Help with blood test results please: Have... - Thyroid UK

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Help with blood test results please

bex2016 profile image
7 Replies

Have recently had an Ultimate blood test through Medichecks and need some help deciphering what I need.

I’ve managed to work out that I need to supplement Vit D and B12 but am struggling with the iron panel & thyroid results.

It was done through Eurofins County Pathology

Iron - 21.5 umol/L - (5.8 - 34.5)

TIBC - 58.9umol/L - (45 - 81)

UIBC - 37.4umol/L - (24.2 - 70.1)

Transferrin Saturation - 36.5% - (20-50)

Ferritin - 32.2ug/L - (13 - 150)

Do I need to supplement my iron?

TSH - 0.16 mU/L - (0.27 - 4.2)

Free T3 - 4.51pmol/L (3.1 - 6.8)

Free Thyroxine - 20.1pmol/L (12-22)

Thyroglobulin antibodies - 155 IU/ml (<115)

Thyroid peroxidase antibodies - 154 IU/ml (<34)

Whenever I have tested my antibodies, they have been raised but this is the highest I’ve seen them.

I’ve been hypothyroid for 20 years and take levothyroxine. Its usually fairly stable but it has dropped since March and I’m not sure why.

I have been on HRT for a year and recently had a hysterectomy.

Can these affect thyroid?

Or do we need less thyroxine as we get older?

Can I reduce my antibodies somehow?

I’m just stabbing in the dark, that’s why I’ve come here.

Many thanks

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SeasideSusie profile image
SeasideSusieRemembering

bex2016

Iron - 21.5 umol/L - (5.8 - 34.5)

TIBC - 58.9umol/L - (45 - 81)

UIBC - 37.4umol/L - (24.2 - 70.1)

Transferrin Saturation - 36.5% - (20-50)

Ferritin - 32.2ug/L - (13 - 150)

Whenever we discuss iron panel results we tend to refer to optimal levels as suggested by

rt3-adrenals.org/Iron_test_...

which are:

Serum iron: 55 to 70% of the range, higher end for men - yours is 54.7% which is pretty good.

Saturation: optimal is 35 to 45%, higher end for men - yours is 36.5% which is good.

Total Iron Binding Capacity (TIBC): Low in range indicates lack of capacity for additional iron, High in range indicates body's need for supplemental iron - yours is 38.61% through range so at the lower end

So these results do not suggest any problem with your actual iron and do not suggest iron supplementation is necessary.

Your ferritin is low but you don't have iron deficiency.

You can help raise ferritin your level by eating liver regularly, maximum 200g per week due to it's high Vit A content, also liver pate, black pudding, and including lots of iron rich foods in your diet

bda.uk.com/resource/iron-ri...

everydayhealth.com/pictures...

TSH - 0.16 mU/L - (0.27 - 4.2)

Free T3 - 4.51pmol/L (3.1 - 6.8)

Free Thyroxine - 20.1pmol/L (12-22)

When did you take your last dose of Levo before the test? We advise last dose should be 24 hours before the test to avoid a false high or false low FT4 result.

Do you take biotin, B Complex or any supplement containing biotin, and if so did you leave this off for 3-7 days before testing?

If your test was done as above then your results are as accurate as can be and your FT4 is 81% through range with FT3 at 38.11% through range. This shows poor conversion of T4 to T3 and low T3 causes symptoms.

We need optimal nutrient levels for good conversion to take place and obviously your ferritin level needs work.

What were your B12, folate and Vit D results? What do you intend supplementing with and the dose?

If you can get all of your nutrients at optimal levels:

Vit D -100-150nmol/L

B12 - over 100 for Active B12, if Total B12 is measured then top of range

Folate - at least half way through range

Ferritin - half way through range although some experts say the optimal level is 90-110ug/L

and you still have low FT3 compared to high FT4 then you may benefit from the addition of some T3.

Whenever I have tested my antibodies, they have been raised but this is the highest I’ve seen them.

Can I reduce my antibodies somehow?

Antibodies fluctuate. It's said that supplementing with selenium (no more than 200mcg daily) can help reduce antibodies. However, antibodies aren't the problem, they have a job to do which is to mop up after an immune attack.

