I’m still new to this forum and finding my way around.
I posted earlier this week for the first time about my story and received lots and lots of helpful information, more information than I’ve ever received from my GP since my diagnosis so thank you everyone!
It was recommended that I started a new post once I received my most recent test results. I have a GP appointment tomorrow to discuss them and I’d really like to go in armoured with as much information as possible. I’ve been trying quite hard to be referred to an Endo to no avail and my GP assured me that these results will decide whether or not I’m referred.
I assumed that I was going to have my TSH and T4 tested but that wasn’t the case on this occasion.
My last Thyroid results were normal:
5th January 2024
TSH - 0.96 miu/L [0.27 - 4.2]
T4 - 19.0 pmol/L [10.5 - 22.0]
My most recent tests were done to determine the cause of my extreme fatigue/tiredness and ectopic beats. These are:
Ferritin - 21 ug/L [13 - 150]
Though my result is within range, it’s showing as ‘borderline’.
Vitamin D - 21 nmol/L [50.0 - 140.0]
Result - Deficient
Iron - 19.9 umol/L [5.83 - 34.5-]
Result - Normal
B12 - 487 ng/L [197.0 - 771.0]
Result - Normal
Folate - 4.9 ug/L [3.0 - 26.8]
Result - Normal
Tissue Transglutamise IGA - 0.4 u/mL [0.0 - 6.9]
Result - Normal
Full blood count - Normal
Urea, Creat & Electrolytes - Normal
Bone Profile - Normal
Liver Function Tests - Normal
I’ve continuously had low levels of Vitamin D. Even though I have been given supplements in the past to take for a short time. I do eat a lot of Vitamin D rich foods so I’m confused as to why I am always so low on Vitamin D.
Is there any reason why I would be borderline or on the lower range of Ferritin despite having good Iron levels?
None of this really shows why I have such debilitating fatigue. Google suggests Vitamin D deficiency causes bone issues but not fatigue.
Any help would be so appreciated. I want to be well informed for my GP visit tomorrow.
Thank you ☺️
Written by
Dissydee
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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
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
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
Eating iron rich foods like liver or liver pate once a week plus other red meat, pumpkin seeds and dark chocolate, plus daily orange juice or other vitamin C rich drink can help improve iron absorption
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.
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 264l
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.
Unfortunately for me, my doctors appointment didn’t go very well. My doctor has provided me with a high dose prescription for Vitamin D only. She did not feel I needed an iron supplement despite having Ferritin levels below 30.
I cried, I begged and pleaded with her to help me with this debilitating fatigue and her answer was that I’m depressed. I am NOT depressed. I currently take anti-depressants (Fluoxetine 20mg) but I am certainly not depressed and being an expert on my own feelings and emotions, I would for sure be certain if I were depressed. I have been on this path before and know it very well.
I explained that there must be another reason for my fatigue, it’s so severe I can barely function daily. I’m barely surviving. Her answer was that all my tests are normal and that there is nothing else she can do expect prescribe me more anti-depressants.
She was also adamant that Vitamin D is the reason I’m so fatigued and to review in 10 weeks whether or not it’s improved.
I feel so helpless right now. I’m thinking I need to go private.
No other medication or supplements at same as Levothyroxine, leave at least 2 hour gap.
Some like iron, calcium, magnesium, HRT, omeprazole or vitamin D should be four hours away
(Time gap doesn't apply to Vitamin D mouth spray)
If you normally take levothyroxine at bedtime/in night ...adjust timings as follows prior to blood test
If testing Monday morning, delay Saturday evening dose levothyroxine until Sunday morning. Delay Sunday evening dose levothyroxine until after blood test on Monday morning. Take Monday evening dose levothyroxine as per normal
Do you always get same brand levothyroxine at each prescription?
No point (yet) considering private consultation
Work on improving terrible vitamin levels……then retest thyroid (and ideally vitamin levels too) ……if Ft4 is too low, or TSH too high by then …..GP should increase dose Levo as next step
If after next test ……TSH low, Ft4 high …..but Ft3 low …..then it’s time to be looking at getting T3 prescribed alongside levothyroxine via endocrinologist
But it’s ESSENTIAL vitamin levels are optimal BEFORE considering adding T3
Here’s link for how to request Thyroid U.K.list of private Doctors emailed to you, but within the email a link to download list of recommended thyroid specialist endocrinologists who will prescribe T3
Ideally choose an endocrinologist to see privately initially and who also does NHS consultations
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