help with results: Hi, These are my resent blood... - Thyroid UK

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help with results

BlueLipsNoBrows profile image
20 Replies

Hi,

These are my resent blood results, can anyone help deciphering please. These are copied from my not yet fully completed bio, with the addition of a date for the vitamin D test.

Blood tests results were:

This result was received in April 2024

vitamin D 35 - range insufficient

These bloods were taken fasting at 9.30 in the morning on the 09/05/24:

TSH 3.15mIU/L - range 0.27-4.2 mIU/L

T4 13 pmol/L - range 11-22 pmol/L

TPO 104 IU/ml - range under 34

On the same day at 10.30 am I did a postal blood test also fasting and the results came back:

TSH - 3.32mIU/L range 0.27-4.2 mIU/L

T4 14.2 pmol/L range 11-22 pmol/L

TPO 131 IU/ml range under 34

Many thanks for any help.

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BlueLipsNoBrows profile image
BlueLipsNoBrows
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20 Replies
BlueLipsNoBrows profile image
BlueLipsNoBrows

I also have T3 result from postal test:

T3 4.4 pmol/L - range 3.1-6.8 pmol/L

SovietSong profile image
SovietSong in reply toBlueLipsNoBrows

Hi,what thyroid meds and dose are you taking currently?Your frees are pretty low T4 18% and T3 35%.Also recommended that TSH be 1 or under although as you know yourself GP’s won’t do much as it’s supposedly in range.Were B12,ferritin and folate tested?

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSovietSong

Hi, sorry I thought I’d put that. Doctor reluctant to treat but offered me a low dose of 25 micros of what I am assuming is a generic brand of Levothyroxine called wockhardt. I’ve been taking that for 7 days. Said the TPO was only an indicate that I may have thyroid problems in the future. Will take a look at bloods and see what there is and update.

Tha k you for the help it’s much appreciated.

SovietSong profile image
SovietSong in reply toBlueLipsNoBrows

Oh, ok, you have just started levo. 25mcg is the general starting dose.Have you been given another date for retest in 6-8 weeks or so? The dosage is usually upped in increments of 25mcg or so.Most end up needing around 100-125 daily.Just read your bio and lots of the usual hypo symptoms there ie fatigue, weight gain, skin issues.It won't happen overnight but when you get on the correct dose and get vitamins in order you will notice a huge difference.Hang in there.

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSovietSong

Hi, I found these.

Ferritin 46ug/L - range 30-330 ug/L in April - 46 in Jan.

B12 L - 456 ng/L - range 197-771 ng/L in April.

Thanks

Jaydee1507 profile image
Jaydee1507Administrator in reply toBlueLipsNoBrows

Welcome to the group.

We need OPTIMAL levels of key vitamins for our thyroid hormone to work well.

Ferritin is too low.

Ferritin should be around 90 - 100 for best use of thyroid hormone. Suggest increasing iron rich foods in diet and eating them often. Chicken livers, pate, red meat etc

Link with ideas for dietary iron:

dailyiron.net/https://three...

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150.grassrootshealth.net/projec...

B12 is a little on the low side. Its a serum B12 result and a more accurate indicator would be an active B12 test available privately and sometimes on the NHS.

Suggest you start a good active/methyl type B complex to help keep all the B's in balance.

B complex suggestions: Slightly cheaper options with inactive B6:

amazon.co.uk/Liposomal-Soft...

Contains B6 as P5P an active form:

bigvits.co.uk/thorne-resear...

healf.com/products/basic-b-...

Explanation about the different forms of B6:

helvella.blogspot.com/p/hel...

B complex comparison spreadsheet:

healthunlocked.com/thyroidu...

It's ideal if you can always get the same brand of levo at every prescription. You can do this by getting GP to write the brand you prefer in the first line of the prescription. Many people find that different brands are not interchangeable.

Always take Levo on an empty stomach an hour away from food or caffeine containing drinks & other meds. Many people find taking it at bedtime works well for them.

Many with autoimmune thyroid disease aka Hashimoto's benefit from a gluten free diet. A smaller percentage of those also need to remove dairy from their diet to feel well. These are intolerances and will not show up on any blood test.

Did you do the test as per the protocol recommended here? Recommended blood test protocol: Test at 9am (or as close as possible), fasting, last levo dose 24hrs before the blood draw & no biotin containing supplements for 3-7 days (Biotin can interfere with thyroid blood results as it is used in the testing process).