Hashi's is where the immune system attacks the thyroid and gradually destroys it. When the attack happens, the dying cells release a lot of thyroid hormone into the blood and this can cause TSH to become suppressed and Free T4 and Free T3 to be very high or over range. These are called 'Hashi's swings'. You may get symptoms of being overmedicated (hyper type symptoms) to go along with these results that look as though you are overmedicated. The hyper swings are temporary, and eventually things go back to normal. Test results settle back down and hypo symptoms may return. Thyroid meds can be adjusted slightly at these times if necessary, but will need readjusting when hypo symptoms return.

Hashi's isn't treated, it's the resulting hypothyroidism that's treated.

If you decide to supplement with selenium then look for selenium l-selenomethionine or a yeast bound selenium, avoid selenite or selenate versions.

I’ve been hypothyroid for 20 years and take levothyroxine. Its usually fairly stable but it has dropped since March and I’m not sure why.

I have been on HRT for a year and recently had a hysterectomy.

Can these affect thyroid?

Oral HRT can affect Levo's absorption so should be taken at opposite ends of the day. The difference could just be due to Hashi's activity.

Or do we need less thyroxine as we get older?

I've been diagnosed/treated since 1975 (in my mid-20s) and I haven't needed less as I've got older. We need what we need, it's very individual, no set rules.

bex2016 profile image
bex2016 in reply to SeasideSusie

Hi SeasideSusie,

Thankyou so much for all of the information and clearing up my iron panel!

Thyroid test - I did leave the Levo for 24 hours before and the only supplement I use is a magnesium spray at night.

Is my TSH too low? Should I reduce my dose? I do alter my dose occasionally depending on how I feel (maybe Hashi’s flare?) and at the moment take alternate 125 and 150 per day. I was thinking of reducing to 125per day and retesting in 3 months.

Folate serum - 7.74 ugL (>3.89)

B12 active - 85.9 pmol/L. (37.5 - 150)

Vit D - 59 nmolL (50 - 200)

After much reading on here, the supplements I thought to use are the b12 sublingual methylcobalamin and B complex (not sure of dose) and the D3 at 3700iu to begin with to increase level.

I was going to supplement for 3 months and retest because I have a medichecks that expires in December

SeasideSusie profile image
SeasideSusieRemembering in reply to bex2016

bex2016

Is my TSH too low?

TSH is useful for diagnosis but has little use when on thyroid hormone replacement. This is because it's a pituitary hormone, not a thyroid hormone, and can't tell us our thyroid status. Once on thyroid replacement hormone it's the FT4 and FT3 that are important, these are the thyroid hormones, these tell us our thyroid status.

Your FT4 and FT3 are well within range. It's over range FT3 that tells us if we are overmedicated. So look at your FT4 and FT3 and take into account how you feel, don't worry about TSH when it's low.

Should I reduce my dose?

Your results don't suggest that you need to. Do you have symptoms of overmedication - these would be similar to hypERthyroidism, ie jittery, tremor when hands are outstretched, etc. If you feel OK with these results then don't lower your dose. In fact with your FT3 level you could be feeling symptoms of hypOthyroidism.

I was thinking of reducing to 125per day and retesting in 3 months.

What's your reasoning for this? Are you experiencing symptoms of over medication?

Folate serum - 7.74 ugL (>3.89)

B12 active - 85.9 pmol/L. (37.5 - 150)

Vit D - 59 nmolL (50 - 200)

After much reading on here, the supplements I thought to use are the b12 sublingual methylcobalamin and B complex (not sure of dose) and the D3 at 3700iu to begin with to increase level.

I agree. 1 x bottle of sublingual B12 methylcobalamin 1,000mcg plus good quality bioavailable B Complex (eg Thorne Basic B x 1 capsule), then once B12 is finished just continue with the B Complex. Remember to leave off B Complex for 3-7 days before any blood test.

For the Vit D the nearest dose of D3 you'll get is 4,000iu. If you buy 5,000iu that will be cheaper (if considering Doctor's Best softgels) and you could take that 6 days a week instead of 7.

