

[helenshubby]

My wife's bloods are still way off. It's listed below. She recently had a nasty bug on 29th December and feels shes still a bit chesty. She also developed a rash on the top front of her chest which was treated with hydrocortisone (Daktacort) but still feels there's a little left there. Still tired, brain fog , sinus and ear issues, which seem to drain down the back of her throat which makes her cough. Helen finds it difficult to wake up and could sleep for hours. Other than looking after me with my problems she is unable to do much more than the washing and washing up. Forget anything else. After her last test her levothyroxin was increased to 100 mcg a day and we have added 1000iu/day. of Vit D. We are not getting out much and have additional stresses with my elderly parents declining health and her frustration at being unable to function properly and do the things she feels she should be doing..

This is a fasting Advanced well woman test:

RBCs

Haemoglobin 119 NR:115-165

Haematocrit 0.363 NR 0.37-0.47 Under range

Red Cell Count 4.11 NR: 3.8-5.8

MCV 88.4 NR 80-100

MCH 28.9 NR 27-32

MCHC 327 NR 320-360

WBCs

White Cell Count 4.5 NR 3-11

Neutrophils 2.4 NR 2-7.5

Lymphocytes 1.6 NR 3-11

Monocytes 1.6 NR 1.5-4.5

Eosinophils 0.2 NR 0-0.4

Basophils 0 NR 0-0.1

All low and HCT below range.

Platelets 257 NR 150-450

RFTs

Urea 4.1 NR 2.58-7.8

Creatinine 84.5-100

eGFR 68 NR > 60p

LFTs

Bilirubin 7.7 NR< 22

ALP 114 NR 30-130

ALT 14 NR <34

GGT 16 NR <38

Protein

Total Protein 71 NR 60-80

Albumin 44 NR 34-50

Globulin 28 NR 19-35

Blood Sugar

HbAIC 38 NR 21-41.999

Cholesterol

Total Cholesterol 5.86 NR NR < 5

LDL Cholesterol 3.82 NR <3

Non-HDL Cholesterol 4.59 NR <4

HDL Cholesterol 1.27 NR > 1.27

Total Cholesterol/HDL Ratio 4.61 NR <6

Triglycerides 1.69 NR < 2.3

Inflammatory Markers

C Reactive Protein 4.9

Uric Acid 3.08 NR 140-360

Iron

Iron 14.6 NR 10-30

TIBC 46.0 NR 45-81

UIBC34.0 NR 13-56

Transferrin Saturation 30 NR 25-45

Ferritin313 NR 30-650

Magnesium 0.93 NR 0.7-1

Vitamins

Folate Serum >45 NR >7

Active B12 >150 NR 37.5-188

Vit D 69.5 NR 50-250 has increased from 52.5 after increasing to 2000iu day about a few weeks ago

Thyroid

TSH 3.180 NR 0.27-4.21

Free T3 4.3 NR3.1-6.8

Free Thyroxine 19.1 NR 12-22

Helen does not seem to be converting to T3 at all well

Other tests state she's menopausal.

Any suggestions as to what's going on with persistently low RBC's WCCs, RFTs, proteins, Vitamin D which looks as if it improved after taking an additional tablet and considering starting vit K2 to assist in better absorption. THe CRP has gone up noticeably (it was just under 3 last time)

The HDL/TC ratio is under 5 we're not worried about that as a previous GP and work said up to 5.0 was OK and the level quoted is NFN!

We think this is all down to her autoimmune thyroid (Hashimoto's) as last time her antibodies were 10 x normal. Any other ideas please? Very few of the results are above the midpoint of the range and as the "range" is generally a Bell Curve related to Standard deviation in statistics they should be considering increasing various treatments so that the levels move into the higher quartile until the patient feels well as it's all too easy to say you're in range so you must be OK. We have limited headroom to increase Helen's Levo as it could take her hyper as she's only 3 points off the top. We need some proper guidance on how to put her in the right place.

Putting this up here as we have an appointment with the GP to discuss these results and I want to push perhaps to 112.5 or 125 mcg Levo, Vitamin D, Iron etc.

Helen is classed as vulnerable to Covid and is also taking OTC Zinc and Selenium. We are also considering K2 but I've seen that the ratio of Vit D to K2 is 10:1 and Healthspan offers 75mcg capsules which seems too much but Holland & Barrett are the same.

[TiggerMe Ambassador]

Could you edit to add the fT3 result that is missing

I'd also suggest she needs to double the Vit D dose (and certainly add K2) as aiming to get it to 100-150

grassrootshealth.net/projec...

Have you looked into HRT?

[helenshubby in reply to TiggerMe]

Done. I also forgot Iron and have corrected this and added a bit more in the comments. Haven't even thought of HRT. Helen was on OCP from late 20's to 47 but never resumed as I gather Hashi's affects Fertility

[TiggerMe Ambassador in reply to helenshubby]

Like you say she really isn't converting well so her fT3 is dragging behind

Free T4 (fT4) 19.1 pmol/L (12 - 22) 71.0%

Free T3 (fT3) 4.3 pmol/L (3.1 - 6.8) 32.4%

T4:T3 Ratio 4.442 

Ft4 at 70% there is still room for an increase perhaps adding 12.5mcg per day or 25mcg every other day could give her a little boost...

What are the chances of seeing a private Endo?

