help to understand test results

[Mac2013]

After a year of monitoring my TSH due to a bout of subacute thyroiditis, initially suspected as thyroid cancer. I am now at a point where my GP feels medication may be required and have undertaken an extensive range of blood tests through the GP I have an appointment on the 4th July to discuss options.

I have been working with a nutritionist and herbalist for 18 months to try to get my thyroid and adrenals functioning well after a recent cancer diagnosis.

I tested privately using Medicheks for a full range of thyroid tests in March 23 and just done the same again this month as my GP has only been testing my TSH. Although I annually have a full panel undertaken since my endometrial cancer diagnosis two years ago.

Please see my medicheck results below:- (hope I’ve typed these out correctly

March 23 - Medichecks

TSH 0.48 miu/L (0.27-4.2)

FT4 22.6 pmol/L (12-22)

FT3 5.05 pmol/L (3.1-6.8)

T4:T3 ratio 4.475

TgAb 52 IU/ml (3.89)

Vitamin B12 150nmol/L (37.5. -150)

Vitamin D 163 nmol/L (50-200)

Ferritin 195 ug/L (13-150)

June 24 Results - Medichecks

TSH 5.03 miu/L (0.27-4.2)

FT4 14.8pmol/L (12-22)

FT3 3.1 pmol/L (3.2-6.8)

T4:T3 ratio 4.774

TgAb 18.2 IU/ml (0-115)

TPO 11 IU/ml (0-34)

CRP 2.420 mg/L (7)

Vitamin B12 150nmol/L (37.5-188)

Vitamin D 137nmol/L (50-250)

Ferritin 55ug/L (30-332)

I have several variants on my genes as outlined in my bio which I hope helps. I welcome any help as I’m really struggling at the moment as to how to move forwards. Many thanks.

[TiggerMe Ambassador]

As you can see your results have plummeted so I can imagine you feel pretty grim!

Your vits and mins look good except for your low end ferritin, worth getting a full iron panel to see if supplementing is the way to go

TSH 5.03 mIU/L (0.27 - 4.2) 121.1%

Free T4 (fT4) 14.8 pmol/L (12 - 22) 28.0%

Free T3 (fT3) 3.1 pmol/L (3.2 - 6.8) -2.8%

T4:T3 Ratio 4.774 

Yes time to start treatment

[Mac2013 in reply to TiggerMe]

Thank you. To be honest I’m not feeling grim but definitely felt better in 2023. Will ask for full iron panel.

[TiggerMe Ambassador in reply to Mac2013]

Possibly your adrenals are holding you up at the moment but once they start to struggle things get a whole lot tougher

[Mac2013 in reply to TiggerMe]

Yes, possibly - I’ve been working really hard on adrenal support since my endometrial cancer as testing revealed they were flatlining in 2022…… not tested again but maybe from what you’re suggesting that side of what I’m doing is working right now.

[TiggerMe Ambassador in reply to Mac2013]

Dr Peatfield's book highlights that we should support adrenals before supporting the thyroid so you are one of the few to get it in the right order and will likely have a pretty easy ride when you add some thyroid hormone 🤗

[DippyDame]

I always look at FT3 first based on my personal experience/ thyroid isues and you are seriously deficient in what is one of the body's most important hormones....T3

You must be feeling rubbish!!

TSH is not a reliable marker ( research shows) so your GP needs to up his advice/ testing and understand that for good health every cell in the body must be flooded with T3 by way of an adequate and constant supply.....your labs show neither is happening!

You absolutely need replacement thyroid hormone(s) or your health will suffer

Starter dose 50mcg levothyroxine...

test after 6 weeks

increase dose to 75mcg levo

test again after 6 weeks then...

review dose...

you most likely need to raise to 100mcg levo but first post labs here 6 weeks after increase to 75mcg for advice before increasing further

These labs will then show if conversion is poor ( high FT4 with low FT3) It is not obvious at this point

Are you saying that you have the Dio2 polymorphism which has the potential to affect T4 to T3 especially if inheritance is homozygous ( Panicker et al)

Hope your GP helps

[Mac2013 in reply to DippyDame]

Thank you. It’s strange I’m not feeling rubbish but know I could feel better. Yes, my genotype which affects T4 to T3 conversion not sure if homozygous or not?

[Jaydee1507 Administrator]

Do you have a folate result?

I’d recommend starting treatment at 50 mcgs levo.

[Mac2013 in reply to Jaydee1507]

Thank you

My serum folate was:-

19.98 ug/L (>3.89) in 2023

And

33.1 nmol/ (range >7) in 2024

Not sure how I missed those…… 🙃

[Jaydee1507 Administrator in reply to Mac2013]

That looks good.