Don't forget that you need D3's important cofactors - magnesium and Vit K2-MK7.

From what you have posted I think you may have already seen what I normally write so know what to do/get, but if you need me to repeat it here just say and I'll be happy to do so.

I was going to supplement for 3 months and retest because I have a medichecks that expires in December

Sounds about right 👍

bex2016 profile image
bex2016 in reply to SeasideSusie

Thankyou again for your reply, so much useful information.

I was only going by my TSH when considering my dose, doctor in the past has reduced my dose when under 1.

I’m actually having symptoms of hypo so that’s what confused me. I’ll sort out my supplements and retest in 3 months and see where I am.

Thanks again, you’ve been so helpful

SlowDragon profile image
SlowDragonAdministrator

what are vitamin D, folate and B12

Hashimoto's affects the gut and leads to low stomach acid and then low vitamin levels 

Low vitamin levels affect Thyroid hormone working 

Poor gut function can lead leaky gut (literally holes in gut wall) this can cause food intolerances. Most common by far is gluten. Dairy is second most common. 

According to Izabella Wentz the Thyroid Pharmacist approx 5% with Hashimoto's are coeliac, but over 80% find gluten free diet helps, sometimes significantly. Either due to direct gluten intolerance (no test available) or due to leaky gut and gluten causing molecular mimicry (see Amy Myers link) 

Changing to a strictly gluten free diet may help reduce symptoms, help gut heal and slowly lower TPO antibodies 

While still eating high gluten diet ask GP for coeliac blood test first or buy test online for under £20, just to rule it out first 

Assuming test is negative you can immediately go on strictly gluten free diet 

(If test is positive you will need to remain on high gluten diet until endoscopy, maximum 6 weeks wait officially) 

Trying gluten free diet for 3-6 months. If no noticeable improvement then reintroduce gluten and see if symptoms get worse

chriskresser.com/the-gluten...

amymyersmd.com/2018/04/3-re...

thyroidpharmacist.com/artic...

drknews.com/changing-your-d...

Non Coeliac Gluten sensitivity (NCGS) and autoimmune disease

pubmed.ncbi.nlm.nih.gov/296...

The predominance of Hashimoto thyroiditis represents an interesting finding, since it has been indirectly confirmed by an Italian study, showing that autoimmune thyroid disease is a risk factor for the evolution towards NCGS in a group of patients with minimal duodenal inflammation. On these bases, an autoimmune stigma in NCGS is strongly supported

nuclmed.gr/wp/wp-content/up...

In summary, whereas it is not yet clear whether a gluten free diet can prevent autoimmune diseases, it is worth mentioning that HT patients with or without CD benefit from a diet low in gluten as far as the progression and the potential disease complications are concerned

restartmed.com/hashimotos-g...

Despite the fact that 5-10% of patients have Celiac disease, in my experience and in the experience of many other physicians, at least 80% + of patients with Hashimoto's who go gluten-free notice a reduction in their symptoms almost immediately.

bex2016 profile image
bex2016 in reply to SlowDragon

Hi SlowDragon,

Thankyou so much for all of the information, makes a lot of sense!

I have been gluten and dairy sensitive for about 10 years, I avoid it as much as I can but can be lazy. Symptoms I get from gluten and dairy have lessened which I’m hoping is because leaky gut have healed a little?

Folate serum - 7.74 ugL (>3.89)

B12 active - 85.9 pmol/L. (37.5 - 150)

Vit D - 59 nmolL (50 - 200)

I’m going to supplement the vitamin D and B12 for a few months and retest.

I’m just wondering if my TSH is too low and I should reduce my levo dose too? I thought the same about being on HRT, I thought I’d have to increase dose as I did when I was on the Pill.

My hysterectomy was 10 weeks ago, not sure how long anaesthetic is in the system, there are differing opinions when I look online.

SlowDragon profile image
SlowDragonAdministrator

When was hysterectomy

Anesthetic can significantly reduce B12

b12-vitamin.com/anesthesia/

Levothyroxine dose frequently needs increasing on HRT

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