help with new test results

[Norrahsjake]

hi, could someone please help with these results.iv been on levothyroxine 75mg for about 4 years . Diagnosed in 2019 as underactive thyroid.

Thyroid function test

Serum TSH level 2.15 mu/L [0.35 - 4.94]

Serum free T4 level 13.2 pmol/L [9.0 - 19.0]

Thyroid Therapy Levothyroxine (T4)

It has come back as borderline

Thank you

[Jaydee1507 Administrator]

Your TSH has risen and FT4 dropped since you last posted results. Here is my last reply to you which still stands now.

healthunlocked.com/thyroidu...

How do you mean your result is borderline? Is that what was written on the lab report?

You may need to ask repeatedly for a dose increase but you do have to do that. Ask for an increase on a trial basis which can go down better sometimes. Keep going back and badgering them.

Did you manage to get your vitamin levels tested? Likely they will be low as you are under replaced.

[Norrahsjake in reply to Jaydee1507]

Hi

These are the Vitamin results from this time, as I had to keep asking for them to be tested they wouldn’t do them last year .

25-OH Vitamin D

Serum calcium level 2.40 mmol/L

Calcium adjusted level 2.43 mmol/L [2.2 - 2.6]

Serum albumin level 42 g/L [35.0 - 50.0]

Serum 25-Hydroxy vitamin D3 level 48.8 nmol/L [> 50.0]; Below low reference limit

Active B12 Active B12 concentration >70 pmol/L - Vitamin B12 deficiency unlikely

Active Vitamin B12 97 pmol/L [> 24.0]

Both classed as borderline like the TSH and t 3 results by doctors

so I need to be put on a higher dose ?

I feel so tired and my hands are numb in a morning and I get so hot at night , it’s a very uncomfortable hotness.and my mouth is burning too at night .

Thank you

[Jaydee1507 Administrator in reply to Norrahsjake]

Most people feel well with their TSH at 1 or just under so yes you need a dose increase which should help with symptoms.

I'm a bit confused by the 2 results for active B12? The first one looks right, not sure about the second one.

No result for ferritin or folate?

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...

Your B12 is on the low side. For active B12 it needs to be over 75. Suggest a B complex to help keep all the B's in balance.

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...

[SlowDragon Administrator]

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test and last dose levothyroxine 24 hours before test

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Is this how you did this test

Free T4 (fT4) 13.9 pmol/L (9 - 19) 

Ft4 only 49.0% through range

Results strongly suggest you need next increase in dose Levo

What vitamin supplements are you taking

When were vitamin levels last tested

[Norrahsjake in reply to SlowDragon]

Hi

These are the Vitamin results from this time, as I had to keep asking for them to be tested they wouldn’t do them last year .

25-OH Vitamin D

Serum calcium level 2.40 mmol/L

Calcium adjusted level 2.43 mmol/L [2.2 - 2.6]

Serum albumin level 42 g/L [35.0 - 50.0]

Serum 25-Hydroxy vitamin D3 level 48.8 nmol/L [> 50.0]; Below low reference limit

Active B12 Active B12 concentration >70 pmol/L - Vitamin B12 deficiency unlikely

Active Vitamin B12 97 pmol/L [> 24.0]

Both classed as borderline like the TSH and t 3 results by doctors

so I need to be put on a higher dose ?

I feel so tired and my hands are numb in a morning and I get so hot at night , it’s a very uncomfortable hotness.and my mouth is burning too at night .

Thank you

[SlowDragon Administrator in reply to Norrahsjake]

Vitamin D low

What vitamin supplements are you taking

No folate or ferritin results