Recent Bloods

[WorriedUser]

Evening,

Recent bloods are back. Can anyone give any advice on this? Waiting for the consultant to call this week to advise if change of medication amounts needed.

Currently on 1 x 20mg Carbimazole and 3 x Proponanol 40mg

October 2024 Serum TSH Level. 0.30

Normal range: 0.27 to 4.2

20 August 2024 < 0.02 mIU/L

18 June 2024 < 0.02 mIU/L

October 2024 Free T3- 4.2

Normal range: 4.2 to 7.1

20 August 2024 7.0 pmol/L

18 June 2024 17.3 pmol/L

October 2024 Free T4 - 9.2

Normal range: 8 to 18

20 August 2024 30.4 pmol/L

thank you!

[TiggerMe Ambassador]

How are you feeling? If you are starting to feel cold, sluggish it maybe that your results are a little on the low side so it may mean a small reduction is required

I'm no expert with hyper treatment though, I'm sure someone will be along soon 🤗

Free T4 (fT4) 9.2 pmol/L (8 - 18) 12.0%

Free T3 (fT3) 4.2 pmol/L (4.2 - 7.1) 0.0%

T4:T3 Ratio 2.190 

Have I got these results right?

[WorriedUser in reply to TiggerMe]

Hello.

At the moment I am feeling ok… not cold (any more than usual anyway!) or particularly sluggish….

[TiggerMe Ambassador in reply to WorriedUser]

Thanks to pennyannie for her great response below 🤗

[pennyannie]

Hey there again :

Your TSH looks to have recovered and now in range -

and I take this to mean your immune system is no longer in control of your thyroid -

Now its just a question of allowing more of your own new daily thyroid hormone production to be released back into your blood stream -

so the AT drug needs to start being titrated down - so your T3 and T4 levels will start to build and rise back up into the ranges again -

best to try and aim for the T4 to sit at around mid range with the T3 tracking just behind at around 45% through its range - it is a fine balance -

The Propranolol will also be affecting T4 to T3 conversion so needs to be factored into this -

and only change 1 drug at a time -

I didn't need to take a beta blocker but read it's best to come off this drug very, very slowly ?

I think I remember your B12 and vitamin D being low - were any further AI health issues tested for as previously suggested ?

Blood tests are just a snapshot in time and tend to run behind symptoms being tolerated -

It can be a bit of a roller coaster ride of symptoms with little of the fun - hopefully given time, your energy will start to improve and you'll feel a gear change rather than stuck in neutral.

[WorriedUser in reply to pennyannie]

Thank you so much for always replying to my posts. This group has been invaluable for me! B12 was fine , but Vit D was slightly under. Consultant recommended upping my dose to 3000 per day, then more bloods will be run in 3 months. I have also been advised today to come off Propranolol and my Carbimazole is being reduced to 10mg per day.... let's see how that goes!

[pennyannie in reply to WorriedUser]

Okey doke - sounds like a plan -

Just for reference I now aim to maintain my ferritin at around 100 - folate around 20 - active B12 around 125 ( serum B12 500++ ) and vitamin D up at around 125 :

My maintenance dose of vitamin D is 5000iu daily !!

Is the Propranolol being slowly eased off / phased out ?

Maybe start a new post - just asking How Best to come off Propranolol -

as I have no knowledge but think slowly is suggested rather than stopping it dead ?

[WorriedUser in reply to pennyannie]

I did ask about coming off immediately or slowly, after I had seen your earlier reply, and she said it was ok to come off straight away. I will start a post though as I have just started to feel 'normal', so don't want any adverse effects.

[pennyannie in reply to pennyannie]

P.S. You need to take K2- MK7 alongside any vitamin D supplement so to divert the vitamin towards teeth and bones - rather than heart and arteries !!

[Cornwaller in reply to WorriedUser]

B12 was fine.

Was there a number? Sometimes people are told it's fine when it is actually pretty poor and potentially affecting their health.

[WorriedUser in reply to Cornwaller]

above results

B12 Results

[Cornwaller in reply to WorriedUser]

Hi,

B12 serum levels are probably the best but not a particularly reliable indicator of b12 deficiency - strange as this may sound. The reasons are several and not completely understood.

The ranges vary slightly. But generally- (eg. See - google BMJ B12 Best practice)

<200 deficiency likely

200-350 deficiency possible - further testing eg MMA and signs and symptoms to

diagnose.

>350 deficiency unlikely

>500 generally considered optimal

So your results are towards the lower third of the deficiency possible and look like the level may be decreasing. You can check your symptoms at B12d.org.

I will send another message with a link to an excellent video. It is probably worth considering quite carefully what, if anything, to do next. Supplementing orally will raise your serum levels but may make getting a b12 diagnosis more difficult if you have b12 deficiency and in addition oral supplements do not give symptom relief in all cases as the increase in serum levels is insufficient.

The PA forum on HealthUnlocked is an excellent source of information.

I am not medically trained and the above are thoughts for your consideration.

Best wishes

[Cornwaller in reply to Cornwaller]

Cytoplan & Dr David Morris: Understanding the complexities and central role of B12 in health and life

vimeo.com/891099138/4150efa06b

[ Edited by admin to add title of video. ]

[tattybogle]

bear in mind that your TSH may take quite along time to catch up with your now lower T4/T3 levels . TSH often has a bit of a delay in coming back up after it's been supressed, this is due to a thing called Hysteresis ( for information about hysteresis look at the end of the first reply this post, also continued in another reply a long was further down : healthunlocked.com/thyroidu.... )

i would be wary of coming of propanolol suddenly, could be quite unpleasant from experiences i've read on here ,though i've no experience of it myself. Asking further advice re. this in a separate post is a good idea.

[WorriedUser in reply to tattybogle]

Thankyou. New post has been posted!