Advice on blood test results: 10 years after full... - Thyroid UK

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Advice on blood test results

Lily1970 profile image
10 Replies

10 years after full thyroidectomy (goitre with 4 nodules) and years of somewhat very unstable hormone replacement levels (on levothyroxine only), here are my most recent blood tests done early morning without taking Levothyroxine: 0.48TSH and Free T4: 12.4

I had asked a full panel but got this only done on NHS.

Last Feb, I consulted privately as part of my recently diagnosed severe cold urticaria with anaphylaxis. Those blood tests from Feb were done in the afternoon (I had taken my Levothyroxine as I was not expecting these blood tests).

FT4 17.7 FT3 5.63 TSH 0.33

NT-proBNP 67ng/L

I was told by my GP all was ok but still feel very tired and dizzy.

I have also inserted my iron and vit profile.

I feel really lost . Could someone please advise me ? I would be very grateful. Thanks

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Lily1970
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Jaydee1507 profile image
Jaydee1507Administrator

Can you add the ranges for the thyroid results? Ranges differ between labs.

Your FT4 looks low by most lab ranges.

You have some work to do to get your vitamin levels to OPTIMAL which is where we need them for our thyroid hormone to work well.

As hypo people we are losing vitamns the whole time due to low stomach acid and need to supplement continuously.

Are you vegan or vegetarian? If not:

B12 - do you have symptoms of B12 deficiency? The reference range for B12 is very wide and cut off point too low. theb12society.com/signs-and...

If you do then you should discuss this with your doctor for further tests for Pernicious Anaemia.

If not, then start with a methyl B12 sublingual spray or lozenge for a week, then add a good B complex. Once you run out of the separate B12 just continue with the B complex.

cytoplan.co.uk/vitamin-b12-...

amazon.co.uk/Better-You-Boo...

Folate - aim for a level of 20. Recommend taking an active/methyl (should say on label) B complex which contains 400mcgs folate (also B12).

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...

Ferritin is good.

No result for vit D.

NHS easy postal kit vitamin D test £31 via

vitamindtest.org.uk

Lily1970 profile image
Lily1970 in reply to Jaydee1507

Thanks very much for your great advice.I really appreciate and shall definitely supplement in folic acid and B12.

My Vit D most recent result was 106 nmol/L (50-120). The latter increased a bit as I was at 78 back in July 2023. I started to take Vit D daily spray (Better You D3000+K2) in November.

As for the Thyroid profile range (NHS lab):

TSH O.48 mu/L (0.35- 4.94)

Free T4 :12.4pmol/L (9- 19.1)

I am not vegetarian but eat a variety of veg and fruit. Nevertheless, my folate level is so low!

Yes, I definitely have a wide range of B12 deficiency despite being in range (sensory issues,dry skin and hyperpigmentation near wrists, bone issues -both knees have a meniscal tear, general malaise, taste changes, dyspnea at times, pain down jaws appearing and disappearing quickly, anxiety…) This doc. on B12 deficiencies is so thorough and helpful.

I remember reading that you could be in range but still having symptoms,which is why gps cannot perceive there is a problem. Thanks a lot for the B12 supplements recommendations. 👍

pennyannie profile image
pennyannie in reply to Lily1970

Hey there again :

Your T4 is only around 34% through its range which means your T3 will also be low - and it is too low T3 for you that causes all the symptoms of hypothyroidism.

As detailed in my previous post to you - we generally feel best when on Levothyroxine when our T4 is up in the top quadrant of its range with the T3 tracking slightly behind at around 60/70% through its range.

You can find your previous posts by pressing the Profile icon on this screen -

on my laptop - it's top right alongside My Hub-Chat-Post- Alerts and Menu icons.

Lily1970 profile image
Lily1970 in reply to pennyannie

Thank you very much again. That is very useful advice. Please see my reply to Jaydee1507 and recent FT3 levels with thyroid profile.

Jaydee1507 profile image
Jaydee1507Administrator in reply to Lily1970

To get a fuller picture of your thyroid levels we do really need to see FT3 to check conversion. That said your FT4 is really low at 34% of its range and really needs to be a minimum of 70%, probably more.

If you can persuade GP you need to trial an increase of 25mcgs then that would help.

Also getting on top of your B12 & folate will really help. You will need to continue supplements continuously.

GPs can be reluctant to prescribe B12 injections but it would be worth trying with your GP. Otherwise, begin oral supplements.

Vit D is good.

Lily1970 profile image
Lily1970 in reply to Jaydee1507

Many thanks for your previsions. In terms of free T3 the most recent results (ordered privately by cardiologist) date from February as follows:

Free Thyroxine (FT4) 17.7 pmol/L

(10.9-25.3)

Free triiodothyronine (FT3) 5.63 pmol/L (4.26-8.10)

Thyroid Stimulating H. (TSH) 0.33 (0.40-4.05)

NT-proBNP 67 ng/L

Please note that the blood test was done mid afternoon with Levothyroxine (100ug) taken the same morning as I was not made aware thyroid hormone levels would be investigated.

I ought to try and increase my dose by 25ug 3 times a week maybe to see if there is a major difference in my symptoms.

Thank you again for your advice .

Jaydee1507 profile image
Jaydee1507Administrator in reply to Lily1970

So your FT3 was quite low then at 37% of range but your FT4 is also low and needs improving.

Next blood test try and get all the timing of test & last Levo right and get FT3 tested at the same time.

Lily1970 profile image
Lily1970 in reply to Jaydee1507

Will do. I trusted my gp when I said I wanted a full panel 😥. Next time I literally will have to spell it out for him. I also asked (for the 3rd time!) to be referred to an endocrinologist. He replied this would be refused as my TSH level was back in range 🙃.

Now I will do what is best for my health as they have no clue how awful symptoms can be when treatment is not optimal 😉. Thank you ! Best wishes

pennyannie profile image
pennyannie in reply to Lily1970

Yes I saw this but it was mid afternoon with you having taken your thyroid hormone replacement -

However - now you have given us the T3 range - and at 37% through the range this is much too low to function on -

As is your T4 result at around 50% through its range.

I'm afraid you may find doctors are just looking at your TSH - which is a very unreliable measure of thyroid hormones - once taking thyroid hormone replacement - especially when you haven't a thyroid.

You must be dosed on your T3 and T4 blood test results and we generally feel best when on T4 Levothyroxine once the T4 is up in the top quadrant of the range with the T3 tracking just behind at around 60/70% through its range.

Lily1970 profile image
Lily1970

Thanks again for your helpful input. This comforts me in the idea that my treatment is not optimal. My immune system is super sensitive (cold urticaria with skin reaction threshold 0-27 degrees!)and there must be an interplay between various hormones.

I have bought a supplement of B12/folic acid which should help me .🙂

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