Hi! Can you provide the specific ranges for each of those?
Also, if you have your previous test results on hand, it would be great to see those and understand the trends. I’m curious, if your Free Ts have always been at the bottom of the range as you note… what has your TSH been?
Difficult to interpret blood test results without the ranges, because they vary from lab to lab.
Although we don't need a range to see that that TSH is low. TSH varies thoughout the day with its highest point around midnight and lowest point around midday. So the time of day you have the blood draw is important. We always recommend just before 9 am and fasting. TSH can also be lowered by cafeine and certain foods. And, unfortunately, doctors only tend to look at the TSH. They have no idea what the other results mean. So, looking at yours, a doctor would be more inclined to diagnose you with subclinical hyper than hypo, even though your thyroid hormone levels are low - TSH is a pituitary hormone.
So, two more things we need to know before anyone can comment:
- The ranges for the FT4 and FT3
- the time of the blood draw
Oh! And have you ever had any antibodies tested? TPOab and TgAB.
Doesn't matter what the TSH range is, a TSH is always a TSH and should be around 1.
So, the TSH isn't reponding to the Free levels:
ft4 15.3 (12.0-22.0) 33.0%
Ft3 4.1 (3.1-6.8) 27.03%
which should both be around 50% through the range. So, that looks like a pituitary/hypothalamus problem - or what we call Central Hypo. And, by the look of your results going back to 2013, you've had it for some time.
The problem is, very few doctors have even heard of Central Hypo, let alone be capable of recognising it when they see it. They believe the TSH 'tells them all they need to know', which is patently not true. They don't understand the thyroid hormone levels themselves.
So, what you need is an endo that is well up on pituitary problems, but doubtful you'd get one on the NHS because your doctor is unlikely to refer you with those numbers. It's a bit like painting by numbers, the apple is n° 5, n° is red, so apples are red. What they don't understand is that sometimes apples are green, or russet colour. But as the intructions say red, red it is. They cannot, or will not, think outside the box.
Least I am now armed with something I will find a endo and try to get this sorted. I will speak to my doctor as she has requested to see me because if these results so hopefully she will recognise there is a problem
Well went to the doctors … apparently all my levels are fine and I do not need to see a endo.
Even tho I have been going in for over 10 years with symptoms. She even drew me a diagram about the signalling. I said about the percentages t3&4 and that it’s not responding to these so perhaps a signalling issue.
Said she will email and ask if I could be seen but very doubtful . Also she will ask od there is any bloods that they can do now which may help.
So I have just ordered a blood test through blue horizon. I will now wait and hope the endo says they will see me.
Well, that doesn't surprise me. They're like robots, incapable of thinking outside the box. They've been taught that TSH 'tells them all they need to know' and they cannot - are not capable of - thinking otherwise.
I don't know what other blood tests there could be. Taken altogether, those results tell you all you need to know. Although, testing other pituitary hormones might open her eyes a little, but I don't know if she can do that. She could do an 8 am cortisol, though, but that doesn't prove anything except that further investigation into the adrenals might be useful.
I had a 8am cortisol done years ago and that was 354 doc at time said was ok . I will wait for the lab tests I ordered for my antibodies etc then go back armed lol
Well, what was done years ago is hardly relevant today. And although 354 was more than likely within the range, it sounds low to me. But, as long as a result is somewhere within a range, doctors think it has to be ok. They don't really know what they're doing.
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.
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement
After you finish prescription folic acid suggest you look at adding 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
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
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
Post discussing how biotin can affect test results
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