Ferritin still needs some work. Optimal for ferritin is said to be 90-100.

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/

threearrowsnutra.com/en-uk/...

[ Edited by admin. Links MUST have a space or new line between them. ]

[Mac2013 in reply to Jaydee1507]

Thank you. I’ll put focus on that.

[Mac2013 in reply to Jaydee1507]

Can’t seem to access the link.

[Jaydee1507 Administrator in reply to Mac2013]

Click on where it says iron food. The page seems to have moved.

[TiggerMe Ambassador in reply to Jaydee1507]

Think you have two different links there fused together as one is for

threearrowsnutra.com/en-uk/...

dailyiron.net/

p.s. I wouldn't recommend the heme unless your serum iron comes back low as it is very effective at raising levels so you could overdo it if only going on a ferritin bt

[Mac2013 in reply to TiggerMe]

Just realised my GP ran my iron blood sample:-

Serum Iron 6.1 umol/L (5.8 - 34.5)

Serum transferrin level 2.63 g/L (2.0-3.6)

Transferrin saturation index 9% (150 - 50.0)

[TiggerMe Ambassador in reply to Mac2013]

Not sure about your range on the saturation index?? It would normally be more like 20-50%

I'd suggest you get on and order some heme iron as your levels are pretty tragic and you would certainly benefit from supplementing 🤗chicken liver a couple of times a week if you can stomach it is a good addition

The Simply Heme is out of stock until mid July but the Iron Repair is available, it also contains B12 and folate which you don't really need (or could swap if you are already supplementing?) both the same price, cheapest option is 3 bottle for free shipping and 10% off with FRANKLIN

It's a pretty awful website but a great product which nobody makes over here 🙄

We have had a bit of a chat about it here... healthunlocked.com/thyroidu...

[Mac2013 in reply to TiggerMe]

Thank you so much! Seeing my GP this week about the results of my annual bloods and no mention has been made of this for the referral…….. 🥹

[TiggerMe Ambassador in reply to Mac2013]

They don't flag things up until you are actually anaemic/ deficient when it comes to vits and mins 😡 honestly the NHS would save a fortune if they just suggested to people to supplement when they are near the bottom of range rather than stamp 'Normal' on your file.... we are aiming for optimal 🤗 why wouldn't you 🤷‍♀️

Your 'Normal' is 0.3 off being deficient!

Serum Iron  6.1umol/L  (5.8 - 34.5) 1.0% and their ranges are too wide!

Don't know about you but I don't tend to leave even my phone battery below 30%!!

[Mac2013 in reply to TiggerMe]

Agree - learning so much here! Feel like I’m on a completely vertical learning curve 😵‍💫 thank you again

[TiggerMe Ambassador in reply to Mac2013]

You are welcome, I was the same just a couple of years ago having been told by GP it's easy to treat just take this pill every morning for life after 4 years of decline I landed here 😅

Learn as much as you can and be prepared to fight your corner 🤗

[Mac2013 in reply to TiggerMe]

🙏🏾 learning quickly that I have to advocate for myself. When my subacute thyroiditis developed I was initially advised that the rhs of my thyroid required removal to rule out suspected cancer after biopsy results via a Fna. I was feeling really well and the swelling had reduced significantly so requested a core biopsy which thankfully was approved by the MDT team and this subsequently showed thyroiditis not cancer…… however my thyroid function doesn’t appear to be recovering after what has been two years of poor health. Fingers crossed I will get there 🤞🤞 thank you again.

[Mac2013 in reply to TiggerMe]

Hi again, can I ask should I also take a B vitamin complex alongside the suggested above?

[TiggerMe Ambassador in reply to Mac2013]

Always a good idea to take a B complex to keep everything in balance hopefully, one of the less powerful ones perhaps like...

amazon.co.uk/Vitamin-Comple...

or you can get a liquid sublingual...

healthunlocked.com/thyroidu...

[Mac2013 in reply to Jaydee1507]

Just realised my GP ran my iron blood sample:-

Serum Iron 6.1 umol/L (5.8 - 34.5)

Serum transferrin level 2.63 g/L (2.0-3.6)

Transferrin saturation index 9% (150 - 50.0)

Would welcome advice on this. Thank you

[Jaydee1507 Administrator in reply to Mac2013]

Serum iron is low. Needs to be 55 to 70% of the range.

Transferrin Saturation needs to be optimal is 35 to 45% of range.

Transferrin is 39% of range which is on the lowish side.

Low in range indicates lack of capacity for additional iron

High in range indicates body's need for supplemental iron

You would be safer increasing iron rich foods in your diet. Chicken livers/pate 2 times a week if possible and extra red meat.

[Mac2013 in reply to Jaydee1507]

Thank you - I will focus on this.