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Friends blood results

Hi , my friend has been diagnosed with  thyroid problems , her first blood tests showed she had anti bodies too.

She started on 25mg meds for first 3 weeks then on 50mg for the last moth . she has now taken a new blood test and this is her results :

FT3  3.22 Pmol/L      range 3.10 - 6.80
FT4 1.12  Pmol/L                0.9    - 1.7

VIT B12 679.4 pg/mL    range 250 - 900

VIT D 22.8 ng/mL          expected >30
                                       moderate deficiency between 10 -30
                                       deficiency <10

I can see that her FT3 is low and vit D . Her doctor told her , her results are fine :(

I would personally think she needs to increase her meds now , she has all the normal thyroid symptoms too.

Any advice would be appreciated .

2 Responses
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Avatar universal
No doubt she needs an increase.  Better yet would be to also add a source of T3.
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Avatar universal
Everyone can have different thyroid hormone levels at which they feel their best, but your friend's results are much too low for most people.  The doctor should be titrating her thyroid med dosage based on symptoms not based on blood test results.  The objective of treatment is relief of symptoms, not just getting her test results within their ranges.    Due to erroneous assumptions used to establish ranges they are far too broad and skewed to the low end, so moat people do better when their Free T4 is at mid-range, and Free T3 in the upper part of its range, and adjusted from there as needed to relieve symptoms..    She can get some good info from this following link to a study in which they quantified for the first time the effect of Free t3 on the incidence of thyroid symptoms.

https://www.ncbi.nlm.nih.gov/pubmed/29396968

In the link note the following:   "Hypothyroid symptom relief was associated with both a T4 dose giving TSH-suppression below the lower reference limit and FT3 elevated further into the upper half of its reference range. "

In addition to getting her fT4 and FT3 to levels adequate to relieve symptoms, she needs to supplement her Vitamin D to achieve a level of at least 50 ng/mL.  She also should test for B12 and ferritin and supplement as needed to optimize.  B12 should be in the upper end of its range, and ferritin should be at least 100.

The main thing she needs is a good thyroid doctor that will treat clinically (for symptoms).
Helpful - 0
3 Comments
Thank you for your answer , hard to find a good doctor when they only test for FT4 and TSH only , her  results are above for B12 , is in the higher range but Im thinking she still needs to supplement .
I will advise her to test for ferritin too.  
Im guessing she will need an increase in thyroxine too.
Her B12 result is for cobalamin B12, which is not necessarily bioactive.
A methylmalonic acid (MMA) test will be preferable for  B12 levels, however, together with
homocysteine testing will return the most accurate results for B12 status.
If necessary to supplement, methylocobalamin B12 would be a better choice, as it does not
need further conversion.
And as far as D levels go,  she'll need to aim for over 60 ng/ml, for optimum health and prevention. It will take time to reach this and will need larger doses, specially if she has vitamin D resistance, due to obesity, high/low cortisol levels or vitamin D receptor polymorphism.
Supplementing with adequate Magnesium and moderate K2 will work synergistically with D3 to ensure efficiency and safety.
She should check with a knowledgeable & reputable natural health practitioner, not a conventional doctor, who usually has very little training in this field.
Best wishes,
Niko
Thank you for your kind reply
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