Blood results.

[Someday_maybe]

Hi all,

Just a quick one for any thoughts on recent bloods. First was pre medication. I've been on Carbimazole 10mg BD and Propanalol 40mg TDS for just under a month.

TSH <0.0005 (0.27-4.2) no change

T3 was 23.5 now 22.6 (3.1-6 8)

T4 was 68.6 now 84.9 (12-22)

Not surprised or worried about the TSH.

T3 dropped slightly and T4 increased though? So Carbimazole not working / not high enough dose?

Any other suggestions or ideas on what else I can do? I have NHS bloods booked for next week- they would not do them any sooner despite me saying I feel rubbish still/again.

[Jaydee1507 Administrator]

Your TSH will likely remain suppressed/very low for years so ignore that.

Looks like you need more carbimazole as you indicated. Results are far too high for FT4 & Ft3.

If you use Monitor My Health its an NHS lab and so your GP surgery should accept results from there.

Have you tested key vitamins ferritin, folate, B12 & D3?

[Someday_maybe in reply to Jaydee1507]

Thanks Jaydee1507

I have checked as follows (about a month ago) - not rechecked this time.

Ferritin 327.00 ug/L (Range: 30 - 207)

Folate 9.6 nmol/L (Range: > 7)

B12 active 31.4 pmol/L (Range: 37.5 - 188)

Vit D 47.7 nmol/L (Range: 50 - 250)

Supplementing VitD + K2 spray and B12 Sublingual (about to move to Bcomplex)

[Jaydee1507 Administrator in reply to Someday_maybe]

Are you vegan or vegetarian? Your B12 level was very low indeed.

Likely you will need the B complex in addition to the B12 spray. Best to check your B12 level before stopping the B12 spray.

Active B12 needs to be 75+

[Someday_maybe in reply to Jaydee1507]

I'm not vegan/vegetarian. There is a family history of pernicious anaemia and I'm collecting autoimmune conditions.

I will check my b12 again next week before stopping b12- thank you.

My

[Jaydee1507 Administrator in reply to Someday_maybe]

If this were me I'd be discussing my B12 level with my GP. Do you have symptoms of B12 deficiency? theb12society.com/signs-and...

Suggest you retest B12 3 months from starting supplement or even sooner.

[Someday_maybe in reply to Jaydee1507]

Thanks Jaydee. I have spoken to my GP. My NHS test was in range (albeit right at the bottom) so they won't do anything.

[Jaydee1507 Administrator in reply to Someday_maybe]

What was your NHS test result?

You are legally entitled to a printed copy of your results, ask at GP reception. In England you can get the NHS app and ask for permission to see your blood results on that by asking at GP’s reception.

[Someday_maybe in reply to Jaydee1507]

Serum B12 - 266 (189 to 883)

This was early April 2024.

[Jaydee1507 Administrator in reply to Someday_maybe]

I'd recommend getting some advice from the PA group here on HealthUnlocked.

healthunlocked.com/pasoc

The NICE guidelines have fairly recently been updated and if you have symptoms then your GP should be acting.

[pennyannie]

Hey there again :

This dose of AT medication doesn't seem to be having much effect - with your immune system still in the ' driving seat ' -

I wonder if Block & Replace would be a better option for you as I mentioned in a previous reply ?

In this way the AT drug dose increased to fully block your own thyroid hormone production

BUT a measured dose of T4 - thyroid hormone replacement is also prescribed so your thyroid

hormones - T3 and T4 to not fall through the bottom on the T3 and T4 ranges.

Looking back I saw your ferritin high - and this likely caused by inflammation - do you have there a CRP - inflammation marker ?

Your B12 is an issue, as you know and I now can't remember your folate or vitamin D !!

Just for reference I now aim for a ferritin at around 100 - folate at around 20 -

active B12 at around 125 ( serum B12 500++ ) and vitamin D at around 125.

[Someday_maybe in reply to pennyannie]

Hey pennyannie

Yes perhaps block and replace will be better. I have NHS bloods booked for next week so once those are back, the Endocrinology Nurse might at least talk to me!

My CRP was fine - 0.05 (<3) so I'm not sure where the super high ferritin comes from.

Folate 9.6 nmol/L (Range: > 7)

Vit D 47.7 nmol/L (Range: 50 - 250)

I've supplemented Vit D for a long time as I have vitiligo so being below range still is not great!

[pennyannie in reply to Someday_maybe]

So maybe double up on the vitamin D supplement you take ?

Also take MK7/K2 so to direct vitamin D to bones and teeth rather than arteries and heart.

Folate generally rises alongside B12 - since we know B12 is an issue maybe try a separate Methylfolate ?

So have you been tested for pernicious anaemia and celiac and both these AI conditions ruled out ?

[Someday_maybe in reply to pennyannie]

Thanks pennyannie .

I'm taking Vit D + K2 daily - I can double to twice a day for a bit. The risk of toxicity feels a long way off at the moment!

I can add Methylfolate in - any recommendations?

No, no tests for PA or Celiac as yet.

My TRab came back positive last week. 💜

[pennyannie in reply to Someday_maybe]

I think I used by buy the brand - Jarrow :

Yes no surprise there with the TRab:

Didn't you have an eye appointment - how did that go ?

[Someday_maybe in reply to pennyannie]

Thank you! I'll have a look for Jarrow brand today.

Yes I had the eye appt - came out with antibiotics for 2 weeks and steroids for 6 weeks and then another appt. I also had a telling off for 'not having my thyroid under control' which I dutifully took with a pinch of salt and smiled and said 'of course' to.😂

[pennyannie in reply to Someday_maybe]

Was this eye appointment at the hospital - and whether or not - could / can this eye specialist help in you getting ' speedily sorted ' with the endocrinology unit ?