Test results help please 🙏 : CHEMISTRY... - Thyroid UK

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Test results help please 🙏

Bigsi profile image
9 Replies

CHEMISTRY / IMMUNOASSAY

Vitamin D (25 OH) L 39 50 - 200 nmol/L

Optimal 75-200

Adequate 50-<75

Insufficient 25 -<50

Deficient <25

Magnesium 1.0 0.7 - 1.0 mmol/L

CRP H 9.82 <5.0 mg/L

Ferritin 355.00 30 - 400 µg/L

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

Serum Folate L 8.31 8.83 - 60.8 nmol/L

Active B12 50 37.5 - 150 pmol/L

TSH 2.11 0.27 - 4.20 mIU/L

Free T4 H 22.7 12.0 - 22.0 pmol/L

Free T3 3.8 3.1 - 6.8 pmol/L

T4 Total 116.0 66 - 181 nmol/L

Anti-Thyroglobulin Abs 16 <115 IU/mL

Anti-Thyroidperoxidase abs <9.0 <34 IU/mL

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Bigsi
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9 Replies
Jaydee1507 profile image
Jaydee1507Administrator

Did you remember to allow 24hrs between last dose of Levo and blood test, taking your Levo AFTER the test?

Other than your ferritin, which could be a false high result due to the inflammation you have - raised CRP your vitamin levels are terrible and proof that a multivitamin just won't cut it for hypo people.

You could show these results to your GP who might prescribe folic acid & vit D once they repeat the tests.

Supplements are available online, high street supplements not worth having.

Rraising all your vitamin levels to optimal will really help how you feel. You may in time need to add a small amount of T3 as your conversion is poor.

You can email info@thyroiduk.org for a list of T3 friendly Endo's and/or make a post asking for recommendations stating the general area you live in. Replies need to be via personal message to prevent info being posted publicly.

Vitamin D should be around 100 - 150. Buy one that includes vit K2 to help it go to your bones. Some are available in oil or you can take it with an oily meal for better absorption. Many members like the ‘Better You’ range of mouth sprays that contain both bit D & K2. Use this calculator to work out how much to take to get your level to 100-150.grassrootshealth.net/projec...

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...

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...

Bigsi profile image
Bigsi in reply toJaydee1507

Thank you for your very indepth reply.I took my levo 12 hours prior to the test.

I am confused as to why my free T4 is high and free T3 is low ?

I will order the vit D and foliate.

My cortisol is high too 420.0 73.8 - 507.0 nmol/L

I am a fat pig at the moment and was (138kg ) but having been sticking to a calorie controlled diet and working out 2 hours a day.

Didn't lose hardly anything first 2 weeks so was concerned about the hormones so went for the test.

Kind regards Simon.

SlowDragon profile image
SlowDragonAdministrator in reply toBigsi

I am confused as to why my free T4 is high and free T3 is low ?

For good conversion of Ft4 (levothyroxine) to Ft3 (active hormone) we need GOOD vitamins levels

Your vitamin D, folate and B12 are all far too low

You will need to take daily a separate B12, vitamin B complex and vitamin D

Looking at previous posts you have been on low calorie diet…this can affect conversion of Ft4 to Ft3 as well

Low B12 and folate

With serum B12 result below 500, or as your tests show with active B12 below 70 recommended to be taking a separate B12 supplement

A week later add a separate vitamin B Complex 

Highly effective B12 drops

natureprovides.com/products...

Or

B12 sublingual lozenges

uk.iherb.com/pr/jarrow-form...

cytoplan.co.uk/shop-by-prod...

B12 range in U.K. is too wide

Interesting that in this research B12 below 400 is considered inadequate

healthunlocked.com/thyroidu...

Low folate

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 5-7 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 until active B12 is over 70 minimum

Post discussing how biotin can affect test results

healthunlocked.com/thyroidu...

helvella.blogspot.com/p/hel...

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

likely to need to continue daily vitamin B complex continuously and indefinitely

Your high ferritin shows exactly why it’s NOT recommended to be taking multivitamins - you didn’t need any extra iron

Bigsi profile image
Bigsi in reply toSlowDragon

Excellent advice, thanks 😊

pennyannie profile image
pennyannie in reply toBigsi

Simon -

please stop putting yourself down - it's not helping you and you are wrong anyway -

You are hypothyroid and currently not converting the T4 into T3 - which is the active hormone that runs the body, much life fuel runs a car, and currently you are with too little fuel to do much at all -

Your inflammation CRP reading - is high showing your body under excessive stress - and this alone will slow conversion of T4 to T3 - and your body struggling -

and your regime of restricting calories and working out - is not going to help you and in fact will down regulate your metabolism even further - and you'll find yourself in a vicious circle.

In order for T4 to convert well into T3 we need good wholesome clean food + good fats as good calories = better conversion of T4 into T3.

We also need optimal levels of ferritin, folate, B12 nd vitamin D as already suggested - and there is no quick fix - it's probably taken years in the making and is not going to be fixed in a couple of months.

When on T4 monotherapy we generally feel at our best when the T4 is up in the top quadrant at around 80% with the T3 tracking just behind at around 60/70% -

currently your T4 is around 107% with your T3 around 19% -

The accepted conversion ratio when on T4 only is said to be 1 - 3.50 - 4.50 T3/T4 with most of us feeling at our best at 4 or under -

so if I divide your T4 by your T3 I'm getting your conversion coming in at 5.97 - so very wide of centre - and just confirming the degree of non-conversion.

Of course there are other treatment options containing T3 and an option taking T3 but these will not work well yet anyway as all thyroid hormone replacement options need optimal vitamins and minerals to work well :

I should have looked back at any previous posts to try and understand where you are now - I'll do this now - so may come back in a bit !!

OK - so 10 years on this forum looking for answers - you had high over range antibodies indicative of Hashimoto's a thyroid Auto Immune disease - so progressively you thyroid has been the victim of AI attacks and likely now with very little thyroid function of your own.

You may well ' do better ' on a T3/T4 combo - but first - you really do need to build up the core strength vitamin and mineral stepping stones - and choose less demanding forms of exercise and start building back the basics to replenish and restore your overall health and well being.

Bigsi profile image
Bigsi in reply topennyannie

Thanks for taking the time to answer, appreciate it.

Jaydee1507 profile image
Jaydee1507Administrator in reply toBigsi

SD has already replied for me.

You need a vit D+ K2, separate B12 spray & B complex.

You get T4 from Levo which your body is supposed to convert to T3. Some peoples genetics mean that their bodies dont make this conversion very well and then they may need a small amount of T3 to add to their Levo. The NHS doesnt always acknowledge this though. Its also why private testing is almost essential as the NHS rarely test FT3.

Weight loss will be difficult with low vitamin levels and low thyroid levels.

SlowDragon profile image
SlowDragonAdministrator

Vitamin D

GP should prescribe 1600iu everyday for 6 months

NHS Guidelines on dose vitamin D required

panmerseyapc.nhs.uk/media/2...

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...

But with thyroid disease , 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

Suggest you try 3000iu daily and retest in 3-4 months

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

TSH 2.11 0.27 - 4.20 mIU/L

Free T4 H 22.7 12.0 - 22.0 pmol/L

Free T3 3.8 3.1 - 6.8 pmol/L

T4 Total 116.0 66 - 181 nmol/L

You say you took your levo 12 hours prior to the test.

So Ft4 is falsely high

TSH is over 2

Most people when adequately treated will have TSH around or below 1

How much levothyroxine are you currently taking

You very likely have room to increase your dose levothyroxine

Do you always get same brand Levo at each prescription

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