Medichecks blood test, low T4: I would appreciate... - Thyroid UK

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Medichecks blood test, low T4

NotAFlyingMonkey profile image

I would appreciate it if someone could take a look at my blood results please - I haven't had T3 tested before. Test was done first thing, fasting, etc.

The vits were ok, with B12 at the low end of the tolerance levels.

I've been taking 50mg of Levo for the past month.

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NotAFlyingMonkey profile image
NotAFlyingMonkey
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17 Replies
SlowDragon profile image
SlowDragonAdministrator

Several previous posts members have asked what your vitamin levels are

Extremely important to test vitamin D, folate, ferritin and B12 too

Not just thyroid levels

Was this test done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine dose 24 hours before test

Results suggest you are under medicated and ready for next 25mcg dose increase in levothyroxine

Retest thyroid and vitamin levels in further 2 months

SeasideSusie profile image
SeasideSusieRemembering

NotAFlyingMonkey

As it is one month since you increased from 25mcg to 50mcg, you have retested too early, you really should have left it 6-8 weeks to allow for levels to stabilise.

As was mentioned previously, your below range FT4 then suggested Central Hypothyroidism and your FT4 is still below range. There is a long way to go. You could increase to 75mcg Levo but then wait 8 weeks to retest, remembering to take last dose of Levo 24 hours before the test and no biotin or any supplement containing biotin (eg B Complex) for 3-7 days before the test.

NotAFlyingMonkey profile image
NotAFlyingMonkey in reply toSeasideSusie

I know I've tested too soon, but I went to see an Endo recently who wanted my GP to do a full blood test so that he could see what was what. There is zero chance of my getting bloods done through my GP, so I went to Medichecks instead, and have sent the results to the Endo.

bloods 3
SlowDragon profile image
SlowDragonAdministrator in reply toNotAFlyingMonkey

Active B12 below 70 suggests B12 is inadequate (very common due to low stomach acid when hypothyroid)

viapath.co.uk/our-tests/act...

Reference range:

>70*; * between 25-70 referred for MMA

Ideally…….You really need testing for Pernicious Anaemia before starting on any replacement vitamin B complex and separate B12

What was ferritin?

NotAFlyingMonkey profile image
NotAFlyingMonkey in reply toSlowDragon

Ferritin 38.10 ug/L (Range: 13 - 150)

SlowDragon profile image
SlowDragonAdministrator in reply toNotAFlyingMonkey

So that’s terrible…..borderline anaemic

You need full iron panel test for anaemia

medichecks.com/products/iro...

cks.nice.org.uk/topics/anae...

In all people, a serum ferritin level of less than 30 micrograms/L confirms the diagnosis of iron deficiency

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

dailyiron.net

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.

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...

Never supplement iron without doing full iron panel test for anaemia first

Iron and thyroid link

healthunlocked.com/thyroidu...

Posts discussing why important to do full iron panel test

healthunlocked.com/thyroidu...

healthunlocked.com/thyroidu...

Iron/ferritin and restless legs

healthunlocked.com/thyroidu...

Helpful post about iron supplements and testing

healthunlocked.com/thyroidu...

NotAFlyingMonkey profile image
NotAFlyingMonkey in reply toSlowDragon

Thank you, so much. Why is it I get so much more help and advice here than through my own GP?

SlowDragon profile image
SlowDragonAdministrator in reply toNotAFlyingMonkey

NHS will only test and treat vitamin deficiencies ….

Even then they can ignore low levels

We see hundreds of thyroid patients with very poor ferritin levels

When hypothyroid we frequently have low stomach acid, this leads to poor nutrient absorption and low vitamin levels as direct result

Rare to find a GP who understands the connection

Thousands of posts on here about low stomach acid

healthunlocked.com/search/p...

Web links re low stomach acid and reflux and hypothyroidism

nutritionjersey.com/high-or...

articles.mercola.com/sites/...

thyroidpharmacist.com/artic...

stopthethyroidmadness.com/s...

How to test stomach acid levels

healthygut.com/articles/3-t...

naturalendocrinesolutions.c...

meraki-nutrition.co.uk/indi...

huffingtonpost.co.uk/laura-...

lispine.com/blog/10-telling...

Protect your teeth if using ACV with mother

healthunlocked.com/thyroidu...

Have you had ultrasound scan of thyroid?

Cost £150 privately

20% of Hashimoto's patients never have raised antibodies

healthunlocked.com/thyroidu...

Paul Robson on atrophied thyroid - especially if no TPO antibodies

paulrobinsonthyroid.com/cou...

