Help interpreting results

[jennylouise91]

Hello

I posted previously as had some blood tests with elevated levels.displaying symptoms fatigue, struggle to lose weight, heavy periods, muscle aches. Been taking vitamin d, iron, zinc and turmeric since December which has raised iron levels. Can anyone help with interpreting these results all NHS aside from march 24 which was medicheck

September 2023 results

TSH 5.95mIU/L (0.27 - 4.2) 144.5%

Free T4 (fT4) 12.5 pmol/L (11.0 - 21.2) 14.7%

Vitamin B12 348 nmol/L (197-771) 26.9%

Jan 2024

TSH 1.95 mIU/L (0.27 - 4.2) 42.7%

Free T4 (fT4) 12.5 pmol/L (11.0 - 21.2) 14.7%

Thyroid Peroxidase Antibodies (TPO) 15 IU/mL (≤ 33)

Vitamin D 46nmol

Feb 2024

Folate - Serum 3.1 ug/L (3.0 - 20.0) 0.6%

Vitamin B12 328 nmol/L (197 - 771) 22.8%

Ferritin 98 ug/L (13 - 150) 62.0%

March 2024

TSH 1.710 mIU/L (0.27 - 4.2) 36.6%

Free T4 (fT4) 14.9 pmol/L (12 - 22) 29.0%

Free T3 (fT3) 5 pmol/L (3.1 - 6.8) 51.4%

T4:T3 Ratio 2.980 

Folate - Serum 3.1 ug/L (3.0 - 20.0) 0.6%

Vitamin B12 328 nmol/L (197 - 771) 22.8%

Ferritin 98 ug/L (13 - 150) 62.0%

Thyroid perioxidase antibodies 263 kIU/L (0 - 115) 228.7%

Thyroglobulin antibodies  18 KIU/L (0 - 34) 52.9%

[SlowDragon Administrator]

Been taking vitamin d, iron, zinc and turmeric since December which has raised iron levels.

Vitamin D 46nmol

How much vitamin D are you taking

Vitamin D is still insufficient

GP should prescribe 1600iu everyday for 6 months

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 with Hashimoto’s, improving to at least around 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 when supplementing

Can test via NHS private testing service

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

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...

Too much Vitamin D is toxic

Important……Test twice a year

healthunlocked.com/thyroidu...

[jennylouise91 in reply to SlowDragon]

Test was before I started on vit D, now taking 1000iu otc as advised by gp

[SlowDragon Administrator]

Thyroid perioxidase antibodies 263 kIU/L (0 - 115) 228.7%

Thyroglobulin antibodies  18 KIU/L (0 - 34) 52.9%

I think you have these the wrong way around

Suspect Thyroglobulin antibodies that are high

Range on TG antibodies is less than 115

Range on TPO is less than 34

pubmed.ncbi.nlm.nih.gov/303....

Conclusions: Elevated TgAb levels are associated with symptom burden in HT patients, suggesting a role of thyroid autoimmunity in clinical manifestations of HT. Based on these results, we recommend screening for TgAb antibodies in HT patients with symptom burden.

NHS currently does accept just high TG antibodies as confirmation of autoimmune thyroid disease

[jennylouise91 in reply to SlowDragon]

yes these are the wrong way round thyroglobulin antibodies were 263

[SlowDragon Administrator]

Folate - Serum 3.1 ug/L (3.0 - 20.0) 0.6%

Vitamin B12 328 nmol/L (197 - 771) 22.8%

These are both far too low

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

Igennus B complex popular option. 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...

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 can be difficult to find at reasonable price, should be around £20-£25. iherb.com often have in stock. Or try ebay

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...

Retest full thyroid and vitamin levels in another 8-10 weeks

Likely to see some symptom improvements by improving low vitamin levels