I'm fairly new to this site & this is the first time I've posted.
I had recurrent non-malignant cysts on my thyroid with no other apparent symptoms in around 2006. Initially the cysts were drained using needle aspiration. (At this time, one of the sonographers who was performing the needle aspiration said that, on-screen, the fluid had a "sparkly" effect which usually indicates Hashimoto's - no-one has ever mentioned this since.) After about four visits for drainage over a period of around 18 months or so, the consultant decided to operate to remove the right half of my thyroid. I had endocrinology appointments following surgery with fluctuating blood results for around 12-18 months. First I was given levothyroxine, then taken off of it before being put back on it again and eventually finding the right level of medication. I now take 75mg and 100mg doses on alternate days.
For years I have felt quite well - I was given Mercury Pharma consistently for many years until around COVID time. Now I have a constantly changing hotchpotch of tablets and never feel totally right - sluggish and headachey mainly. GP has stipulated on my prescription that I am to be given Mercury Pharma but the pharmacist says he cannot order specific brands & can only issue what he has been given. I currently have Teva for the 50mg and 100mg and Mercury for the 25mg. From what I've read on here, I realise that I am going to have to do a bit of leg work to see if any other pharmacies can help with the prescriptions.
Following my latest annual blood test, I was contacted by the GP surgery and asked to make an appointment to discuss the results. I am currently waiting an estimated 4-6 weeks for a telephone appointment. So, in the meantime, I decided to do an in-depth blood test through Blue Horizon so that I am armed with more facts and figures. My latest GP blood test (3pm in the afternoon non-fasting) only gave results for :
Serum FreeT3 - 4.3 (in range)
Serum TSH - 0.07 (out of range)
The results from Blue Horizon (9.30 am fasting test with no medication in past 24 hours) are as follows:
Sample Type: V- Serum,
Biochemistry
CRP: 0.76 <5.0 mg/L
Ferritin: 44.8 13 - 150 ug/L
Magnesium: 0.87 0.66 - 0.99 mmol/L
Hormones
Cortisol: (Random) 285.0
6am - 10am 166 - 507 nmol/L New range
4pm - 8pm 73.8 - 291
Thyroid Function
TSH: L 0.04 0.27 - 4.20 mU/L New range & unit (This line is shown in red on report)
T4 Total: 134.0 66 - 181 nmol/L
Free T4; 18.9 12.0 - 22.0 pmol/L
Free T3: 5.38 3.1 - 6.8 pmol/L New range
Immunology
Anti-Thyroidperoxidase abs: 32 <34 IU/mL New units
Anti-Thyroglobulin Abs: 18 <115 IU/mL New units
Vitamins
Vitamin D (25 OH): 81 Optimal 75-200 nmol/L New range
Adequate 50-<75
Insufficient 25 -<50
Deficient <25
B12-Active: 51.8 37.5 - 150 pmol/L New range
Serum Folate: 43.50 8.83 - 60.8 nmol/L
Page 1 of 1 FINAL REPORT
Any help with interpreting this would be most welcome - I did think the report was going to have more in the way of analysis when it arrived - the only comment is: "The thyroid stimulating hormone (TSH) level is low. If you are already taking thyroxine, dose adjustment may be necessary - you should discuss this with your usual doctor. If you are not taking thyroxine, it would be wise to keep an eye on this level - either by reference to previous results if known or by checking TSH again in 6 months time or so. There is a possibility that hyperthyroidism (overactive thyroid gland) will develop if the TSH fails to rise (a low TSH implies excessive thyroxine production from the thyroid gland)." At first glance I thought it all looked OK ish apart from the TSH?
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Izziethecat
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If a patient reports persistent symptoms when switching between different levothyroxine tablet formulations, consider consistently prescribing a specific product known to be well tolerated by the patient.
Physicians should: 1) alert patients that preparations may be switched at the pharmacy; 2) encourage patients to ask to remain on the same preparation at every pharmacy refill; and 3) make sure patients understand the need to have their TSH retested and the potential for dosing readjusted every time their LT4 preparation is switched (18).
With serum B12 result below 500, (Or active B12 below 70) recommended to be taking a separate B12 supplement and 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 too. Nice small tablets. Most people only find they need one per day. But a few people find it’s not high enough dose
IMPORTANT......If you are taking vitamin B complex, or any supplements containing biotin, remember to stop these 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
Thank you so much for your reply. I haven't had a chance to catch up until this evening.
I should mention that I'm 65, BMI 21, active, rarely drink & never smoked. I have a largely vegetarian diet but usually have fish (salmon, mackerel or sea bass) once or twice a week. I take vitamin D (Vitabiotics Ultra) daily in winter months. I have also started taking Menopace tablets which seem to have a good range of vitamins and minerals - maybe these aren't good enough quality? I will look at the vitamin B & folate options that you've listed above.
The last full blood count test I had was in May 21 when most readings appear to be mid-range - maybe this needs to be repeated. Apart from the tiredness and occasional bloating, nothing resonates with coeliac symptoms but perhaps worth testing.
Prescription - GP has entered "Mercury Pharma Brand" in brackets so will ask for this to be amended. I don't know why pharmacist couldn't have told me that - I have had plenty of discussions with him. And why doesn't GP know........
Following my latest annual blood test, I was contacted by the GP surgery and asked to make an appointment to discuss the results. I am currently waiting an estimated 4-6 weeks for a telephone appointment.
they won’t like low TSH
However simply refuse to reduce dose
Explain that you are having ongoing difficulties getting same brand at each prescription
That you want to stay on current dose …..and ensure going forward that brand doesn’t alter
FT4: 18.9 pmol/l (Range 12 - 22)
Ft4 is 69.00% through range
FT3: 5.32 pmol/l (Range 3.1 - 6.9)
Ft3 is 58.42% through range
Improving vitamin levels should improve Ft3 result
Your active B12 is very low and it's worth testing for pernicious anaemia/B12 deficiency before you try supplements as it's your best chance of getting a diagnosis. Ferritin also low, so do a full iron panel for an overall picture. Head over to that forum and post for advice.
My last FBC test was in May 2021 so I'll ask GP to repeat when I eventually get to speak to them. B12 and Ferritin were both on the low side of normal in 2021 too.
(It's all very well have ranges for results but, unless everyone is regularly monitored and assessed throughout their life, we'll never know what "normal" looks like for any one individual. Annual or bi-annual MoTs needed.)
The FBC is good to do but you also need a full iron panel. Precisely! We are the only ones monitoring results, GPs are not and they don't look beyond the numbers anyway, having little clue as to what they mean for an individual.
1) you say you took your thyroid meds 24hrs before you private blood test. If this is correct your real T3 level might be incorrect as it is advises that you take T3 8-12 hrs before the test.
2) I may be incorrect but I’ve always understood that taking T3 over reduces TSH and even if the dose is reduced or stopped TSH will remain low for weeks, months or even years.
I followed the advice given on this forum regarding meds, food & drink before the private blood test. I think the instructions in the testing kit also advised the same - I know they were very time specific for testing for optimal readings.
My first blood test with GP was at 3pm and I had taken medication and had been eating and drinking during the day. The T3 result from that test was 4.3.
The second fasting/no medication private test gave T3 as 5.38.
I only take Levothyroxine - not a separate T3 medication.
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Test results - GP vs Blue Horizon with ranges
Advice on Blue Horizon thyroid blood results please
blue horizon blood results
Blood results from Blue Horizon
Private blood test results from Blue Horizon, please advise