SeasideSusie profile image
SeasideSusieRemembering in reply toNotAFlyingMonkey

What's happening about your very low B12. It was mentioned before to check for signs of B12 deficiency, with an Active B12 below 70 this suggests testing for B12 deficiency and pernicious anaemia.

Vit D isn't bad although the Vit D Society and Grassroots Health both recommend a level of 100-150nmol/L with a recent blog post on Grassroots Health recommending at least 125nmol/L.

NotAFlyingMonkey profile image
NotAFlyingMonkey in reply toSeasideSusie

I'm taking a B12 supplement, my GP says she will not do anything more as according to her my levels are fine

SeasideSusie profile image
SeasideSusieRemembering in reply toNotAFlyingMonkey

Did you check for signs and symptoms, I gave you links in this post:

healthunlocked.com/thyroidu...

As I said there, emphasise any symptoms, these must be taken into account when interpreting results, it's not just down to numbers alone, according to NICE

cks.nice.org.uk/topics/anae...

Vitamin B12 level — interpret the results of the serum cobalamin test taking into account clinical symptoms, other laboratory findings and the following limitations:

The clinically normal level for cobalamin is unclear, although it is thought that serum cobalamin of less than 200 nanograms/L (148 picomol/L) is sensitive enough to diagnose 97% of people with vitamin B12 deficiency.

Cobalamin levels are not easily correlated with clinical symptoms, although people with cobalamin levels of less than 100 nanograms/L (75 picomol/L) usually have clinical or metabolic evidence of vitamin B12 deficiency.

NotAFlyingMonkey profile image
NotAFlyingMonkey in reply toSeasideSusie

I thought that the symptoms of B12 deficiency ticked a lot of boxes for me, but the GP completely dismissed me. I had to fight to get her to refer me to an NHS endo.

SeasideSusie profile image
SeasideSusieRemembering in reply toNotAFlyingMonkey

I thought that the symptoms of B12 deficiency ticked a lot of boxes for me, but the GP completely dismissed me.

Did you list the symptoms and give the GP the list? If you believe you have symptoms of B12 deficiency then fight for yourself, don't let the GP dismiss you. See another one, and another if necessary. Make a fuss so that you get tested. It's the squeaky wheel that gets the oil.

If you have Pernicious Anaemia (one cause of B12 deficiency) this affects absorption of nutrients. You already have very low ferritin as well, not far off iron deficiency so really you need testing for that as well.

What about Vit D and Folate - what are those levels?

NotAFlyingMonkey profile image
NotAFlyingMonkey in reply toSeasideSusie

My GP surgery has no appointments showing online for the next 16 weeks. I am made to feel like a pest. What I will do is send the blood test results to the endo and write down everything that people have told me here so I go to the appointment armed with information.

vits
SeasideSusie profile image
SeasideSusieRemembering in reply toNotAFlyingMonkey

Your folate's pretty good, Vit D isn't bad although I'd definitely want mine within the recommended range so I'd be supplementing to improve that level if it was me.

Don't pin your hopes on your endo being any better informed about B12 and ferritin than your GP, doctors don't get taught nutrition so if a result is anywhere within range, even 1 point above the lowest limit, then they see that as a good result.

Emphasise your B12 symptoms and quote the NICE guidelines.

Also check symptoms of low ferritin and iron deficiency here:

Symptoms of low ferritin include:

◾Weakness

◾Fatigue

◾Difficulty concentrating

◾Poor work productivity

◾Cold hands and feet

◾Poor short-term memory

◾Difficulty remembering names

◾Dizziness

◾Pounding in the ears

◾Shortness of breath

◾Brittle nails

◾Headaches

◾Restless legs

Symptoms of iron deficiency include:

◾Persistent fatigue

◾Pale skin

◾Shortness of breath

◾Headaches

◾Dizziness

◾Heart palpitations

◾Dry skin

◾Brittle hair and hair loss

◾Swelling or soreness of the tongue or mouth

◾Restless legs

◾Brittle or ridged nails

SlowDragon profile image
SlowDragonAdministrator in reply toNotAFlyingMonkey

If you can’t get GP or endocrinologist to test for Pernicious Anaemia………Suggest you start taking vitamin B complex and separate B12

NotAFlyingMonkey profile image
NotAFlyingMonkey

Thanks. I have started taking B12 sublingually, and have ordered the B complex tabs recommended here. I'm a vegetarian, so I think I need to do some serious work on my iron intake.

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