It's taken me weeks to get these results ,they don't give ranges & didn't test T3 which I'm livid about ! I'd be grateful for any input FT 4 15.4
TSH 5.62
Iron 12.7umol/l
Serum ferritin 23 ug/l
Folate 3.3 ug/l
B12 366 ng/l
Potassium 3.8 mmol/l
Sodium 141 mmol/l
Was told everything is normal , also my gp doesn't test vitamin D , hospital dr checked levels August 24 ,it was 32 at that point .
Hi , you TSH is not normal , too high. I hope you having treatment for it . Best wishesJanet
No treatment & still very symptomatic, thank you Janet
I had similar TSH few years ago . I am on small dose of levotroxyn now , it helps . Talk to you GP , hopefully she will consider to prescribe you some .
TSH too high, indicates low free ts, which 15 is likely in the range of 9-22 through 22 or thereabouts. So lower range probably by any measure.
Yes you need ft3, but you can save your money til next time as it must assuredly is too low with the tsh and ft4 you have.
Iron is likely bottom of range.. my guess is the range starts around 10. Supported by your dismal ferritin… reflecting what is likely low iron, but need full iron panel to understand why.
D at 32 too low, likely in a range where we target 100.
Folate and b12 need to be 20 and well over 500 respectively.
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You could work on optimizing your vitamins with over the counter supplements while you fight through the system to ultimately get your thyroid looked at.
It is true that with those vitamins your thyroid doesn’t have a chance. Optimizing those vitamins will help your thyroid numbers ( time will tell how much, but will need to in any case.)
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Doctors always say “in range “ equates to “nothing to see here” “shouldn’t have any symptoms “ at those levels.
It’s absolutely categorically wrong.
Yet here we are.
Thank you , I'm so so cross but kind of knew to believe nothing I'm told anymore . I'm very symptomatic still yet repeatedly told I can't be ... but I am. My neck is so sore and has been for a very long time, now radiating to my jaw & around my ear . I asked for an ultrasound before any bloods were off ,told we don't do that unless bloods are off ,they've been off since last September & being told no still. I will speak to my gp about vitamins on Wednesday but feel it's a bit futile & see no point in seeing the endo consultant either because I know what will happen, nothing! Thanks again for your knowledge
I will speak to my gp about vitamins on Wednesday but feel it's a bit futile
GP should
A) request full iron test for anaemia because ferritin is below 30
B) Thyroid
Request/politely insist on ultrasound scan of thyroid and testing of BOTH TPO and TG thyroid antibodies for autoimmune thyroid disease
Other vitamins
Not worth discussing with GP
But note
GP should have prescribed 1600iu vitamin D daily last August for 6 months
You need vitamin D retesting.
NHS only funds testing once every 2 years……test yourself and self supplement
No range on Folate result
assuming folate is deficient GP should prescribe folic acid ……but you’re better off taking a good quality vitamin B complex …..starting a week after separate B12 first
You need TSH, Ft4 and Ft3 tested
Obviously need range on Ft4
2 separate tests with TSH over 5
But with this being 2nd test with TSH over 5 and previous test TSH was 13 you should be started on levothyroxine
Standard starter dose is 50mcg……but with your complex history probably will be started on 25mcg
Starting levothyroxine - flow chart
gps.northcentrallondonccg.n...
Your vitamin levels are terrible BECAUSE you are hypo
Serum ferritin 23 ug/l
Ferritin below 30 is deficient
Improve to at least 70ug/l
Get FULL iron panel test for anaemia now
cks.nice.org.uk/topics/anae...
Serum ferritin level is the biochemical test, which most reliably correlates with relative total body iron stores. In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency
Never supplement iron without doing full iron panel test for anaemia first and retest 3-4 times a year if self supplementing.
It’s possible to have low ferritin but high iron
Test early morning, only water to drink between waking and test. Avoid high iron rich dinner night before test
If taking any iron supplements stop 5-7 days before testing
Medichecks iron panel test
medichecks.com/products/iro...
monitormyhealth.org.uk/anae...
Look at increasing iron rich foods in diet
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
List of iron rich foods
Links about iron and ferritin
irondisorders.org/too-littl...
davidg170.sg-host.com/wp-co...
Great in-depth article on low ferritin
oatext.com/iron-deficiency-...
drhedberg.com/ferritin-hypo...
