advice with latest results

[Burgerballs]

Hi all , been gaining some great knowledge from this site over the past few years but now feel I’d like some advice on my latest blood results please. I’ll try to be as brief as possible with my story: I stared noticing what I now know to be hypo symptoms about 5 years ago but after a trip to the doctors and ENT about 3 years ago I had a ultrasound which discovered a nodule on my thyroid. There were no blood tests done at the time of the scan to get an updated picture of my thyroid function so I asked for them to be done myself. My Doctor told me the results were fine when they came back to which I asked if he was sure , as I felt awful. On a second look he noticed my TSH was at 11 so he put me on 50 mg of Levothyroxine ( teva brand ). Ive never had a weight gain issue and actually lost a stone when I started taking medication. I’ve since put a half a stone back on thankfully. I’ve been on this for about 3 yrs without any change in dose. I’ve gone through ups and downs with a recent bout of high anxiety and what I would describe as a brief mental breakdown which lasted about 2 weeks and got very emotionally charged. I suffer from time to time with slightly painful knees and I’ve had bouts of aching arms and kneck/head. I also have bouts of trouble sleeping.with restless legs and bum cheek 😳. I have a palpitation or two every other day. I do still try to exercise when I can, all be it not as well as I used to , I think there has been a bit of muscle wastage and find it hard to put any on and I do feel like there’s a spark missing somewhere within me. Apart from all that I’d say I feel generally ok if that makes any sense ? so any help and advice about moving forward would be greatly appreciated. Here are my latest bloods from blue horizon , taken at 09.45 am 24hrs from last dose. Just as a foot note , I had this test below done by the NHS on 02 feb 2024 before I had the private test , again test done around 9.30am , why would TSH on the latest one be so different? Thanks in advance for any help.

Serum TSH level:

0.49 mIU/L

Normal range:

0.55 to 4.78

[greygoose]

Hi Burgerballs, welcome to the forum.

OK, so your vit D is low. That needs supplementing. And, you also need to take vit D's cofactors: magnesium and vit K2-MK7.

Doesn't matter that your magnesium result is high, because results are unreliable due to the way the body handles magnesium. Not much point in testing it, really.

Your CRP is very high, meaning that you have a lot of inflammation going on. So, because of that, your ferritin result isn't reliable, either. Inflammation tends to falsely raise ferritin levels, so your actual ferritin will be a lot lower than that. Possibly too low, which would explain the restless legs.

Folate and B12 are fine.

TSH is rather high for someone on thyroid hormone replacment. Probably because your FT3 is too low. You are a poor converter and, whilst your FT4 is quite good, there's still room for a small increase in levo.

You have Hashi's - I take it you know that - so levels can jump around a lot. And your GP just testing TSH is of no help whatsoever! We cannot know if the difference is due to natural variations of TSH or due to thyroid hormone variations due to Hashi's. The TSH alone tells you nothing of value, whatever your GP may think.

Anxiety, palpitations, weight-loss and muscle-loss can all be symptoms of hypo. And with that low FT3 you are still hypo.

Your cortisol could be higher, but that will maybe rise as your FT3 rises.

So, moving forward you need to optimise your vit D, eat more iron-rich foods - and don't forget to always consume a source of vit C with your food to increase absorption of iron; no point in just eating a steak, you need the chips with it! - and get an increase in levo from your doctor. Retest six weeks later and see how it's going.

[Burgerballs in reply to greygoose]

Tgank you greygoose for your rapid response 😊 it’s much appreciated, what increase would you suggest I try and get from my GP ?

[greygoose in reply to Burgerballs]

I think maybe 12.5 mcg a day, maybe. You don't want that FT4 going too high. But, if necessary, you can increase by another 12.5 mcg in six weeks time. Slow and cautious is the best way to do it.

[Burgerballs in reply to greygoose]

Many thanks for your time greygoose x

[greygoose in reply to Burgerballs]

You're welcome.