Advice after recent blood test results please - Thyroid UK

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Advice after recent blood test results please

yorkshiregirl4 profile image
6 Replies

I have been taking Levothyroxine for decades but only recently appreciated, after advice from this fabulous website, the correct way to undertake thyroid blood tests.

After decades of iron deficiency I had an iron infusion a few months ago (therefore ferritin now high), I inject B12 regularly for Pernicious Anaemia, 2 months ago I reduced my Levothyroxine to 100mcg following GP advice when my incorrectly taken blood test gave a TSH of under 0.3. I now take my levothyroxine late evening and it's working well at this time of day.

Blue horizon results this week are:

* Vitamin D (25 OH) 58 50 - 200 nmol/L Adequate 50-<75

* Magnesium 0.91 0.66 - 0.99 mmol/L

* CRP 3.53 <5.0 mg/L

* Ferritin H 333.00 13 - 150 µg/L

* Serum Folate 24.70 8.83 - 60.8 nmol/L

* Active B12 H >150 37.5 - 150 pmol/L

* TSH 2.08 0.27 - 4.20 mIU/L

* Free T4 18.7 12.0 - 22.0 pmol/L

* Free T3 4.1 3.1 - 6.8 pmol/L

* T4 Total 96.5 66 - 181 nmol/L

* Anti-Thyroglobulin Abs 14 <115 IU/mL

* Anti-Thyroidperoxidase abs <9.0 <34 IU/mL

* Cortisol (Random) H 541.0 73.8 - 507.0 nmol/L

6am - 10am 166 - 507.0

If anyone can give advice on these results I would be extremely grateful. Many thanks.

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SlowDragon profile image
SlowDragonAdministrator

I now take my levothyroxine late evening and it's working well at this time of day.

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

Is this how you did this test?

vitamin levels

Vitamin D (25 OH) 58 50 - 200 nmol/L

Are you taking any vitamin D and how much

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...

Folate

Are you taking any vitamin B complex

Serum Folate 24.70 8.83 - 60.8 nmol/L

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...

yorkshiregirl4 profile image
yorkshiregirl4 in reply to SlowDragon

Many thanks for your comments SlowDragon. I did as you suggested in relation to the Levothyroxine before and after the test. I have only just received the Igennus Super B-Complex so didn't have to stop it before this blood test but will do so before any further tests. I have only been taking 25mcg daily Vitamin D and my GP will not prescribe it for me under any circumstances irrespective of blood test results.

I do not understand some of the blood test results but have never taken any thyroxine blood tests as you suggest before. My TSH is way higher than it has ever been for many years. It is normally nearer 1 or much less. Does the TSH result suggest insufficient overall thyroxine levels now that I have reduced the levothyroxine from 125mcg to 100mcg? Is my fT3 too low in the reference range? Do the antibody test results indicate Hashimoto's? Should I be considering increasing levothyroxine and/or T3? Is the raised cortisol level a problem?

Sorry to pose so many questions but I'm afraid I am hearing this completely different approach for the first time. Many thanks.

SlowDragon profile image
SlowDragonAdministrator in reply to yorkshiregirl4

I have only been taking 25mcg daily Vitamin D and my GP will not prescribe it for me under any circumstances irrespective of blood test results.

Most U.K. patients need to self supplement and test privately

25ug vitamin D is only 1000iu

Suggest you double that

Consider vitamin D mouth spray

Aiming to be 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

Trial and error what you personally need

Probably somewhere between 2000iu - 5000iu daily

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

Does the TSH result suggest insufficient overall thyroxine levels now that I have reduced the levothyroxine from 125mcg to 100mcg?

Is my fT3 too low in the reference range?

Yes and yes

Free T4 (fT4) 18.7 pmol/L (12 - 22) 67.0%

Free T3 (fT3) 4.1 pmol/L (3.1 - 6.8) 27.0%

Is your 100mcg and 25mcg tablets both same brand at every prescription

You have room to increase the Levo dose a little

Perhaps try 100mcg 3 days and 125mcg 4 days

Or cut 25mcg tablets in half and take 112.5mcg daily

Retest in 8 weeks

With Hashimoto’s poor conversion is common

Improving lowish vitamin levels may help improve conversion rate of Ft4 to Ft3

But ultimately many of us with Hashimoto’s eventually need small dose T3 added alongside Levo

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

thyroiduk.org/contact-us/ge...

Getting Levo dose fine tuned, all four vitamins at optimal levels

And

Are you on gluten free or dairy free diet

Always worth trying these

SlowDragon profile image
SlowDragonAdministrator

Do the antibody test results indicate Hashimoto's?

Anti-Thyroglobulin Abs 14 <115 IU/mL

* Anti-Thyroidperoxidase abs <9.0 <34 IU/mL

Well both antibodies are low and negative for hashimoto’s

But you say you have Pernicious Anaemia which is autoimmune

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

Gluten intolerance is often a hidden issue too.

Request coeliac blood test BEFORE considering trial on strictly gluten free diet

High cortisol should reduce as Ft3 improves

yorkshiregirl4 profile image
yorkshiregirl4

Thank you so much for your comments and advice. It is all sounding to make a bit more sense thanks to your replies and explanations to me. I am extremely grateful and now have a sensible way forward.

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