This is interesting because I have noticed that many patients with Hashimoto’s disease and hypothyroidism, start to feel worse when their ferritin drops below 80 and usually there is hair loss when it drops below 50.
healthunlocked.com/thyroidu...
Posts discussing Three Arrows as very effective supplement
Great replies from @FallingInReverse
re ferritin and Three arrows
healthunlocked.com/thyroidu......
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great reply by @fallinginreverse
healthunlocked.com/thyroidu...
Ferrodyn supplement
healthunlocked.com/thyroidu...
Thyroid disease is as much about optimising vitamins as thyroid hormones
healthunlocked.com/thyroidu...
restartmed.com/hypothyroidi...
Post discussing just how long it can take to raise low ferritin
healthunlocked.com/thyroidu...
Iron and thyroid link
healthunlocked.com/thyroidu...
Posts discussing why important to do full iron panel test
healthunlocked.com/thyroidu...
Good iron but low ferritin
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Chicken livers if iron is good, but ferritin low
healthunlocked.com/thyroidu...
Shellfish and Mussels are excellent source of iron
healthline.com/nutrition/he...
Iron deficiency without anaemia
healthunlocked.com/thyroidu...
Ferritin over 100 to alleviate symptoms
healthunlocked.com/thyroidu...
healthunlocked.com/thyroidu...
Great research article discussing similar…..ferritin over 100 often necessary
ncbi.nlm.nih.gov/pmc/articl...
Low Iron implicated in hypothyroidism
healthunlocked.com/thyroidu...
Updated reference ranges for top of ferritin range depending upon age
healthunlocked.com/thyroidu...
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 264
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.
Folate 3.3 ug/l
What’s the range
Almost certainly deficient aim for top of range
B12 366 ng/l
Far too low aiming for 500 minimum
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
Highly effective B12 drops
natureprovides.com/products...
Or
B12 sublingual lozenges
uk.iherb.com/pr/jarrow-form...
cytoplan.co.uk/shop-by-prod...
In-depth article on different forms of B12
perniciousanemia.org/b12/fo...
B12 range in U.K. is too wide
Interesting that in this research B12 below 400 is considered inadequate
healthunlocked.com/thyroidu...
perniciousanemia.org/b12/le...
And why aiming to keep B12 over 500 recommended
perniciousanemia.org/b12/le...
Great reply by @humanbean on B12 here
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 and may need 2 per day and/or may need separate methyl folate couple times a week
Post discussing different B complex
healthunlocked.com/thyroidu...
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 5-6 days before ALL BLOOD TESTS , as biotin can falsely affect test results
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 if last test result serum B12 was below 500 or active B12 (private test) under 70
Vitamin D needs retesting
How much have you been taking since August last year
It’s trial and error what dose we need, with thyroid issues we frequently need higher dose than average
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 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
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...
Vitamin D may prevent Autoimmune disease
newscientist.com/article/23...
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...
Interesting article by Dr Malcolm Kendrick on magnesium
drmalcolmkendrick.org/categ...
Vitamin K2 mk7
betterbones.com/bone-nutrit...
healthline.com/nutrition/vi...
Thank you slowDragon, I'm so cross! Endo secretary wouldn't give me latest results over the phone ( test was 3rd feb) the other tests I mentioned were done early November last year, I'd asked to have them repeated when I was there 3rd Feb including others due to my symptoms & they said no . I will gather & write down what I need to say for my appointment on Wednesday and just pray I don't break down or get myself in a muddle I'm that annoyed. The prescribed vitamin D was 800 ui for 4 months
The prescribed vitamin D was 800 ui for 4 months
Which was half the recommended NHS guideline dose and 2 months short
NHS Guidelines on dose vitamin D required
panmerseyapc.nhs.uk/media/2...
Get vitamin D tested yourself now and self supplement
retest in 3-4 months
25 years ago my vitamin D was 12nmol …..GP didn’t tell me or prescribe anything 🤷♀️
They STILL think vitamin levels are irrelevant
Low thyroid levels results in low stomach acid and poor nutrient absorption
Low vitamin levels tend to lower TSH
Getting vitamin levels tested at least annually and improve all four vitamins to optimal levels will frequently increase TSH so that you can get started on levothyroxine and dose increases slowly upwards over 6-18months until on full replacement dose
Helly, you might find it helpful to write a letter to your GP to discuss with them at your appointment and also you can ask it to be kept on your notes. They might worry that you are going to get legal on them if you ask for this, that wont do any harm.
