Good morning These are my blood test results....if you can help me interpret them in time to see the doc, I'd be very grateful. The test was taken at 7am, no food/drink beforehand).
TSH. 2.18 (was 2.30 in Aug)
Vit D. 38nmol (was 54 in Aug)
B12. 316ngl (was 502 in June)
Ferritin. 65ug/L (84 in June)
As you'll see my Vit D is very low (range is 50-174) with note to see doctor, so am expecting a call.
I am also on Letrozole for breast cancer and I know that this is detrimental to my bone health/risk of osteoporosis. I currently take 1000IU VitD tablet daily as am limited with what else I can take due the the breast cancer.
Any suggestions would be helpful.
Thank you
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BlueLido
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You need TSH, Ft4, Ft3 and both thyroid antibodies tested
Test privately via Medichecks or BH …..details in previous reply above
Vitamin levels are low and dropping at each test because you are on inadequate dose levothyroxine
Levo doesn’t top up failing thyroid, it replaces it
Request 25mcg increase in Levo to 75mcg
Suggest you initially only increase by 12.5mcg daily for first 6-8 weeks….then retest FULL thyroid levels
Which brand of levothyroxine are you currently taking
how much do you weigh in kilo
Even if we frequently start on only 50mcg, most people need to increase levothyroxine dose slowly upwards in 25mcg steps (retesting 6-8 weeks after each increase) until eventually on, or somewhere near full replacement dose (typically 1.6mcg levothyroxine per kilo of your weight per day)
Adults usually start with a dose between 50 micrograms and 100 micrograms taken once a day. This may be increased gradually over a few weeks to between 100 micrograms and 200 micrograms taken once a day.
Some people need a bit less than guidelines, some a bit more
TSH should be under 2 as an absolute maximum when on levothyroxine
If symptoms of hypothyroidism persist despite normalisation of TSH, the dose of levothyroxine can be titrated further to place the TSH in the lower part of the reference range or even slightly below (i.e., TSH: 0.1–2.0 mU/L), but avoiding TSH < 0.1 mU/L. Use of alternate day dosing of different levothyroxine strengths may be needed to achieve this (e.g., 100 mcg for 4 days; 125 mcg for 3 days weekly).
With serum B12 result below 500, (Or 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
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 and may need separate methyl folate couple 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
Is TSH the only thing your GP is testing for your thyroid? This is insufficient as you need to know your T4 and T3 levels to make a better judgement.
Are you still on 50mcg? This is by far too low a dose, I know why they have done this as your TSH was low, but as they have not tested your T4 and T3, which are the actual thyroid hormones (the TSH is just a signal from your brain in reaction to hormones), they cannot make an informed judgement. Many patients have a low TSH when on replacement therapy, but this is often needed so their T4 and T3 levels can be at least 60-80% through the range.
Your TSH is now 2.18, which is too high for someone on replacement therapy, most people feel well when the TSH is 1 or even below. Could you do a private thyroid test that includes T4 and T3? That would give you a better indication of your levels and I suspect that they are quite low. This is why you are symptomatic and you need an increase in dose. A normal replacement dose is 1.6 mcg of levothyroxine per kg of body weight, so someone weighing 63 kg would need 100 mcg levothyroxine. This is documented in the NICE guidelines
Your Vitamin D is also very low, which you need to top up. It will take a long time to top up your levels if you are taking low doses. Could you take a higher dosed Vitamin D preparation? If you can, I would supplement with 3000IU plus Vit K2 plus Magnesium, which will help with absorption, perhaps speak to your doctor about it. A higher level of Vit D can also help you process your levothyroxine better.
Thank you for your reply, I will discuss with my doctor. I am also going to get some private blood test to see what my T3/4 levels are. I think it's not helped by having one half of my thyroid being removed and half remaining, as not sure how effective it is. Hopefully the private blood test will give me a clue. Thanks again.
I think it's not helped by having one half of my thyroid being removed and half remaining, as not sure how effective it is.
Once we start on levothyroxine almost everyone eventually ends up on full replacement dose (approximately 1.6mcg per kilo of your weight per day) …..this is because once you start on levothyroxine, TSH reduces, and your own thyroid makes less and less hormones
Low vitamin levels as result of being on too low a dose levothyroxine
Low vitamin levels tend to result in lower TSH because we must have GOOD vitamin levels to convert Ft4 (levothyroxine) to Ft3 (active hormone)
Poor conversion results in lower Ft3 and lower stomach acid…….spiral downwards
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