[greygoose]

Vitamin D which looks as if it improved after taking an additional tablet and considering starting vit K2 to assist in better absorption.

Vit K2 does not assist absorption of vit D. That is a misconception a lot of people have. However, taking vit D increases absorption of calcium from food, and the K2 makes sure it goes into the teeth and bones, and doesn't build up in the soft tissues and arteries.

On the other hand, she does need to take magnesium with vit D because the two works together and the vit D won't do much for her without it.

We think this is all down to her autoimmune thyroid (Hashimoto's) as last time her antibodies were 10 x normal.

More likely to be down to the resulting hypothyroidism. Antibodies do not affect blood test results of other things.

Hypos very often have low stomach acid - due to low T3 - which means that you have difficulty digesting food and absorbing the nutrients.

Low T3 also causes high cholesterol because the body cannot process cholesterol correctly without enough T3.

as the "range" is generally a Bell Curve related to Standard deviation in statistics they should be considering increasing various treatments so that the levels move into the higher quartile until the patient feels well as it's all too easy to say you're in range so you must be OK.

Totally agree with you! And it is a scandal that that doesn't happen.

We have limited headroom to increase Helen's Levo as it could take her hyper as she's only 3 points off the top.

You have no headroom. Her FT4 is probably already too high and affecting her conversion. Plus long-term high FT4 is linked to great risk of some cancers and heart attacks.

What she needs is some T3 added to a reduced dose of levo, because, as you say, she is a poor converter.

[FallingInReverse in reply to greygoose]

greygoose On the other hand, she does need to take magnesium with vit D because the two works together and the vit D won't do much for her without it.

Did not know! Magnesium on my long list and I haven’t gotten to it yet.

So magnesium is a must when taking D for the best approach? What’s the best dosing guidance?

[TiggerMe Ambassador in reply to FallingInReverse]

No idea about his supplements but this tells you about the different sorts... drjockers.com/best-magnesiu...

[greygoose in reply to FallingInReverse]

Do you mean how much should one take? Around 350 to 400 mg.

[HealthStarDust in reply to greygoose]

In elemental magnesium? Or just total content. That always throws me!

[greygoose in reply to HealthStarDust]

That's all it says in the ingredients, so I don't know.

[HealthStarDust in reply to greygoose]

Thank you.

[helenshubby in reply to FallingInReverse]

so we’ looking at possibly increasing the vit, d, probably after adding in a dose of magnesium and K2 and further testing snd giving 6 weeks to let things settle. Sound like a plan? We tried t3 last year but I think the endo started Helen on two high a dose of t3, 20mcg/day

[greygoose in reply to helenshubby]

20 mcg as a starter dose is much too high. Should be 5 mcg for at least two weeks. Then, if that goes well, add in another 5 mcg, and continue like that.

I sometimes think these endos set people up to fail by prescribing too much to start on, because they just don't want to prescribe T3.

[helenshubby in reply to greygoose]

The thought came to me as well. The Consultant (Neupane) seemed to think 20mcg was a low dose.

[greygoose in reply to helenshubby]

Sigh. They really are gormless, aren't they! Or, lying through their teeth! I have a suspicion it's the latter!

[Shellian in reply to greygoose]

Hi Greygoose, I've seen your reply to Helen'shubby. Just wondering about my T4 and T3 . I'm awaiting new test results but my last test showed T4 at 22.4 ( 7.5- 21.1) ( 109.56%)

FT3 4.9 (3.8-6.8) (36.67%)

TSH is always undetectable

B12 351 (110- 914.0) I am supplementing now (nature provides 3000mcg daily along with Thorne Basic B complex)

Ferritin 56 (10-180)

Calcium 2.31 ( 2.2-2.6)

Folate 7.3 (3.1-19.9)

Vit D 55 (60-150) supplementing with 5000iu weekly dose

I have no thyroid or parathyroids due to MEN2a so had Medullary Thyroid Cancer.

I currently take 112mg levo per day plus 100 one Alpha for calcium.

I am wondering about your comments about T4 being over the range . The doctor has told me to reduce levo to 100 per day ( I haven't yet, as don't want to get sluggish again.) But I am worried about heart attacks etc with high T4. Up until now I thought that as long T3 was in range it didn't matter if T4 was over a bit.

I also take Cod Liver oil and vitamaze K2)

How can I increase T3 ? Endo will not prescribe T3. Is my high T4 dangerous?

Thank you

[greygoose in reply to Shellian]

Shellian can you copy and paste this into a new question/thread, please. If we start answering other people's questions on this thread it gets very confusing.

Thank you for your understanding.

[HealthStarDust]

How long has your wife been on 100mcg a day? It may worth staying on the dose longer and retesting as I suspect the numbers will change. I think I have read, perhaps on this forum, that the numbers often lag behind symptoms.

I for one have seen my FT4 going up the down on the same dose after 1 week, then a few weeks later.

[helenshubby in reply to HealthStarDust]

IIRC About 3 months at least

[HealthStarDust in reply to helenshubby]

TSH 3.180 NR 0.27-4.21

Free T3 4.3 NR3.1-6.8

Free Thyroxine 19.1 NR 12-22

Based on these results it’s hard to know what to suggest as the TSH suggest increase but the FT4 is almost near the top. Maybe a small increase such as 112.5mcg is warranted.

What will she do?