I've actually considered doing this , I've been unwell for nearly 7 years now & have been brushed off a lot to the point I'm quite traumatised even trying to advocate for myself. Sounds a bit daft for an almost 50 year old but being told it's anxiety & symptoms aren't real has worn me down to a jibbering wreck
Thanks a lot , will do it also . Also selenium tablets was prescribed by my endocrinologyst
[redacted name of Endo]- functionalthyroid great doctor helped me regarding the thyroid - get in touch with him has lots of experience with TSH -
Thanks a lot ,sounds great
Hello Helly, was that done by the NHS or did you pay for that?
These are nhs tests
typical. Have you done the necessary to be able to see all your medical records? You are entitled to that and on there you should be able to see everything any gp, nurse or anyone in any clinic or hospital has ever entered into your notes......
I'm not amused , the tft test goes directly to endocrine so the deal was that I contact them for results, this time the secretary didn't seem to want to be bothered with me and told me to just wait for the letter so the bloods were taken on the 3rd & I only got the results yesterday. I'm finding out the hard way they do not care
Gosh, that makes me cross! And as for the secretary - that makes me even more gross! I say this as I was a medical secretary to a v busy Consultant but helpfulness+civility are part+parcel of yr role! Presently, I have a private Endo+his PA is so helpful - I needed some results for GP surgery who were being a pain in the butt; I emailed her Friday afternoon+she sent a copy of her email to GP on Sunday afternoon! Such a v helpful lady! Should not matter if NHS or private - supporting patients in part of that role!
I am so sorry you have to go through this. Sadly it seems to be the situation most of us on here find ourselves. The NHS is broke, and broken ( and I fear broken beyond repair)
In the last 3 years I have taken my health into my own hands, which means my doctors do not want to know me at all and just send me packing, regardless. I have done so much learning and book reading, I am convinced that in the subjects of under active thyroid/hashimoto's and B12 deficiendy (autoimmune disorders) I may know more than the GPs that are (not) treating me. Of course I do not know enough, so there is always a danger of safety, but I personally rather live a few more years with a certan amount of quality of life than a great many years sitting in a corner shivvering with cold , unable to move as no energy and unable to sleep at night in spite of being so tired. Do beware, the GPs answer to everything these days is anti depressants, even in the face of bloodtests being outside of the already way too large normal range and in no way near optimal ranges, they think we must be depressed. I wish I could find out what meds they get paid for dispensing ( backhanders) and which they have to pay for. As I think that is where all our answers lie.
I have an appointment tomorrow with my gp & have myself worried sick because I already know what's going to happen, I'm still feeling very unwell & quite distressed so I will probably cry out of frustration, I feel it's pointless now but still feel so annoyed about being left like this with nowhere to turn
you still have this siote to turn to. We are all here so you can ask questions, vent, cry, we have all been there so this is a place where there is no judgement, only understanding.
rehearse in your mind what you want to say to the GP, write it down and practice in front of the mirror if that will help, the more you do this the more you have a script to keep you on track. It's what I do , and it might work for you too.
If you can access the test results on the NHS website and post it here I am sure you will get plenty of people telling you what you need to tell the GP in order for him/her to sit up and take notice. I keep my fingers crossed for you and wish you luck!!! All the best
Thank you , if it wasn't for this site I'd still be clueless on all things thyroid, I'd no idea it could cause such systemic havoc! I will write some things down today and try not to worry too much about it
Good luck with your GP. tomorrow. You never know your appointment might be to start you on Levothyroxine.
Thank you , I'm not very hopeful given my history but we will see
If you can, go private! Worth every penny as I got my life back+try in every way I can to keep far from the GP surgery!! Id go without holidays, new clothes, whatever so I could afford to pay for my appointments+T3!
I've spent a small fortune in the private sector already & looks like I'm going to have to do it again, I worked out from other people's posts on this site & before even seeing an endocrinologist that they aren't interested & won't help me . Finding one to see privately where I live could be an issue though, I'm in Northern Ireland
Some Endo's provide appointments by phone or zoom+as long as you have up to date bloods for T4/T3+TSH so that could be an option even if you're in N Ireland. I get my T3 via Roseway Labs from private Endo - £60 for box of 200x20mcgs that I split with pull cutter. Depending on the dose can last quite a while. Check Thyroid UKs list for a suitable candidate.
nhsapp.service.nhs.uk/login...
go here, open an account and you should be able to see it all
Blood Test Results.
Latest results not good... 
Latest results
Latest results