Testing like this gives consistency in your results and will show stable blood levels of hormone and highest TSH which varies throughout the day. Taking Levo/T3 just prior to blood draw can show a falsely elevated result and your GP/Endo might change your dose incorrectly as a result.

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toJaydee1507

Thank you so much… lots to read. I’ll be back.

SlowDragon profile image
SlowDragonAdministrator in reply toBlueLipsNoBrows

Very helpful profile 👏👏👏👏

Breathlessness and hair loss linked to low ferritin

Request full iron panel test and CRP test for inflammation

High CRP will falsely raise ferritin

Iron can be low independent of ferritin

cks.nice.org.uk/topics/anae...

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

Stop iron supplements 5-7 days before testing

Medichecks iron panel test

medichecks.com/products/iro...

Look at increasing iron rich foods in diet

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

List of iron rich foods

dailyiron.net

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSlowDragon

Thank you, you have no idea how much I deleted! Haha. I’m 67 in July. I will read and be back. I do have blood test results from January I believe. I will upload today. 😊

Sleepman profile image
Sleepman

How do you feel? Vit d looks low and will not help.

How do you feel

Have you seen thyroid uk symptoms list? On website.

Not easy as if starved of thyroid hormone different people respond differently.

B12 / folate and iron are recommended for testing. Low b12 is similar symptoms to underactive thyroid.

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSleepman

Hi, just posted ferritin and b12, I think ferritin looks low. I’ve started taking high dose vit D and my energy levels have improved. I’ve just started listing symptoms in my bio, so I will copy and paste them here tomorrow.

Thank you so much for the reply.

Sleepman profile image
Sleepman

It's an incredibly busy forum.

This thread likely will get missed now by the real experts.

Post new info frequently it's just the way it works

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSleepman

Thank you for the advice. I will do!

SlowDragon profile image
SlowDragonAdministrator

How old are you

Standard STARTER dose levothyroxine is 50mcg unless over 65 years old

B3 aware that starting on only 25mcg can make you feel more hypothyroid

Levothyroxine doesn’t “top up” failing thyroid. It replaces it. So starting on low dose can make you more hypo

Get retested 6-8 weeks time

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

About 90% of primary hypothyroidism is autoimmune thyroid disease, also called Hashimoto’s……usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

SlowDragon profile image
SlowDragonAdministrator

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels

Low vitamin levels affect Thyroid hormone working

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances.

Most common by far is gluten.

Dairy is second most common.

A trial of strictly gluten free diet is always worth doing

Only 5% of Hashimoto’s patients test positive for coeliac but a further 81% of Hashimoto’s patients who try gluten free diet find noticeable or significant improvement or find it’s essential

A strictly gluten free diet helps or is essential due to gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link)

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and may slowly lower TPO antibodies

While still eating high gluten diet ask GP for coeliac blood test first as per NICE Guidelines

nice.org.uk/guidance/ng20/c...

Or buy a test online, about £20

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

Similarly few months later consider trying dairy free too. Approx 50-60% find dairy free beneficial

With loads of vegan dairy alternatives these days it’s not as difficult as in the past

Post discussing gluten

healthunlocked.com/thyroidu...

SlowDragon profile image
SlowDragonAdministrator

vitamin D at 35nmol is insufficient

Low vitamin D

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 around 80nmol or 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...

Recipe ideas

bbc.co.uk/food/articles/mag...

Interesting article by Dr Malcolm Kendrick on magnesium

drmalcolmkendrick.org/categ...

Vitamin K2 mk7

betterbones.com/bone-nutrit...

healthline.com/nutrition/vi...

SlowDragon profile image
SlowDragonAdministrator

only add one supplement at a time or make one change at a time

Wait at least 10-14 days to assess before adding another

B12 slightly low

No folate result?

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 supplements

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

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSlowDragon

Hi, I haven't disappeared! ☺️ I have people staying for a couple of weeks so getting ‘me’ time right now is not possible. Concentration and crying when too many people are talking (5 in the house now) is a major problem for me so trying to hold it together without making their trip a nightmare is taking all of my energy. Thank you again when I have a chance to digest your responses I will be back.

Sleepman profile image
Sleepman

The/our mighty slowdragon has shared.I am similar with struggling multiple people speaking.

I have hopefully linked you to a fresh post asking about it.

BlueLipsNoBrows profile image
BlueLipsNoBrows in reply toSleepman

Thank you Sleepman. I’ve been reading Slowdragons advice to others before I started posting personally, so I am extremely happy to have her take and advice personally. Have a good weekend.

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