As a result of my GP pressurising me to reduce Levothyroxine intake I have had tests carried out privately. My weight justifies the dosage of 200mcg daily that is currently prescribed. (1.6mcg/kg) However this dosage results in incredibly low TSH levels. My GP seeks to raise TSH levels.
Results are below:
CHEMISTRY / IMMUNOASSAY
Vitamin D (25 OH) nmol/L 50 - 200 25 L Optimal 75-200 Adequate 50-<75 Insufficient 25 -<50 Deficient <25
Magnesium mmol/L 0.66 - 0.99 0.82
CRP mg/L <5.0 1.63
Ferritin µg/L 30 - 400 106.00 Ferritin is the most useful indicator of iron deficiency, but also an acute phase reactant and may be elevated in malignancy, chronic inflammation, liver damage and iron overload
Thank you for your comments. Looks as if I have more than one issue to contend with. Prior to the tests I ceased all vitamin supplements for 3 to 4 weeks with a view to gaining a better insight into potential deficiencies.
The results are a cut and paste from the report.
Yes, I am still on propranolol. I have an appointment with a Gastroenterologist next week where this will definitely be raised. Will also raise a question about high TSH affecting the Liver/NAFLD.
I have occasionally taken Magnesium so will do so more often.
Having read that Selenium may be helpful, a daily supplement of Selenium + Vits A, C and E is being taken together with D3 2000 IU. This has been implemented since the tests were taken.
When it comes to Ferritin, I am regularly monitored by my local Haematology team where an optimal value of 100 is used to help control RLS. I am not happy with this 'optimal' value.
For info these are the latest Haematology results: (No ranges have been quoted)
Haemoglobin 135 g/L
White cell count 5 10 to the power of 9 /L
Platelets 142 ---- ditto----
Neutrophils 3 ‐----- ditto ‐----
Ferritin 86 ug/l
B12 528 g/L
And
Folate 10 g/L
If you could spare the time for further guidance please, I shall be eternally grateful.
When weening off propranolol it must be done incredibly slowly, especially on levothyroxine because it lowers conversion of Ft4 to Ft3 significantly
Dropping 5mg per day…..wait 2-4 weeks before dropping another 5mg etc etc
Propranolol also lowers magnesium
B vitamins
Active B12 pmol/L 48 (37.5 - 150)
Serum B12 528 g/L
Active B12 is very low but serum B12 looks reasonable.
Serum Folate nmol/L 17.40 (8.83 - 60.8)
Folate 10 g/L - no range
Folate on low side.
suggest
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
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 5-7 days before ALL BLOOD TESTS , as biotin can falsely affect test results
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
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
Thank you for your incredible patience while you have been awaiting the outcome of our ferritin reference range review. We conducted this with Inuvi lab, which has now changed the reference ranges to the following:
Females 18 ≤ age < 40. 30 to 180
Females 40 ≤ age < 50. 30 to 207
Females 50 ≤ age < 60. 30 to 264l
Females Age ≥ 60. 30 to 332
Males 18 ≤ age < 40 30 to 442
Males Age ≥ 40 30 to 518
The lower limits of 30 are by the NICE threshold of <30 for iron deficiency. Our review of Medichecks data has determined the upper limits. This retrospective study used a large dataset of blood test results from 25,425 healthy participants aged 18 to 97 over seven years. This is the most extensive study on ferritin reference ranges, and we hope to achieve journal publication so that these ranges can be applied more widely.
Thanks for the additional info.Propranolol is prescribed to be taken twice daily at 30mg per dose. I therefore take it at Breakfast and before bed. For the record, Levothyroxine is taken well before any food or other medicines usually 05:00 -06:00hrs.
Vit D is as shown in the test results. An associated comment states 'There is significant Vitamin D insufficiency.'
Low iron and Hypothyroidism-for many years my Ferritin level was in the 'basement ' hovering around 25 but nothing was ever done about it!
Broached the subject of Thyroid function and mentioned fT3 and reverse T3. I was told in no uncertain terms that 'It does not work that way!'.
Not a good outcome as the recommendation now to be communicated to my GP is to reduce Levothyroxine to 150mcg daily as TSH is extremely low. Hmmmm.
Of course a Gastroenterologist is not an Endocrineologist so perhaps I shall ignore the recommendation and take it up with my GP at a later date. I think however, the same outlook applies a my Surgery.
Can anyone recommend a good Endocrinologist in the south-east of UK pse., as this will definitely be the next step?
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